Save the meniscus!
How does a meniscus injury occur?
Meniscus injuries are becoming more and more frequent due to increasing stress, especially during sports. In the past, the procedure was usually radical and the meniscus was removed completely.
However, the meniscus tissue is a non-regenerative collagen. This means that new formation does not occur. Removing the meniscus leads to premature arthrosis in the knee joint, because without the meniscus the cartilage damper is missing.
Why should the meniscus not be removed?
The meniscus serves as a kind of shock absorber in the body. If it is damaged, very radical measures are often taken unnecessarily. The meniscus is partially or completely removed. But especially in young people, the meniscus should never simply be removed.
Every resection (removal) leads to an increase in the load on the joint. Without shock absorbers, this stress results in chronic pain and premature knee osteoarthritis in the long term.
How should a meniscus injury be treated?
A very good way to preserve the meniscus is to sew the torn out meniscus back onto the joint capsule and fix it with a special tissue adhesive. If the meniscus is restored at an early stage, arthrosis is prevented and the resilience for work and sport is maintained.
What are the limits of treatment?
In our practice, we suture meniscus tears up to the age of 65. Because it has been shown that every attempt must be made to save the meniscus. This preserves the shock absorber function and prevents arthrosis.
If the meniscus is too damaged or has been removed in a previous operation, it is possible to implant a meniscus implant made of collagen. This grows into the joint capsule and takes over the original function again.
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FAQ
How is a meniscus tear treated?
First of all, it depends on the degree of cross-linking of the meniscus tear. The damaged parts of the torn meniscus can be removed or sutured after diagnosis. During removal, the frayed parts of the meniscus caused by the tear are sheared off. This allows the rough surface of the torn meniscus to be smoothed. In a few rare cases, the meniscus tear is restored by a transplantation, which is sewn in place and replaced by donor meniscus or biological tissue substitute.
Can a meniscus tear heal by itself?
Whether the meniscus tear can heal on its own is also decided here on the basis of the degree of injury. You should know that the meniscus contains different zones. Some areas are well supplied with blood and other regions, which are more central in the knee joint, are not.
If the tear is in the region of the meniscus with good blood supply and it does not go too deep into the areas with poor blood supply, it can heal conservatively.
How long does it take for a torn meniscus to heal?
How long the meniscus takes to heal depends on the type and method of treatment and on the individual case of each patient. The exact type of injury and the location of the tear are decisive. In most cases, the meniscus takes 6 to 14 weeks to heal.
How quickly does a meniscus tear need to be operated on?
The pain and inability to move can be painful after a meniscus tear. The knee can usually no longer be fully extended or bent. You should therefore see a doctor as soon as possible to discuss the next steps.
What happens if a torn meniscus is not treated?
If you decide against the recommended treatment for the meniscus tear, this will inevitably lead to cartilage damage and arthrosis. The tear will be further damaged with every movement until walking will only be possible with great difficulty.
FAQ
1. risks?
Postoperative effect. If this occurs, prosthesis and joint inner mucosa must be removed. Knee is then irrigated several times and then a "spacer" is then inserted (prosthesis made of bone cement containing an antibiotic). This spacer remains in the body for an average of 6 months, patient is not allowed to buy 6 months. After the 6 months, it is replaced with a full prosthesis.
2. complications?
- Incorrect placement of the prosthesis:
- too large or too small implants
Movement restrictions, in the worst case worse after surgery than before.
3. rehabilitation?
6-7 days in hospital. There are rehab facilities or outpatient rehab (4 hours a day in a hospital and treat there) → but for people living alone is not an option.
4. service life and durability?
Depends on several factors:
- Quality
- Medication
- Gender and load
- Positioning of the load, loose prostheses must be replaced. It is advisable to check the prosthesis every 2 years, so that any loosening can be seen and prevented.
5. sports?
Cycling, swimming, no problem. Stop-and-go sports, both shear forces on the knee joint, should be avoided if possible.
6. the right time for the prosthesis?
This is achieved when the patient says it cannot get any worse. It may be that after the implementation of the knee prosthesis the complaints are worse than before. If a patient can walk 5 km before the surgery, he may be able to walk only 500 m after the surgery. Therefore, the right time is only when there is no other way out.
7. duration of sick leave?
Sedentary work them earlier than stressful work. On average, it is 8-12 weeks.
8. how long do you walk with crutches?
After an arthroscopy with degenerative procedures, the patient must walk with supports for an average of 4 weeks, after which, depending on the findings, a splint takes over this function. However, if the meniscus is still implanted or if the upper and lower legs have cartilage damage on the opposite side and this has been repaired, this time is extended by 6-6 weeks, depending on the patient's body weight.
9. what to discuss with doctor before knee surgery?
As a patient, you should leave the consultation with the feeling that you know that and why surgery may be necessary. This is the only way you can go into surgery with a good feeling. Therefore, you should definitely ask what the alternatives to surgery are (and why they may not be an option for you). You should also ask what the possible risks of the operation are - more on this below - as well as when the best time for the operation is. If you are still unsure after the surgery consultation, get a second opinion.
10. Should I get a second opinion before knee surgery?
A surgical intervention on the knee should be avoided if it can be avoided. On the one hand, every patient prefers to avoid going to the hospital, and on the other hand, every operation represents a limited, but nevertheless existing risk that should only be taken if other forms of therapy have been exhausted. This applies in particular to the question of whether an artificial knee joint needs to be used.
The knee joint is the joint in the body that is subjected to the greatest stress. In this respect, problems at the knee joint occur frequently. There are many things you can do to relieve the joint. Avoiding sports that put a strain on the knee in favor of physical activities that are easy on the knee and targeted exercises for the knee (physiotherapy); medication, bandages, orthoses - all of these can help to reduce pain and relieve and stabilize the knees.
Even when surgery is unavoidable, it is often not necessary to use an artificial knee joint. Today, there are already procedures that can even repair extensive cartilage damage with a transplant (cartilage cell transplantation).
If your treating physician advises you to undergo surgery, then it makes sense to obtain a second opinion. Often, obtaining a second opinion is also covered by health insurance. Of course, there are clear criteria as to when which procedure should be used. But there are also borderline cases where different specialists may well have different opinions. So if you want to be sure whether surgery is really necessary in your case, you should definitely get a second opinion from an expert in the field.
But always keep in mind that risk also brings opportunity; avoiding one risk can lead to another. Going without knee surgery may not only result in permanent pain and reduced mobility in the knee joint and, therefore, quality of life. It can also have repercussions on the leg and hip, should the pain lead to incorrect stresses in the knee.
11. what is the recovery process?
This question is very individual and cannot be answered in general terms. It depends on the individual case and in particular on the type of surgical intervention. In any case, it will take several weeks before you can walk again without crutches after a knee operation, and it usually takes up to six months, and in some cases even 12 months, before you can put full weight on your knee again.
In the case of a cartilage cell transplant, for example, the knee can usually only be loaded normally again one year after the operation. The recovery process for cruciate ligament tears is also very long; full weight-bearing is not permitted until six months at the earliest. This is more difficult to assess in the case of meniscus surgery. Whatever knee surgery you have, it is very important that physiotherapy begins immediately after the operation and that the recovery process is well supervised by specialists. Therefore, do not miss the follow-up examinations under any circumstances. They help to ensure that the
Whatever knee surgery you get, it is very important that immediately after the operation physiotherapy begins and that the recovery process is professionally well accompanied. Therefore, do not miss the follow-up examinations under any circumstances. They help to ensure that the operation is worthwhile for you and that you can hopefully move (almost) pain-free again.