What is a Partial Meniscectomy
A partial meniscectomy is a surgery to remove a portion of the meniscus, a crescent-shaped piece of cartilage in the knee. The meniscus acts as a shock absorber and helps to keep the knee stable. It can be damaged by an injury or by wear and tear over time. A partial meniscectomy, or trimming of the torn portion of the meniscus, can relieve pain and restore function. It may be an option if you have a meniscus tear that doesn’t require a full repair, or is not repairable. If you’ve been diagnosed with a meniscus tear, you may be wondering if a partial meniscectomy is the right option for you.
Why is a Partial Meniscectomy Performed
The initial treatment for most meniscus tears is non-surgical, including physical therapy, activity modification, anti-inflammatory medication, knee braces, and possibly injections. When those treatment modalities aren’t successful, meniscus surgery may be indicated.
Unfortunately, most meniscal tears tend not to be repairable, with only about 25% being suitable for meniscal repair. In these cases, trimming of the meniscus is performed. Although it does not repair the meniscus, it does remove the unstable flap of tissue that is causing the pain, locking, or catching in the knee. This can be compared to trimming a painful hangnail. It can also help to prevent the meniscus from tearing further, much like trimming back a tear in fabric can keep it from spreading.
Trimming of the meniscus on the inside of the knee is referred to as a partial medial meniscectomy, and trimming of the meniscus on the outside of the knee is known as a partial lateral meniscectomy. Very rarely is a total meniscectomy performed. However, the past, doctors thought the meniscus was a vestigial organ that wasn’t useful, and they would perform a complete or total meniscectomy.
How is a Partial Meniscectomy Performed
Trimming of the meniscus is performed arthroscopically, or through a scope. It is a surgical procedure which is performed on an outpatient basis, meaning that you can go home the same day. First the surgeon makes two small incisions in the knee that allow the scope and the instruments to enter the knee joint.
Then, a complete examination of the knee compartments is performed. After the meniscus is closely inspected, the meniscectomy is performed. This can be done with surgical instruments, known as meniscal biters or meniscal baskets, that can trim back small pieces of the meniscus. An arthroscopic shaver is often used. This is a device with a reciprocating blade and suction that allows precise trimming of the torn meniscus.
Knee arthroscopy is considered a minimally invasive procedure, and trimming of the meniscus can take less than an hour if no other procedures are performed at the same time.
Partial Meniscectomy Recovery Time
Arthroscopic surgery is a much less invasive procedure than something like a knee replacement. Recovery is usually quick with weight bearing allowed immediately. You may be given crutches when leaving the surgery center, but it is recommended that you try to quit using them as quickly as possible.
Many times you will be asked to work with a physical therapist to help speed up recovery, restore mobility, regain range of motion, and facilitate return of muscle function in the thigh. Return to high level sports can take 3-4 weeks.
Return to driving can take 1-2 weeks, depending on which knee was operated on. Most people can return to work within 3-5 days, but it may take 4-6 weeks to return to heavy duty work. You should never drive a vehicle or operate heavy machinery if you are still taking prescription pain medications.
If you have knee arthritis, it may take 6 months or longer to notice the full effects of an arthroscopic partial meniscectomy. Most patients over the age of 40 will have some degree of arthritis or cartilage wear. Sometimes, arthroscopic knee surgery will temporarily irritate the knee further and it may take time for swelling and knee pain to improve.
Arthroscopic meniscectomy is one of the more commonly performed orthopedic surgeries in the United States. It is usually performed when mensicus tears have not responded to a prolonged course of non-surgical treatment and the meniscus is not repairable. Recovery is usually rapid, and patients can return to weight bearing activities very quickly.
FAQ. Frequently Asked Questions
How long does it take to recover from a partial meniscectomy?
Partial meniscectomy post op is usually quicker than other knee surgeries such as knee replacement. Each patient will be assessed and treated according to his or her own progress after surgery. Most patients are bearing weight on their knee within 1-2 days after surgery.
What is partial meniscectomy?
Partial meniscectomy is a surgical procedure to trim, or remove, part of the meniscus. The meniscus is a c-shaped piece of cartilage in the knee. It has very poor blood supply and often will not heal on its on.
Does partial meniscectomy cause arthritis?
The meniscus is a crescent shaped piece of cartilage that is an important shock absorber in the knee. When the meniscus is removed, the forces on the articular cartilage increase exponentially, which can lead to arthritis.
Depending on the location of the meniscectomy and the degree of meniscus removed, meniscectomy can lead to earlier arthritis. It is important to leave as much viable meniscus as possible when performing a meniscectomy, and to perform repair when possible.
Does the medial meniscus regrow after trimming?
Unfortunately, the medial meniscus does not regrow after trimming. The meniscus has poor blood supply, with 90% of the vascularity being located in the periphery of the meniscus.
Can you take up running after a meniscectomy?
Yes, you can return to running after meniscectomy. Although traditional wisdom suggested running was bad for your knees, more recent research has demonstrated that for most people, the overall positives of running outweighs the negatives.
Most patients are able to play sports at the same level they did prior to meniscectomysurgery.
How many partial meniscectomies are performed each year?
Over 500,000 arthroscopic partial meniscectomies are performed each year in the United States.
How common are complications with meniscectomy?
Major complications with arthroscopic meniscectomy are uncommon. Some studies have estimated the risk of complication to be less than 1% within 90 days of arthroscopic meniscus trimming.
In a study of over 1 million patients with arthroscopic meniscectomy, the risk of pulmonary embolism (serious condition involving blood clots) was 0.078% and risk of serious infection was 0.135%
Is partial meniscectomy worth it?
A study in 2020 assessed the outcomes of over 600 patients who were aged 40 or above and had isolated arthroscopic meniscectomy (meaning they didn’t have other additional procedures performed at the time of surgery).
There were clinically meaningful and statistically significant improvements in all parameters 1 year after surgery compared to pre-surgical condition. Older patients, overweight patients, smokers, the presence of a lateral meniscus tear, or the presence of a medial meniscus root tear were predictors of less improvement.