Meniscus surgery

What you need to know

Meniscus lesions are frequent and affect the entire population. They can be traumatic and/or degenerative. They cause pain, blockages and joint effusions. Their treatment consists of resection or suturing under local joint anaesthesia and outpatient surgery.
Small anatomical reminder:
There are two meniscias in the knee, one on the inner side (the inner meniscus) and the other on the outer side (the outer meniscus), interposed between the lower femoral end and the upper tibial end. These meniscus are fibro-cartilage. Their role is to protect femoral-tibial cartilage.
The lesions are of 2 types:
• Degenerative, i. e. related to knee wear and aging.
• Traumatic, i.e. following a sprain or forced flexion of the knee.
They affect the internal meniscus more often than the external meniscus. Internal meniscus lesions are classified into 3 stages (vertical or oblique longitudinal crack, radial or horizontal), the most important being a knee dislocation.
CIRCUMSTANCES OF DISCOVERY:
• Painfulness
• A feeling of moving parts inside the knee
• Temporary or permanent blockages of the joint
• The presence of fluid in the knee (hydarthrosis)
There are also two other knee conditions: cysts and malformations, the latter being rare. When your pain is too intense or your walking gene too disabling, surgery is often necessary.

TIME REQUIRED

Duration of hospital stay
24 to 48 hours en moyenne.
General or local anaesthesia.
Average length of stay
10 to 15 days.
Rest is recommended after the procedure.

Meniscus surgery
Meniscus surgery

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Before the treatment

THE DIAGNOSIS:
It is confirmed by paraclinical examinations:

  • Standard radiography, in charge of both knees and in flexion
  • Magnetic resonance imaging (MRI) of the knees: allows to see the associated lesions, especially ligamentous ones.
    ASSESSMENT BEFORE INTERVENTION:
    Be sure to specify the indication for surgery:
    • Important functional inconvenience
    • Acute blockage
    • High level athlete
    • Associated lesions: rupture of the anterior cruciate ligament
    • Appointment with an anaesthetist
    • Preoperative blood test
    • Chest X-ray
    Meniscus surgery is usually performed on an outpatient basis (day hospital). You enter the hospital on an empty stomach in the morning, and you leave that same evening, if no problems arise. Preparing for the procedure minimizes the risk of infection.
    The day before the operation, at home or in a hotel: peel the leg (from the top of the thigh to the feet) with depilatory cream. Avoid using a razor (the risk being to cause a small injury). On the day of the procedure, take a shower with an antiseptic product that has been prescribed for you. Nails should be short and free of nail polish. Come without makeup.
    On the day of arrival at the hospital, you will again take a shower with the same antiseptic product to perfect your skin preparation.

What does it involve?

There are 2 types of intervention:

  • Refraining from any treatment if the lesion is small and very peripheral or if it does not completely pass through the meniscus and occurs on a stable knee, i.e. without ligament damage.
  • Meniscal regularization, which consists in essentially removing the meniscal lesion by trying to preserve as much meniscus as possible. It lasts 20 minutes and is performed on an outpatient basis (without hospitalization) and under local anesthesia.
  • Meniscal suture, which consists in repairing the meniscus with resorbable anchors or arrows. It is a totally conservative procedure that is performed under general anesthesia.
    These procedures are performed under arthroscopy by 2 mini incisions of less than 5 mm through which a camera and instruments are inserted to treat the meniscus lesion. The joint is then swollen with water, which allows for constant washing and reduces the risk of infection.
    Currently 90% of meniscal lesions are treated by meniscal regularization. This is a simple excision of the damaged meniscus area, which takes an average of 20 minutes.
    It is performed in 70% of cases under pure local anesthesia. Sometimes complementary neuroleptanalgesia or diazanalgesia are desirable. This is an intravenous injection of benzodiazepines or morphine allowing a slight sedation if you do not tolerate local anesthesia.
Meniscus surgery
Meniscus surgery

After the treatment

AFTER THE OPERATION:

  • Placement of a removable immobilization splint for 10 days
    Monitoring of potential haematoma
  • Antiseptic and analgesic treatments to avoid infection and pain: bandages are reapplied every 2 days by a qualified nurse.
  • A 3-week phlebitis preventive treatment is prescribed and the injections are given by a qualified nurse.
    blood test twice A week to determine the platelet level
  • Rehabilitation is done quickly: it is initially limited to the quadriceps, the resumption of work is done from the 8th day and the resumption of sports activities from the 3rd week.

About Meniscus surgery

The resumption of normal and non constraining functional activities can be considered after 3 weeks in the case of meniscal resection, after 6 weeks in the case of isolated meniscal suture and from the 3rd month in the case of anterior cruciate ligament surgery. The resumption of sport must wait until the 6th week for meniscal resections. For other interventions this can not be done before the 3rd month but everything depends on the sport undertaken and your wishes. The decision must then be made with your surgeon who will judge on a case-by-case basis.
Risks and complications:
• Hematoma
• Joint infection
• Phlebitis
• Cysts
MEDICAIM is looking for the best specialists for you and we will offer you several renowned doctors.
MEDICAIM organizes your entire stay for you: post-operative nursing care, biological follow-up, therapeutic, nutritional and psychological support.
Any additional questions? Ask your MEDICAIM doctor about it: careteam@medicaim.com
http://www.medicaim.com

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