Meniscus damage can affect the stability of the entire knee joint and is associated with pain and limited mobility. To prevent further joint damage, such as osteoarthritis, minimally invasive meniscus surgery is advisable under certain circumstances. Find out more about meniscus damage and surgical treatment options here.
Meniscus surgery is used to treat meniscus tears caused by wear and tear or accidents. Torn sections of the meniscus can cause mechanical problems with blockages and jamming in the knee joint.
In the further course of the disease, the knee becomes irritated with inflammation and swelling. To remedy these problems, the meniscus can be sutured or gently partially removed (partial meniscus resection) as part of a meniscus operation.
In young people, a meniscus transplant may also be necessary if large parts of the meniscus tissue are lost.
The menisci consist of a resistant fibrous cartilage tissue and are shaped like "crescent-shaped washers". A distinction is made between the medial (inner meniscus) and lateral (outer meniscus) meniscus.
They form shock absorbers between the femoral condyle and the tibial plateau and ensure an even distribution of pressure on the articular cartilage surfaces.
The initially elastic and tear-resistant meniscus tissue is subject to natural ageing in humans. The causes of premature degeneration are often
Meniscus damage occurs more frequently in occupations that involve kneeling.
© bilderzwerg / Fotolia
Detached parts of the meniscus can cause mechanical damage to the joint cartilage surfaces. The mechanical damage, the lack of cushioning and the recurring inflammation ultimately lead to further degenerative damage to the joint, culminating in the final stage known as osteoarthritis.
As articular cartilage and most parts of the menisci are not innervated with pain fibers, degenerative damage can remain undetected for a long time. Extreme movements and shearing forces can lead to a sudden jamming of parts of the meniscus, for example when standing up from a deep squat. Because the attachment of the meniscus to the joint capsule contains many pain fibers, this results in a sudden onset of severe pain in the knee joint.
In severe cases, the joint may be blocked and extension may be inhibited. If the meniscus damage has been present for a long time, there may already be silent cartilage damage in the joint, which is only discovered during arthroscopy of the joint.
Damage to the meniscus can be treated with meniscus surgery. Depending on the exact diagnosis and individual situation, various procedures are possible, which are explained below.
In many cases, conservative treatment with painkillers and physiotherapy can help. However, this success is not long-lasting. Therefore, after an attempt at conservative treatment, arthroscopic meniscus surgery should be performed before further damage or uncontrolled massive tears of the meniscus occur.
Parts of the meniscus that are no longer mechanically functional may be removed as they no longer have any functional benefit. Arthroscopic meniscus surgery should be considered if there are clear symptoms and a suitable image on magnetic resonance imaging(MRI).
Although the removal of the detached parts of the meniscus reduces its buffering effect, the cartilage-destroying effect of the defective parts of the meniscus that are not removed is much more serious than the reduction in the buffer after partial removal.
Removal should be avoided if possible in the case of accident-related tears in the meniscus. Cruciate ligament injuries in particular are often associated with meniscus tears.
Various suturing techniques are used here. The video shows the procedure for arthroscopic meniscus surgery:
In addition to suturing, which is quite complex in terms of surgical technique, self-dissolving fixation materials for sutures and anchors are usually used nowadays.
Rigid implants such as arrows or screws have not proved successful due to the risk of dislocation and mechanical problems. In contrast to the classic suture technique, fixation aids considerably shorten the operation time.
Patients who lose a meniscus at a young age are at risk of developing early osteoarthritis in the long term.
A procedure that has been used for many years and is only performed in a few centers around the world is the transplantation of a healthy meniscus. This is harvested from a deceased donor and implanted into the recipient arthroscopically.
This is a demanding meniscus operation that requires great experience and outstanding technical skills from the surgeon.
A lifelong intake of medication, such as that taken after heart transplants to prevent rejection, is not necessary after this meniscus operation.
However, the meniscus is a tissue with little blood supply. Therefore, in addition to mechanical anchoring, biology is crucial for success after a donor meniscus transplant. In many cases, the transplant shrinks or is pushed out of the joint capsule.
The collagen meniscus implant is an artificial meniscus obtained from animal collagen, which is used for extensive resections of the medial meniscus. As part of arthroscopic meniscus surgery, the CMI is sutured into the meniscus defect and serves as a placeholder and growth splint.
It is then replaced by the body' s own fibrocartilage and thus fulfills the functions of a natural meniscus. The results of an American study to date are encouraging. The implant can be used on both the inner and outer meniscus.
The preserved ring on the outer wall of the meniscus is aprerequisite for the functioning of the CM. It serves as a mechanical anchor for the sutures and as tissue from which the cells can grow into the collagen scaffold. CMI is not recommended for older people with a low biological regenerative capacity.
The Leading Medicine Guide's quality assurance is ensured by the following acceptance prerequisites.
