Partial Meniscectomy - What You Can Expect - A Work in Progress
Created | Updated Jun 28, 2005
WHAT IS A MENISCUS?
Contrary to other Guide entries, it isn't something you can find in a pint glass, unless someone is playing a very cruel trick on you.
The medial and lateral menisci work as a team inside your kneecap. They are small, C-shaped bands of cartilage which form a sort of cup. These little bands do quite a bit of work, preventing your upper and lower leg bones from grinding together and stabilizing the knee by evenly distributing weight across it.
MENISCI SOUND PRETTY NICE. WHY WOULD I WANT ANY PART OF MINE REMOVED?
The short answer is that it's often less painful and troublesome to remove the torn part of a meniscus than to let in remain in the knee.
The menisci are susceptible to tears, especially in obese and active people. Tears commonly occur when the feet are planted and the knee flexes in a twisting or pivoting motion, as when playing tennis, lifting something heavy, or misjudging a landing when you jump off of something.
If your tear is severe enough, the meniscus will flap around inside your kneecap. It can get caught in the joint's moving parts, and chew up the other soft tissue in there.
Treatment for a torn meniscus depends not just on the severity of the tear, but also on the location. Your menisci are comprised of two parts: the red zone, and the white zone. As the name implies, the red zone receives blood flow. Tears in this location can often be repaired with a simple stitch or two. The white zone receives no blood flow. As tears in this location cannot repair themselves, the torn part must be cut away in order to avoid further pain and damage.
DOES A MENISCAL TEAR FEEL AS AWFUL AS IT SOUNDS?
That depends on the severity of the tear, and the person's pain threshhold. There are no nerve endings in the menisci. Pain and swelling are due to damage to the surrounding tissues.
If you have a small tear, you may feel a little bit of pain at the moment of injury. Your knee may swell very slowly over several days. You'll probably be able to walk with almost no pain, but feel a nasty twinge when lifting or squatting.
Absence of nerve endings or no, chances are that you'll feel a larger tear. It isn't pleasant and you'll definitely know that something is amiss inside your kneecap. Your knee may swell until it looks like someone stuffed a baseball in there and stretched your skin over it. Your movement may be inhibited, and you will feel moderate to severe pain when trying to take weight on your knee.
If you have just the right kind of tear, you may occasionally feel a weird pinching or stinging sensation. That is the torn bit flapping around and getting caught in the joint, and it is very much in your best interests to get it corrected.
If you suspect that you have a torn meniscus, or any kind of tissue damage, please go see an orthopaedic surgeon immediately.
WHAT IS THE ORTHOPAEDIST GOING TO DO TO ME?
A careful orthopaedist will palpate and manipulate your knee. Mind you take some sort of painkiller first, because chances are good that you won't have the prescription drugs yet! He'll ask you all sorts of questions about your symptoms, after which he'll probably send you out to get an MRI. If you are at all claustrophobic, you will want to find an open MRI facility, because claustrophobes won't enjoy lying in a stuffy tube for 45 minutes. The MRI snaps a series of images of the tissues inside the joint, from every possible angle. These images will be sent to a radiologist, who will interpret them and send his findings to your orthopaedist.
While all of this is happening, the careful orthopaedist will have you going to physical therapy or rehabilitation several times a week. Your knee is probably already very stiff, and chances are that you are losing muscle tone rather rapidly. If you are, in fact, facing surgery, it is crucial to go in there with as much of your natural movement and muscle tone as possible. Otherwise, you could wind up with a permanently stiff knee, and walk funny for the rest of your life.
Once your orthopaedist receives the results of your MRI, he will be able to make a complete diagnosis. Further treatment depends on what those films show.
THE FILMS SHOW THAT I HAVE A TEAR. IT'S IN THE WHITE ZONE. MY ORTHOPAEDIST IS TAKING IT OUT. YIKES!
Bah! It's a breeze.
Meniscal tears are repaired via a non-invasive outpatient surgery called arthroscopy. You will probably have the option of staying awake and watching on the surgeons' monitor, or being put under a general anesthetic.
The worst part of the ordeal is not being able to eat, drink, or smoke for twelve hours leading up to the surgery.
Please note that anesthesia is different for everyone and your experience might be different. Either way, anesthesia is your friend.
In all likelihood, this is what will happen:
The anesthetist will put an IV into the back of your hand. The first thing to go into the IV will be a sedative. Sit back and enjoy the happiest fifteen minutes of your life!
Follwing the sedative, you will be wheeled into the operating room, where you will meet your surgeon and his team. You couldn't get scared at this point if you tried, so enjoy it! If you're going under, one member of the team will stick a mask to your face and ask you to count back from 10 (or 100, or whatever number suits that day). If you're lucky you'll get to 7 (or 97) before you pass out.
Contrary to other Guide entries, it isn't something you can find in a pint glass, unless someone is playing a very cruel trick on you.
The medial and lateral menisci work as a team inside your kneecap. They are small, C-shaped bands of cartilage which form a sort of cup. These little bands do quite a bit of work, preventing your upper and lower leg bones from grinding together and stabilizing the knee by evenly distributing weight across it.
MENISCI SOUND PRETTY NICE. WHY WOULD I WANT ANY PART OF MINE REMOVED?
The short answer is that it's often less painful and troublesome to remove the torn part of a meniscus than to let in remain in the knee.
The menisci are susceptible to tears, especially in obese and active people. Tears commonly occur when the feet are planted and the knee flexes in a twisting or pivoting motion, as when playing tennis, lifting something heavy, or misjudging a landing when you jump off of something.
If your tear is severe enough, the meniscus will flap around inside your kneecap. It can get caught in the joint's moving parts, and chew up the other soft tissue in there.
Treatment for a torn meniscus depends not just on the severity of the tear, but also on the location. Your menisci are comprised of two parts: the red zone, and the white zone. As the name implies, the red zone receives blood flow. Tears in this location can often be repaired with a simple stitch or two. The white zone receives no blood flow. As tears in this location cannot repair themselves, the torn part must be cut away in order to avoid further pain and damage.
DOES A MENISCAL TEAR FEEL AS AWFUL AS IT SOUNDS?
That depends on the severity of the tear, and the person's pain threshhold. There are no nerve endings in the menisci. Pain and swelling are due to damage to the surrounding tissues.
If you have a small tear, you may feel a little bit of pain at the moment of injury. Your knee may swell very slowly over several days. You'll probably be able to walk with almost no pain, but feel a nasty twinge when lifting or squatting.
Absence of nerve endings or no, chances are that you'll feel a larger tear. It isn't pleasant and you'll definitely know that something is amiss inside your kneecap. Your knee may swell until it looks like someone stuffed a baseball in there and stretched your skin over it. Your movement may be inhibited, and you will feel moderate to severe pain when trying to take weight on your knee.
If you have just the right kind of tear, you may occasionally feel a weird pinching or stinging sensation. That is the torn bit flapping around and getting caught in the joint, and it is very much in your best interests to get it corrected.
If you suspect that you have a torn meniscus, or any kind of tissue damage, please go see an orthopaedic surgeon immediately.
WHAT IS THE ORTHOPAEDIST GOING TO DO TO ME?
A careful orthopaedist will palpate and manipulate your knee. Mind you take some sort of painkiller first, because chances are good that you won't have the prescription drugs yet! He'll ask you all sorts of questions about your symptoms, after which he'll probably send you out to get an MRI. If you are at all claustrophobic, you will want to find an open MRI facility, because claustrophobes won't enjoy lying in a stuffy tube for 45 minutes. The MRI snaps a series of images of the tissues inside the joint, from every possible angle. These images will be sent to a radiologist, who will interpret them and send his findings to your orthopaedist.
While all of this is happening, the careful orthopaedist will have you going to physical therapy or rehabilitation several times a week. Your knee is probably already very stiff, and chances are that you are losing muscle tone rather rapidly. If you are, in fact, facing surgery, it is crucial to go in there with as much of your natural movement and muscle tone as possible. Otherwise, you could wind up with a permanently stiff knee, and walk funny for the rest of your life.
Once your orthopaedist receives the results of your MRI, he will be able to make a complete diagnosis. Further treatment depends on what those films show.
THE FILMS SHOW THAT I HAVE A TEAR. IT'S IN THE WHITE ZONE. MY ORTHOPAEDIST IS TAKING IT OUT. YIKES!
Bah! It's a breeze.
Meniscal tears are repaired via a non-invasive outpatient surgery called arthroscopy. You will probably have the option of staying awake and watching on the surgeons' monitor, or being put under a general anesthetic.
The worst part of the ordeal is not being able to eat, drink, or smoke for twelve hours leading up to the surgery.
Please note that anesthesia is different for everyone and your experience might be different. Either way, anesthesia is your friend.
In all likelihood, this is what will happen:
The anesthetist will put an IV into the back of your hand. The first thing to go into the IV will be a sedative. Sit back and enjoy the happiest fifteen minutes of your life!
Follwing the sedative, you will be wheeled into the operating room, where you will meet your surgeon and his team. You couldn't get scared at this point if you tried, so enjoy it! If you're going under, one member of the team will stick a mask to your face and ask you to count back from 10 (or 100, or whatever number suits that day). If you're lucky you'll get to 7 (or 97) before you pass out.
