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Meniscectomy is the surgical removal of all or
part of a
torn meniscus. A meniscus tear is a common knee joint
injury. Surgeons who perform meniscectomies (orthopedic surgeons) will make surgical decisions based on the meniscus's ability
to heal as well as your age, health, and activity level.
Your doctor will likely
suggest the treatment that he or she thinks will work best for you based on
where the tear is, the pattern of the tear, and how big it is. Your age, your
health, and your activity level may also affect your treatment options. In some cases, the surgeon makes the final decision during surgery, when he or she can see the how strong the meniscus is, where the tear is, and how big the tear is.
There are different types of meniscus tears. The pattern of the tear may
determine whether a tear can be repaired. Horizontal and flap tears typically
require surgical removal of at least part of the meniscus.
The choice of type of surgery is based on
the size and location of the tear, your age and activity level, the surgeon's
experience, and your preferences. Orthopedic surgeons most often perform
meniscus surgery with
arthroscopy, a procedure used to both examine and
repair the inside of a joint. A thin tube (arthroscope) containing a camera and
light is inserted through small incisions near the joint. Surgical instruments
are inserted through other small incisions. Arthroscopic surgery may limit knee
damage from surgery and may promote fuller recovery. But some tears may
require open knee surgery.
In a total meniscectomy, the entire
meniscus is removed. In a partial meniscectomy, the surgeon removes as little
of the meniscus as possible. Unstable meniscal fragments are removed, and the
remaining meniscus edges are smoothed so that there are no frayed ends.
You may have general or regional
anesthesia for a meniscectomy. Arthroscopic partial
meniscectomy is commonly done in an outpatient surgical center.
Rehabilitation (rehab) varies depending on the
injury, the type of surgery, your orthopedic surgeon's preference, and your
age, health status, and activities. Time periods vary, but meniscus surgery is usually followed by a period of rest, walking, and
selected exercises. Most people who have arthroscopic meniscectomy can bear
weight a day or two after surgery and can return to full activity within 2 to 4
weeks. After the full range of motion without pain is
possible, you can return to your previous activity level.
timetable for returning to walking, driving, and more
vigorous activities will depend on the type and extent of the surgery and your
success in rehab.
To learn about some exercises you can do at home (with your
doctor's approval), see:
A decision to remove all or part of
your meniscus will take into consideration the location, length, tear pattern,
and stability of the tear as well as the condition of the whole meniscus. Your
surgeon will also consider the condition of the entire knee, your age, and any age- or
If a meniscus tear is causing pain or swelling, it probably means that
torn pieces of the meniscus need to be removed and the edges surgically shaved
to make the remaining meniscus smooth. Your orthopedic surgeon will try to
preserve as much meniscal tissue as possible to prevent long-term degeneration
of your knee and allow you to return to full activities.
Removing the whole meniscus generally reduces some symptoms. But losing the meniscus reduces the cushioning and stability of the joint. Most people, especially if they are young or active, are not satisfied with a total meniscectomy. This is why surgeons try to remove as little of the meniscus as possible.
Studies of partial meniscectomy have shown that 78% to 88% of people have good results from partial meniscectomy. This means that 78 to 88 people out of 100 people who have this surgery have decreased symptoms and are able to return to most or all of their activities.1
Meniscectomy is generally well tolerated and does
not usually cause complications. But there is a risk of damaging the nerves
There is a direct relationship between the amount
of meniscus tissue that is surgically removed and the load distribution across
the knee. If more tissue is removed, the knee is less able to sustain the load
of walking, running, or other activities. With uneven load distribution,
degeneration of the knee joint may happen at a faster pace than it would with
an intact meniscus.
In any surgery,
there is risk of infection or bleeding. And there are risks with general or
is generally favored over a partial or total meniscectomy. If the meniscus can
be repaired successfully, it reduces the risk of knee joint degeneration that
may occur with removal of all or part of the meniscus.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
Beynnon BD, et al. (2010). Meniscal injuries. In JC DeLee et al., eds., DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice, 3rd ed., vol. 2, pp. 1596–1623. Philadelphia: Saunders Elsevier.
September 10, 2012
William H. Blahd, Jr., MD, FACEP - Emergency Medicine & Patrick J. McMahon, MD - Orthopedic Surgery
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