Meniscectomy

The meniscus is two parts of thick C shaped connective cartilage, located between the tibia and the femur. It acts to cushions and stabilizes the knee joint. Acting as a natural shock absorber, it protects the knee joint from wear and tear. The meniscus assists to disperse the compressive forces which pass through the knee joint with high loading activities such as going up/downstairs or running.

There is two common mechanisms of injury for meniscal tears. Usually, in younger populations, this injury occurs with acute traumatic movements, (i.e. suddenly twisting or rapidly changing direction) with a bent knee.

In older populations, it can present with gradual onset sore and stiffness or tears with simple movements (i.e. getting out of a car or kneeling to pick something up off the floor.) This is the natural age-related wear of the meniscus over time.

The image demonstrates the various kinds of meniscus tears that can occur.

Classic meniscal signs of injury include the knee joint catching, locking, or the knee giving way suddenly. Furthermore, joint tenderness or pain along the inside or outside of the joint can be an indicator.

Conservative management of meniscal tears generally takes approximately 6-8 weeks to heal. However, this can vary upon the nature and type of injury. For instance, smaller tears may heal naturally, but larger more symptomatic tears may require further management such as arthroscopic surgery. Management is focused on facilitating meniscal healing and gradual loading of the injured tissue. Strengthening of the surrounding muscle groups such as the quadriceps and hamstring muscles assists further to support the joint. Eventually, progressive exercises can involve plyometric/power based drills and activities to prepare the knee for return to activity.

If conservative management fails your surgeon may discuss the idea of surgery. In a meniscectomy, a portion or entire segment of the meniscus is removed. This aims to remove the parts of the meniscus that are interfering with the joint movement, contributing to the “locking” of the joint. The technique used for this is minimally invasive, via arthroscope or keyhole surgery.

Surgery will depend on:

• your age
• tear size
• tear location
• cause of the tear
• your symptoms
• your activity level

Strengthening exercises in the weeks leading up to meniscus surgery can help facilitate a speedy recovery after surgery.

Here are some quick exercises to build the quadriceps & hamstring muscles

1. Inner range Quadriceps
2. Straight Leg Raises
3. Hamstring Curls

After surgery, it is advisable to see a knee physiotherapist for follow up rehabilitation and a comprehensive strengthening program. At iMove Physiotherapy, we have experience with managing meniscus injuries and would love to help you on your journey.

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