Knee surgeon
Treatment

Meniscus

Description

The menisci are crescent-shaped fibrocartilaginous structures that fill the spaces between the articular surfaces of the leg bone (tibia) and the thigh bone (femur). 

There is a meniscus in the inner part (the medial meniscus) and one on the external of the knee (the lateral meniscus). 

They are important for the stability and functionality of the knee joint and also absorb shocks and reduce wear on the cartilage. 

When torn, it can partially or totally lock the knee or simply manifest as pain in turning movements or positions when the joint is highly bended. 

Younger people tend to suffer meniscus injury as the result of practicing sports. Older people often have tears due to wear.

Sometimes, the torn meniscus reflects a bigger problem in the alignment of the lower extremity, and this may require correction.

 

It is one of the most frequent injuries of the knee. It is very important to know how this injury affects your daily activities and how much pain it causes. Match your expectations with the proposed treatments.

Alternatives:

Meniscectomy

Involves a resection of the torn meniscal tissue. The aim is to keep as much of the meniscus as possible. This technique is only used when the meniscal tissue is not repairable. Recovery is usually very rapid, requiring 1 or 2 months to resume sports practice.

Meniscal repair

Whenever possible, to avoid a decrease in the amount of competent meniscal tissue. 

It requires great management of the arthroscopic technique. As the healing capacity of the meniscus is low and slow, recovery usually requires more time to resume sports practice, this being around 4 to 6 months.

Meniscal transplantation

In cases where the patient has symptoms secondary to a prior resection of the entire meniscus. In these cases, the meniscus comes from a tissue bank.

Recovery requires at least 6 months. However, in these cases, returning to high-wear, high-impact sports activities is not recommended.

Care

Before the surgery

When a surgical treatment is scheduled, the patient is instructed with some simple instructions.

After surgery

The day after surgery and before leaving for home, the patient receives all the necessary information relative to postoperative care. The patient also leaves the hospital with an appointment for within 10 days or so to have the wound checked.

Rehabilitation

Postoperative exercises after meniscus surgery depend on the type of surgery performed on them. In phases and as a rule, you should not move on to the next until the goal set at the beginning of each phase is reached. However, the precise exercises that can be done ultimately depend on the type of surgery undergone.

First general phase

Control of pain and inflammation

One notices that the knee is sore and swollen the first few days. To improve this, the recommendation is to:

Meniscectomy

Meniscal repair

Meniscal substitution or transplantation

Every small step you take is an achievement on your road to recovery.
With patience and determination, you will soon be back to an active life.

Recommendations after your knee surgery

Surgical dressing

The dressing placed over the wounds may become wet or stained with blood.

This to some extent is normal and comes from knee fluids generated during surgery and in the first few days after surgery.

If your dressing looks soaked with blood, you should go to the emergency room or contact Dr. Gelber. Wounds should not be wet directly with shower water and should be protected with a waterproof bag until the stitches are removed. In case you accidentally got wet, remove the bandages, dry the wound with a sterile gauze and then cover the wounds again with another gauze with Betadine/Chlorhexidine and fix it with tape.

Activity

Although the recommended activity depends on the type of surgery, avoid excessive movement in the first few days as this will cause inflammation and pain.

 Perform the exercises we have recommended, unless otherwise indicated, several times a day.

The most important things during the first phases is to regain full extension of the knee and begin to bend it.

Secondarily, the aim will be restoring the muscle strength.

Pain Control

You will notice that your knee is sore and swollen for the first few days. To improve this, it is recommended:

Precautions

A few lines of fever for 2 or 3 days after surgery are very common.

This does not indicate any infection. However, if you notice that you have a fever of more than 37.8º or it persists after 4 or 5 days after surgery, contact Dr. Gelber.

Also if you have pain that you cannot control with the prescribed medications or the skin in the surgery area is hot, red and very painful, do not hesitate to call us.

Vehicle driving

Normally you can return to driving once you have no significant pain and your knee has good mobility.

Keep in mind that you need good mobility to avoid delayed reactions while driving your car. Try performing a test in a quiet area and note that pressing any of the pedals does not cause pain or discomfort.

People who require external aids such as crutches to move, are also not allowed to drive.

Sexual Activity

You can resume sexual activity as soon as you feel ready.

Therapy with platelet rich plasma (PRP)

Treatment with PRP, widely and mistakenly known as “growth factors”, work to ameliorate the inflammatory component without it having been shown to promote regeneration of damaged tissue. However, it may be indicated when a surgical treatment cannot be done for various reasons. 

It is also useful in cases where active bodybuilding and exercise work is limited by inflammation and pain. In this way, the exercises can be resumed or increased in intensity while their effects last (between 6 and 18 months).

Hyaluronic acid infiltrations

It has the same objective as the previous treatment. Their main differences are that they have a considerably lower cost, but also their effect and duration are somewhat shorter than with platelet concentrate (PRP).

Terapia con células madres. Stem cell therapy

 Biological therapies are one of the challenges of today and tomorrow. They are indicated in specific cases to promote healing. Its use in the treatment of meniscal injuries is not yet clinically acepted. 

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