Your knee utilizes an intricate network of tendons and ligaments to remain stable, cushioned and functional throughout life. Of these tendons and ligaments, the meniscus provides the most protection by absorbing shocks that would otherwise damage the adjacent cartilage and bone structures. The thick meniscus tissue also stabilizes the knee during movement. Throughout life, your meniscus wears down with normal use and can also sustain damage due to blunt force trauma and other injuries. These factors can cause the meniscus ligament to tear, leaving the nearby cartilage and bone susceptible to wear and injury.
Meniscus Overview
Your knee actually has two c-shaped meniscus ligaments on the inner and outer sides of your joint, the medial and lateral meniscus, respectively. Either of these ligaments sits firmly between the cartilage on either end of your femur and tibia bones. Blood flows through these ligament structures to keep the knee joint and leg bones healthy and strong.
As you age, the blood flow rate through these structures naturally decreases, which can contribute to meniscus degeneration or an increased risk of injury. Furthermore, your unique gait, favored activities and hereditary factors determine the wear rate and risk of injury for these ligaments.
Tear Causes
The two main causes of tears to the meniscus tissue are natural degeneration and acute injury.
Degeneration
The meniscus helps your knee support your weight while also distributing stress and friction from movement across the entire ligament. This multi-functional role continually wears down the ligament tissue, causing it to thin and fray around the edges.
Although all tears through the meniscus tissue are evaluated individually, many caused by degeneration do not require surgical repair. Your body should slowly repair the tissue through its natural healing process. If the pain and discomfort escalates or continues, however, you can always talk to your doctor about having the damage repaired with arthroscopic surgery.
Acute Injury
With acute injury, the meniscus tissue tends to tear in one of the three following ways:
- Bucket handle: Serious tear that allows the tissue to rotate from side to side
- Horizontal cleavage: Large tear that shears the meniscus completely in half
- Radial: Short contained tear that runs from the inner section to the outer edge
In most cases, tears caused by acute injury are too severe for your body to naturally heal on its own. Your surgeon can repair the tears with an advanced arthroscopic surgery procedure to restore the ligament shape and position. To determine if you are an ideal candidate for this surgical procedure, you will need to undergo an MRI to help your surgeon visualize the damage.
Arthroscopic Surgery
During the arthroscopic surgery, your surgeon will remove loose ligament fragments and smooth the frayed edges to prevent additional tears. On very rare occasions, it may be necessary to suture the meniscus back together to facilitate a full recovery. The entire surgery is performed through a tiny incision using a scope to view the meniscus and cartilage up close.
Benefits
Arthroscopic surgery relieves the pain and discomfort associated with meniscus tears. The surgery also helps eliminate inflammation caused by loose fragments irritating your knee joint. Upon making a full recovery, you should be able to gradually resume your active lifestyle without worry about the condition of your knees.
Risks
As with all surgical procedures, the main risks of arthroscopic surgery are the potential for complications from anesthesia and the chance of infection. In rare cases, your surgeon may find additional damage to the meniscus that did not show up on the initial MRI scans. If the damage is not repairable with surgery, you may still have some pain and discomfort after recovering from the procedure.
Recovery
Since arthroscopic surgery is performed with a scope and specialized tools, your body is easily able to recover from the procedure in a relatively short period of time. You should be able to move around on crutches on the same day as the surgery. As a result, most hospitals tend to issue your discharge to go home on the same day as well.
You will need to allow for up to six weeks of recovery with frequent physical therapy appointments. During the recovery period, you should continue to use crutches until your physical therapist or surgeon authorizes moving to a supportive knee brace instead. You will visit with your surgeon within a week or two after the surgery to assess your recovery progress.