The meniscus is a pliable substance that sits between two bones in the knee joint, the femur (thigh bone) and tibia (shin bone). Some patients with meniscus tears can be treated with a combination of activity modification and a focused physical therapy program. Other patients with persistent symptoms or certain tear patterns require surgery. In patients with certain tear patterns, Dr. Keller may recommend removal of the torn part of the meniscus – a partial meniscectomy.
Dr. Keller tries to retain as much healthy meniscus as possible during surgery because patients are more likely to develop arthritis without a meniscus. However, meniscus tears that are located on the inside rim of the meniscus in the “white” zone are less likely to heal than other meniscus tears. Complex-shaped tears are also less likely to heal than other tear-patterns, such as vertical tears. Dr. Keller does not recommend repair of complex meniscus tears in the “white” zone because, even if Dr. Keller sutures the meniscus tear together, the tear likely will not heal. Therefore, for some patients, Dr. Keller recommends partial meniscectomy. During a partial meniscectomy, Dr. Keller uses a minimally invasive, arthroscopic technique to remove the torn, non-functional area of the meniscus that is torn. Dr. Keller smooths out the rim of the remaining meniscus to prevent a tear in the future. Dr. Keller is also careful to retain as much healthy meniscus as possible.
Following surgery, patients are encouraged to bear weight on the affected extremity right away. When the patient is sitting or lying down, Dr. Keller encourages knee range of motion exercises with the brace removed. Dr. Keller also recommends intermittent icing and straight leg raises to strengthen the quadriceps muscles. Dr. Keller recommends starting formal physical therapy two weeks after surgery. Physical therapy focuses on reducing swelling in the knee, restoring full range of motion, and restoring strength to the knee. Most patients start cutting activities and sporting activity approximately six weeks after surgery.