Knee Pain, Part II.

Depending on the extent of the tear and location, some meniscal injuries can be treated without surgery.  Physical therapy to increase muscle strength around the joint and increase your range of motion along with anti-inflammatory medication, knee sleeves, activity modification and time are the regimen.  However, you should have significant improvement within 2-3 months if this approach is working for you.  If little or no improvement is felt, then surgery to remove the part of the meniscus is indicated.  In younger athletes, surgery is generally the better option if the meniscus can be repaired.  Repairing the meniscus can prevent further deterioration of the joint and help to prevent arthritis later in life.

Surgery for meniscus tears is an outpatient procedure which can generally be done in under an hour.  It is performed through two small poke holes in the knee.  One hole is for the arthroscope, a lighted tube connected to a television screen, which is used to visualize inside the joint.  The other hole is for the instruments which are used to either repair or trim the torn meniscus.  If the meniscus is repairable, an additional small incision on the side of the knee may be used to retrieve the sutures and protect the nerves that travel in the skin around the knee.  You are generally allowed to go home within 2-3 hours following the surgery.

Recovery from meniscal surgery varies for different people depending on the extent of other damage to the knee structures and the person’s age.  Some athletes have arthroscopic surgery and are back playing in 2-3 days; however, most people take 2-3 weeks to regain their strength and get rid of their swelling.  If the meniscus was repaired, then you will usually have to be on crutches for 4-6 weeks to allow the meniscus to heal properly.  This is a great improvement over what was the norm 15 years ago when open surgery was done through a large incision and you were out of competition for 3-6 months.

The meniscus is an important structure in the knee joint and as much of it as possible should be preserved.  The meniscus cushions the knee joint and prevents the ravages of arthritis.  Through modern surgical techniques and improved rehabilitation, a quicker return to sports or work is possible for this bothersome condition.

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