Resection of the meniscus and recovery after surgery of the knee joint meniscus

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Content

  • 1Operation on knee joint meniscus: postoperative rehabilitation
    • 1.1Diagnosis
    • 1.2Treatment
    • 1.3Contraindications
    • 1.4Types of arthroscopy
    • 1.5Restoring the Meniscus
    • 1.6Resection and meniscectomy - partial or complete removal
    • 1.7Transplantation
    • 1.8Recovery after surgery
    • 1.9Gymnastics for recovery
    • 1.10Physiotherapeutic procedures
  • 2Operation on the knee joint, at the meniscus: reviews. Rehabilitation after an operation on the knee joint meniscus
    • 2.1What is the knee joint meniscus?
    • 2.2Causes of various meniscus injuries
    • 2.3Meniscus treatment methods, reviews
    • 2.4When is an operation performed on the knee joint meniscus?
    • 2.5What kinds of manipulation are used?
    • 2.6Application of arthroscopy of the knee joint
    • 2.7Operation on the knee joint at the meniscus - duration
    • 2.8Rehabilitation with conservative treatment, reviews
    • 2.9Rehabilitation after surgery
    • 2.10Postoperative complications
    • 2.11Sports after surgery
  • 3How does the recovery after surgery for meniscus?
    • 3.1What is the importance of rehabilitation
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    • 3.2Early and late postoperative period
    • 3.3Tear plastic
    • 3.4Meniscatectomy
  • 4Operations on the knee joint meniscus: types, indications, conduction
    • 4.1Diagnosis of a meniscus injury
    • 4.2Treatment of a meniscus tear
    • 4.3Resection of the meniscus (total and partial)
    • 4.4The technique of resection of the meniscus
    • 4.5Complications after meniscectomy
    • 4.6Contraindications to the operation
    • 4.7Recovery period
    • 4.8Conversation with the doctor
    • 4.9Cost of operation
  • 5Effects of removal of the knee joint meniscus and recovery technique
    • 5.1The appointment of a meniscus
    • 5.2Injuries and consequences of damage
    • 5.3Recovery after surgery
    • 5.4Restoration after arthroscopy
    • 5.5Rehabilitation after stitching of a torn meniscus

Operation on knee joint meniscus: postoperative rehabilitation

Knee joints are a complex system that takes on multiple loads, and at the same time is the most vulnerable. One of the most common diseases of this part of the body is the tearing of the meniscus.

It can be complete or partial. In the articular structure there are two meniscus - internal and external.

As a rule, the inner one is injured most often, since it is less mobile and connected from the inside with a lateral ligament.

Meniscus pathologies are found in professional athletes due to injuries (bruises), and people of advanced age due to degenerative and dystrophic transformations of cartilaginous tissue (arthrosis).

The sports trauma is manifested by sharp strong pain sensations, swelling and redness, blockade of the motor function.

Implicit signs are inherent in the degenerative rupture, however, a pathological process can be detected by swelling in the knee area, aching pain, which periodically becomes intense, and decreasing mobility of the joint.

If the operation of the knee joint meniscus during injury was not carried out in time, the gap provokes the development of gonarthrosis.

Diagnosis

Diagnostic methods are presented by X-ray and MRI. Defects are distinguished:

  1. on the localization of the rupture - on the body of the meniscus, anterior or posterior horn;
  2. in form - longitudinal, horizontal, vertical, oblique, U-shaped, hybrid;
  3. on the coverage area - a full or partial break.

The blood supply to the meniscus is irregular. The red zone is provided with capillaries and is placed in place of the fastening of its body with the capsule.

Behind it is a red and white zone, the central area is occupied by a white zone.

If the line of damage passes close to the inner edge, the chances of conservative healing are extremely small due to the small number of vessels.

At a young age, vertical and longitudinal ruptures are most often observed. In the elderly, they are hybrid and arcuate. If the inner meniscus was not completely ruptured, the part that has come off becomes mobile and shifts into the intercondylar cavity of the hip bone, thereby blocking the joint.

A gap along the oblique line occurs at the border of the central and posterior parts of the meniscus, as a result of which the edge of the rupture is compressed by the joint-forming surfaces. The signs of this form appear in the clicking sounds and the feeling of rolling in the knee.

Hybrid form is characterized by a break in several places at the same time. Can be present in the zone of the horn of the meniscus.

Treatment

In patients with a diagnosis, the knee joint meniscus rupture raises the question of whether to resort to surgery, and how long rehabilitation after surgery is. Very many tend to conservative methods of therapy, but this is not quite the right decision.

It should be understood that gaps in the knee structure are more effective to eliminate immediately, since a long and, often, useless treatment can worsen the condition and lead to additional difficulties in restoring the joint.

Operations are performed in case of significant ruptures, flattening of cartilages, detachment of the body and horns of the meniscus.

This may be an arthrotomy - an open method, in which large incisions are made to access the operated department, and arthroscopy, which represents a small invasive intervention.

In modern medicine, preference is given to the second method for a number of reasons:

  • the ability to diagnose damage at the highest level;
  • there is no need for long incisions of the bursa (articular bag);
  • minor traumatism of periarticular tissues;
  • quick and short rehabilitation;
  • does not require rigid fixation of the limb;
  • short stay in the hospital (no more than 2 days).

Contraindications

Arthroscopy can not be done on the following grounds:

  1. age exceeding 60 years;
  2. inflammatory infections;
  3. Cardiovascular diseases, postinfarction and post-stroke stages;
  4. exacerbation of tuberculosis;
  5. hepatitis;
  6. oncological diseases.

Types of arthroscopy

In the knee, there are 8 points for possible punctures. Usually, for meningus arthroscopy, two are enough. Through one in the joint cavity, an arthroscope (a kind of endoscope) is inserted, through which the surgeon can observe the damage pattern on the monitor.

In the articular cavity, physiological saline is pumped in order to perform a thorough examination from the inside. Surgical instruments for manipulation are inserted through a second puncture.

For anesthesia, a spinal method is used when the patient is conscious and can contact the doctor.

Types of arthroscopy depend on the nature of the meniscus rupture. The objectives of the operation may be:

  1. Recovery.
  2. Complete or partial removal (meniskectomy or resection).
  3. Transplantation.

Restoring the Meniscus

Recovery is possible with knee joint damage, which occurred recently. On the seam, a seam is applied. This procedure is carried out for people who have not reached the age of 40, who have the appropriate testimony:

  • separation of the meniscus from the capsule;
  • rupture at the periphery without offset or offset to the center;
  • longitudinal vertical rupture;
  • absence of pathological changes in cartilaginous tissues.

Resection and meniscectomy - partial or complete removal

The removal of part or all of the meniscus is carried out in the following situations:

  1. detachment of the fragment;
  2. break on the central-vertical line;
  3. complete thinning of the cartilage;
  4. complication.

At this time, they are trying to perform partial resection with alignment of the edges. Total removal is an exceptional measure. This is associated with the risk of joint deformity, and subsequently - the onset of gonarthrosis.

Transplantation

Transplantation represents an operative intervention to replace a fragment or the entire meniscus with donor or collagen material.

The variant of the donor implant is used for full meniskoektomii, artificial - for partial compensation of the meniscus.

Transplantation is associated with some danger, which is due to the long-term selection of a suitable implant in size.

The operation is shown, if available:

  • total destruction of the meniscus;
  • lack of reconstruction.

Recovery after surgery

Rehabilitation includes a set of activities, where the emphasis is on physiotherapy and curative gymnastics. The length of rehabilitation depends on the trauma of the meniscus and the complexity of the operation performed.

When resection, rehabilitative exercises should begin on day 8 after surgery. If there was a stitching of the meniscus, then the exercises will have to be postponed for a while.

Rehabilitation period takes about seven weeks, taking into account the subjective characteristics of the body.

At the initial stage, the actions are aimed at strengthening the hip muscles and stabilizing the knee, eliminating inflammation and restoring the normal circulation of the joint.

The amplitude of the movements should be limited. Exercises can be performed standing on a healthy leg, sitting and gradually unbending the limb, lying down and straining the femoral muscles.

In the future, restoration involves the development of gait and the resumption of motor function, the elimination of contracture and the strengthening of the muscles of the knee. At this time it is recommended to visit the gym and swimming pool, walk more and take bike trips.

Gymnastics for recovery

  1. Walking back along the treadmill.
  2. Stand at the wall. Between the waist and the wall, place the ball. Crouch, observing the angle of 90 degrees.
  3. Use the step (platform). First take a low, then increase the height. Rise and get down. make sure that the knee is not set aside.
  4. Training on an unstable platform to maintain balance.
  5. Take a long ribbon, at one end, attach it to a fixed object, the second - to a healthy leg. Make flies to the side. In this case, the muscles of both legs work.
  6. Jumping through the line and on the steppe. Muscles and the vestibular apparatus are trained.

Physiotherapeutic procedures

Physiotherapy is used to improve the metabolism and blood supply of articular knee tissues, as well as to activate the regeneration process.

They use magnetotherapy, laser therapy and muscle electrical stimulation. In the presence of edema and lack of mobility of the joint, a therapeutic massage is shown.

It is desirable to acquire the necessary skills for independent execution of the procedure, since the effect is achieved by the number of sessions.

All rehabilitation measures are appointed by the doctor, he also controls the patient's condition after the operation. If there are any complications or painful sensations in the process of rehabilitation, it is necessary to eliminate the causes and revise the set of measures.

A source: http://artrozmed.ru/lechenie/operacii-na-meniske-kolennogo-sustava-reabilitaciya-posle-operacii.html

Operation on the knee joint, at the meniscus: reviews. Rehabilitation after an operation on the knee joint meniscus

The question of in which situations surgery on the knee joint is needed at the meniscus is heard quite often. It is difficult to answer it unequivocally.

The testimonies of people who have experienced different problems with this body indicate some suspicion before the operation, so they sought conservative methods of treatment.

In order to fully reveal the topic of the need for surgical intervention, you need to understand what the meniscus is.

What is the knee joint meniscus?

Cartilage pads, which are a kind of shock absorbers and stabilizers, as well as increased mobility and flexibility, are called meniscuses of the knee joint. If the joint moves, the meniscus will shrink and change its shape.

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The knee joint includes two meniscus - medial or internal and lateral or external. They are joined together by a transverse ligament in front of the joint.

The peculiarity of the external meniscus is greater mobility, and therefore its injuries are higher.

The inner meniscus is not so mobile, it depends on the inner lateral ligament. Therefore, if it is injured, then this bunch is also damaged.

In this case, surgery is required on the knee joint at the meniscus.

Causes of various meniscus injuries

So why are their injuries occurring, and in what cases is an operation necessary for the knee joint meniscus?

  • To the rupture of the cartilaginous lining the injuries are caused, which are accompanied by the movement of the shin in different directions.
  • The knee joint meniscus can be damaged (treatment, surgery and other methods will be discussed below) in case of excessive extension of the joint during reduction and removal of the tibia.
  • Gaps are possible with direct action on the joint, for example, from a stroke of a moving object, an emphasis on a step or a drop on the knee.
  • With repeated direct contusion, a chronic traumatism of the meniscus can occur, which can lead to a rupture during sharp rotation.
  • Changes in meniscus can occur with certain diseases, such as rheumatism, gout, chronic intoxication (especially in those people whose work is associated with prolonged standing or walking), with chronic microtrauma.

Meniscus treatment methods, reviews

In all cases, surgery is not shown, as the damage to this tissue may be different.

There are several ways to restore the functionality of the meniscus.

For this purpose, physiotherapeutic procedures are carried out, various medications are used, and traditional medicine recipes are also used.

Many patients choose more conservative methods, as evidenced by their feedback. But they also note the risk of losing time for recovery.

When they instead of carrying out the operation, which experts advised, they chose physiotherapy or treatment with folk remedies, it only got worse. In such cases, however, an operation was performed, but already more complicated and with a long recovery period.

Therefore, sometimes it happens that the operation on the knee joint is inevitable at the meniscus. In what cases is it appointed?

When is an operation performed on the knee joint meniscus?

  1. When crushing the meniscus.
  2. If there is a break and a displacement of it. The body of the meniscus is characterized by circulatory insufficiency, therefore, in the case of a rupture, there is no question of self-healing. In this case, a partial or complete resection of the cartilage is indicated.
  3. With a hemorrhage into the joint cavity, an operation is also performed on the knee joint meniscus. The patient's testimonies testify to a fairly rapid rehabilitation in this case.
  4. When the body and the horns of the meniscus completely disappeared.

What kinds of manipulation are used?

The operations are performed for stitching or partial removal of the cartilage. Sometimes an operation to remove the meniscus of the knee joint is for the purpose of transplanting this organ. In this case, some of the damaged cartilage is removed and replaced with a graft.

This is not a too dangerous surgical intervention, although some patients, according to their reports, were afraid to resort to the help of transplants. After such manipulation, there are few risks, since donor or artificial menisci take root without any problems.

The only drawback in this situation is long-term rehabilitation. On average, it takes 3-4 months for successful transplant survival. After that, the working capacity of a person is gradually restored.

Those who do not want to lose so much time for rehabilitation resort to radical methods of restoring their torn cartilage.

Recently, medicine has reached such a level that it is possible to save even a torn to the part of the meniscus. To do this, do not delay the operation and in a calm state, with properly organized treatment, spend at least a month on rehabilitation.

Proper nutrition also plays a role here. Patients' opinions can be found opposite: some are inclined to replace cartilage with a donor or artificial one, while others prefer their own.

But in these two cases, a positive result is possible only with the correct approach to rehabilitation after surgery.

Application of arthroscopy of the knee joint

With the help of arthroscopy, the surgeon can see most of the structures inside the knee joint. The knee joint can be compared to the hinge, which is formed by the terminal sections of the tibia and femur.

The surfaces of these bones adjacent to the joint have a smooth cartilaginous cover, due to which they can slide when the joint moves. Normally this cartilage is white, smooth and elastic, three to four millimeters in thickness.

With the help of arthroscopy, you can identify many problems, including the rupture of the knee joint meniscus. Operation with arthroscopic technique will help to solve this problem. After it, the person again can fully move.

Patients note that today this is the best procedure for restoring the function of the knee joint.

Operation on the knee joint at the meniscus - duration

When arthroscopy through small holes in the joint cavity, surgical instruments are introduced.

The arthroscope and the instruments that are used in this procedure allow the doctor to examine, remove or stitch the tissues that are inside the joint. The image through the arthroscope falls on the monitor.

The joint is filled with a liquid, which makes it possible to see everything clearly enough. The whole procedure lasts no more than 1-2 hours.

According to statistics, among all injuries of the knee joint, half is due to damage to the knee joint meniscus. The operation makes the patient feel better, relieves swelling. But, the patients note, the result of this procedure is not always predictable. It all depends on the unfolding or worn out cartilage.

Rehabilitation with conservative treatment, reviews

Rehabilitation is required not only after surgery on the meniscus, but also as a result of any treatment for this cartilage. Conservative treatment involves a two-month rehabilitation with the following recommendations:

  1. Make cold compresses.
  2. Every day, devote time to physical therapy and gymnastics.
  3. Use of anti-inflammatory and analgesic drugs.

Rehabilitation after surgery

A few other requirements for recovery involves surgery on the knee joint meniscus.

Rehabilitation in this case involves a little more effort, the same note patients.

This is due to the fact that there was more serious damage to the meniscus, as well as penetration through other tissues of the body. To recover from the operation you will need:

  • Initially, it is necessary to walk with a support to not load the joint - it can be a cane or crutches, the duration of use of which determines the doctor.
  • After that, the load increases slightly on the joint - movement occurs already with the distribution of the load on the joints of the legs. This happens 2-3 weeks after the operation.
  • Then independent walking with ortheses - special fixators of joints is supposed.
  • After 6-7 weeks it is necessary to begin medical gymnastics.

With strict adherence to these recommendations, complete restoration of the knee joint occurs 10-12 weeks after surgery.

Postoperative complications

What negative consequences can the operation on the meniscus of the knee joint leave after itself? Feedback indicates that postoperative complications are rare, but they do happen.

  1. The most common is intra-articular infection. It can get into the joint if the rules of asepsis and antiseptics are not respected. Also, the already existing purulent focus in the joint can lead to infection.
  2. There are also damage to the cartilage, meniscus and ligaments. There have been cases of breakage of surgical instruments inside the joint.
  3. If it is wrong to approach rehabilitation after surgery on the knee joint, its stiffness, up to ankylosis, is possible.
  4. Other complications include thrombemia, gas and fat embolism, fistulas, adhesions, nerve damage, hemarthrosis, osteomyelitis, sepsis.

Sports after surgery

Professional athletes are trying to return to the lessons as soon as possible after a meniscus injury and surgical intervention. With a specially developed rehabilitation program, this can be achieved after 2 months, they note.

For rapid recovery, power simulators (bicycle ergometers), exercises in the pool, certain exercises and so on are used.

When rehabilitation comes to an end, you can run on the treadmill, pass the ball, simulate exercises related to a particular sport.

The responses of these patients indicate difficulties in rehabilitation in this way, since it is always difficult to develop a painful joint. But after hard work and patience you can achieve good and fast results.

Proper rehabilitation after surgery on the knee joint meniscus leads to complete recovery. Forecasts of doctors are favorable.

A source: http://.ru/article/221109/operatsiya-na-kolennom-sustave-na-meniske-otzyivyi-reabilitatsiya-posle-operatsii-na-meniske-kolennogo-sustava

How does the recovery after surgery for meniscus?

Rehabilitation after surgery on the knee joint meniscus takes place in several stages. The result of surgical intervention largely depends on a competent program for restoring motor functions, so it is important to get acquainted with the features of therapeutic activities.

What is the importance of rehabilitation

In arthroscopy, surgeons inject an irrigation fluid into the joint cavity, which is used to delimit joints and organize space for surgery. Sometimes this fluid can seep into the surrounding soft tissues and cause hemorrhage and swelling.

It is not surprising that after the operation there is swelling of the tissues, the patient experiences severe pain. During the surgical intervention, nerve endings and blood vessels are damaged, which contributes to the development of the inflammatory process.

Pain and swelling cause in a person the fear of moving a limb. The patient may develop arthrosis. Therefore, the essence of rehabilitation after resection of the meniscus is as follows:

  • to eliminate painful sensations;
  • accelerate the process of tissue regeneration;
  • normalize the secretion of joint fluid;
  • restore the motor function of the knee.

Restoration after an arthroscopic meniscus consists of a number of treatment procedures:

  1. drug therapy;
  2. physiotherapy;
  3. physiotherapy.

Early and late postoperative period

Early recovery after surgery for the meniscus is intended for:

  • elimination of the inflammatory process;
  • improvement of circulatory processes;
  • prevention of muscle atrophy.
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Immediately after surgery, the knee joint is immobilized. Doctors prescribe drugs of the non-steroid group, which are taken as local anesthetics.

In case of accumulation of fluid in the joint, a puncture should be done to prevent infectious processes. Bactericidal agents are mandatory.

After resection of the meniscus, the doctor appoints chondroprotectors, which contribute to the restoration of damaged cartilaginous tissue. But such medicines must be taken at least 3 months. Experts often prescribe drugs in the form of injections.

In the postoperative period, physiotherapy is necessary. LFK is an important component of the rehabilitation course.

The late postoperative period also has its own peculiarities. The operation on the meniscus implies a gradual increase in the load on the joint. Within 20 minutes, patients do special exercises 3 times a day. Exercise is carried out until the disappearance of painful symptoms.

Exercises after removal of the knee joint meniscus include:

  1. Active movements of various types with the use of safety.
  2. Squats.
  3. Walking with rolls stop back.
  4. Exercises that promote endurance.

During the rehabilitation period, massage is allowed. But it is important to understand that immediately after the operation the abovementioned medical procedure is banned, if the tissue rupture was sewn.

After all, such manipulation can cause damage to the joint capsule. Massage the region of the lower leg and thigh with the purpose of improving tissue regeneration processes.

The length of the recovery period depends on the severity of the damage. It is also important to get acquainted with the existing types of surgical intervention with a meniscus rupture.

Tear plastic

When the meniscus is damaged, doctors use the stitching method. The operation is performed with the help of arthroscopy.

Patients are in the clinic for no more than 2 days in case of surgery. Postoperative therapy lasts no more than 3 weeks. It is important to follow a number of recommendations during the rehabilitation period:

  • 2 days after the operation, you can already walk using the pedestal. But only the doctor can determine the extent to which walks are permissible.
  • For 21 days after surgery, you should move with crutches. You should try not to bend your knee.
  • During the following month, it is necessary to wear an orthosis. The doctor already allows you to bend your knee at this stage.
  • After 2 months you can walk without support.
  • After six months, the doctor may allow certain sports to be practiced.

During the year, it is possible to complete a complete recovery, if you follow the recommendations of specialists.

Meniscatectomy

Resection of the meniscus is a more gentle kind of operation for the knee, since rehabilitation takes place in a shorter period than in the case of the stitching procedure.

It is necessary to consider how the recovery process after meniscactomy normally passes:

  1. On the third day, a number of exercises are carried out to prevent muscle atrophy. The complex is developed on an individual basis, guided by the physiological characteristics of each patient, as well as the presence of positive dynamics of clinical symptoms after surgical interference. Exercises can be adjusted in the process of restorative therapy.
  2. At the beginning of the second week, seams are removed.
  3. For 2 consecutive weeks, the knee is subjected to motor loads. Patients use crutches during this rehabilitation period. They are discharged from the hospital, so all medical procedures must be carried out at home until the painful symptoms disappear completely.
  4. After a month, patients can safely go to work.
  5. After 2 months, people are allowed to exercise.

The positive result of the operation and the duration of the rehabilitation period largely depend on selected type of surgical intervention, the professionalism of the doctor, the state of the patient's health and age. Therefore, in order to avoid deplorable consequences, pass a thorough diagnostic examination and responsibly approach the rehabilitation program after the operation.

A source: https://OrtoCure.ru/travma/menisk/reabilitatsiya-posle-operatsii-na-menisk-kolena.html

Operations on the knee joint meniscus: types, indications, conduction

Partial or complete rupture of the knee joint meniscus -widespread trauma, which is most often received by athletes and people of advanced age.

In young patients, the traumatic factor is associated with a bruise, or increased strain on the joint, in the elderly - with degenerative changes in the cartilaginous tissue (a consequence of chronic arthrosis).

Sports trauma makes itself felt by acute pain, limb edema, blockage of the knee joint, which is the reason for immediate contact with a doctor.

The degenerative rupture proceeds with less pronounced symptoms, but it is possible to suspect such a pathological process by indirect signs like swelling in the knee region, limitation of joint mobility, aching pain, which at times gets intolerable character. In the absence of a timely operation for the meniscus, the traumatic rupture becomes degenerative over time.

Diagnosis of a meniscus injury

The diagnosis of "meniscus rupture" is based on radiographic and MRI data. Classification of damage to part of the knee joint is carried out by the following features:

  • In the place where the rupture occurred (in the area of ​​the body of the meniscus, anterior or posterior horn);
  • According to the form (longitudinal, horizontal, radial, oblique, combined, arc-shaped).
  • On the scale of the injury (complete or incomplete break).

Meniscus is supplied with blood unevenly. Peripheral, or as it is also called, the red zone, is located at the site of the connection of the body of the meniscus with the capsule.

In the central part there are red-white and white-vascular zones.

The closer to the inner edge of the meniscus the line of rupture passes, the fewer vessels fall into the area of ​​injury, and the less chance of conservative healing of the injury.

At a young age, the rupture often passes in the longitudinal and vertical direction, more rarely - along an oblique line.

In the elderly, as a rule, there are combined, or arc-shaped lines of injury, which are also called the "handle of the watering can."

With incomplete rupture of the medial meniscus, the detached part acquires mobility, which often leads to its displacement into the intercondylar fossa of the femur, as a result of which the joint is blocked.

The oblique fracture most often occurs on the border line between the central and posterior part of the meniscus, which leads to a jamming of the rupture edge between the articular planes. With this type of joint damage, there are characteristic clicks and a feeling of rolling in the knee area.

The combined rupture affects several planes simultaneously, or the area of ​​the horn of the meniscus is localized.

The horizontal longitudinal rupture is often a consequence of cystic enlargement. The line of rupture extends from the inner edge to the joint site of the meniscus with the capsule.

Trauma develops under the influence of shearing force in the medial part, and lead to the protrusion of the tissue in the region of the joint gap.

The knee becomes swollen, the swelling gradually increases.

Treatment of a meniscus tear

The treatment of meniscus ruptures can be conservative, and radical.

Surgical intervention, in turn, involves the complete or partial removal of the meniscus.

A separate direction in surgery is cartilage transplantation - the technique has conflicting reviews, and therefore not widely disseminated.

Operations on the meniscus can be urgent (the patient has been treated with severe pain after trauma), and planned (appointed after the examination). It should be noted that surgery for fresh injuries is the most successful in terms of surgery, and rehabilitation.

Attempts to restore the functionality of the joint in a conservative way often lead to an aggravation of the situation, since the cartilaginous tissue that does not receive blood supply becomes loose and softened.

The freely moving edge of the damaged meniscus touches the cartilage, gradually erasing it until it comes into contact with the bone tissue.

This process, called,chondromolation, has 4 stages:

  1. First, cartilage softens;
  2. The second - the cartilage breaks up into fibers;
  3. Third - the tissue is thinned, a dent is formed.

Resection of the meniscus (total and partial)

Resection of the meniscus (meniscectomy) is performed in the absence of the prospects for conservative treatment.Indications for the operation is a confirmed diagnosis of the following types of meniscus lesions:

  • The presence of a break in the center line in the vertical direction;
  • Detachment of the fragment of the meniscus;
  • Rupture in the peripheral region (with and without bias).

The complete removal of the cartilaginous layer allows the patient to get rid of pain and blockade of the knee joint, but leads to the development of dystrophic changes in the articular apparatus in the distant period. Arthrosis develops in 85% of cases 15 years after the operation.

The main goal of partial removal of the meniscus is the high-precision treatment of the inner edge of the meniscus, after which the edge acquires an even line.

If there are destructive changes in the cartilage, the doctor prescribes postoperative treatment aimed at improving the condition of the joint ligament.

For these purposes, special preparations are introduced into the knee area, which increase the elasticity and elasticity of the tissues.

The technique of resection of the meniscus

A low-invasive (gentle) method of removing the meniscus (a part of the meniscus) is performed using an astroscope (endoscopic method).

In the area of ​​the knee joint, three small incisions are made, one of them is inserted, the apparatus projecting the image cavities of the knee joint on the monitor, through the other - a surgical instrument, through the third - the physiological solution.

Manipulation is carried out in conditions of clear visualization of the surgical field. Particles of damaged tissues are removed together with the solution from the joint cavity, the meniscus flaps are removed, the edges are leveled and sutured.

Fastening of the damaged (torn off) fragment of a meniscus is carried out by means of seams, with use of screws, arrows, special darts and other locks.

Total removal is carried out only if the meniscus is completely destroyed.

Advantages of atroscopy are:

  1. High accuracy of diagnostics;
  2. Minimal damage to skin and soft tissues;
  3. Slight blood loss;

Complications after meniscectomy

Operative treatment is associated with minimal risks, but after resection of the meniscus, there may be some complications that the patient should be aware of:

  • Redness and swelling of the knee;
  • Hematomas in the joint cavity;
  • Numbness of the knee;
  • Increased temperature, chills (development of local infections);
  • Allergy to anesthesia;
  • Weakening of muscles and ligaments;
  • Thrombus formation.

After surgery, antibiotics and anticoagulants are prescribed to prevent infections and thromboembolism.

Contraindications to the operation

Contraindications to surgery on the meniscus are:

  1. Diseases of the hematopoiesis;
  2. Old age;
  3. Purulent infections;
  4. Postinfarction and post-stroke state;
  5. Tuberculosis in the active stage;
  6. Viral hepatitis;
  7. Oncological diseases.

Before the operation, the patient passes the tests, undergoes an additional examination to determine the activity of chronic diseases(hypertension, peptic ulcer and duodenal ulcer, cholecystitis, gastroduodenitis, neurodermatitis, etc.). If necessary, a treatment course is conducted to stabilize health indicators.

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Recovery period

In the first two days after the operation, a cold compress is applied to the knee area, and anesthetics are prescribed. If there are no signs of infection, joint development begins.

Showing walking with the support of crutches, flexion-extensor movements in the ankle and toes, exercises to restore the functionality of the quadriceps muscle of the thigh.

Accelerates the recovery process of physiotherapy and massage.

The rehabilitation program after surgery is developed individually for each patient, taking into account the age, severity of the injury, the success of the operation performed, and the psychological state.

In the absence of complications, the gait is restored in a month and a half.In two months the patient can crouch, swim, jog, gradually increasing the load.

The period of full recovery is six months.

Conversation with the doctor

Before the planned operation, the patient should clearly understand the pathology picture. The doctor answers the following questions:

  • The nature of the meniscus rupture (trauma or degenerative rupture);
  • Where is the gap located;
  • In what state are the ligaments (there are injuries);
  • What are the chances for a full restoration of the joint;
  • When you can start work (training).

Obtaining complete and reliable information will help you better prepare for the operation and recovery period.

Cost of operation

The cost of an operation performed with an arthroscope is from 40 to 60 thousand rubles. The quota is rather difficult to obtain, and a long wait for the operation is impractical, as the destructive changes develop rapidly in the knee joint.

The cost of the rehabilitation period depends on the number of services, the status of the clinic, the comfort of staying in a medical institution.The patients' testimonies attest to the high efficiency of surgical treatment.

In the first days after the operation, limb numbness is observed, as well as a pronounced pain syndrome, which fades by the end of the week.

If you follow the recommendations of doctors who develop rehabilitation programs, the functionality of the knee joint
recover fully.

A source: http://operaciya.info/orto/menisk/

Effects of removal of the knee joint meniscus and recovery technique

When the meniscus is damaged, a different treatment is prescribed, which depends on the stage of the development of the disease.

In severe injuries, or because of the lack of results of traditional treatment, a meniscus is removed knee joint, and the presence of consequences after surgery depends on the rehabilitation period.

The appointment of a meniscus

To understand the possible consequences of a rupture of the knee joint meniscus, one should know about the purpose of this internal part of the knee.

Meniscus is a cartilaginous plate that performs special functions:

  1. spreads the load on the articular area, increasing its support surface;
  2. more elastic cartilaginous tissue, with respect to other cartilages, serves as a limb shock absorber for various movements;
  3. if there is damage to the cruciate ligament in the knee, then the meniscus eliminates the displacement of the large femur.

Each knee is provided with two meniscuses (inner and outer). The outer (lateral) meniscus is fixed more freely in relation to the articular parts, so it is rarely injured.

Damage occurs, mainly, with the medial (internal) knee damper, due to rigid fixation to the tibia.

Injuries and consequences of damage

Not all meniscus lesions result in surgical manipulation. Damages can occur on their own, or their causes are certain provoking factors.

To traumatize the meniscus are:

  • detachments of ligaments and the meniscus themselves (in parts or full);
  • detachment of the cushioning cartilage from the fixing section.

The most dangerous injury of the meniscus of the knee joint is its separation, and the consequences of late treatment for medical help can be the most serious:

  1. Articular tissues begin to degenerate, which can lead to disability;
  2. when the stage is started, and the damage is not healed, the knee joint passes several stages chondromalacia (gradual destruction of severed meniscus patches and other tissue surfaces joint). Osteoarthritis begins;
  3. Creation of friction of articular parts, arising from a lack of synovial fluid;
  4. the emergence of inflammatory pathologies in the knee.

If timely treatment, then the consequences of knee injury can be avoided, and the traditional method of treatment (medication together with physiotherapy) is avoided.

There are the following procedures for the operation of the knee meniscus:

  • excision (incomplete);
  • reconstruction of cartilaginous tissue by stitching;
  • resection of the damaged area, and its replacement with an implant;
  • arthroscopic method.

Arthroscopy is considered the most effective method of surgical intervention, and at the same time the least traumatic.

The operation to remove the knee joint meniscus can be complicated by the consequences. This is due to a sharp increase in the joint load, and the subsequent course of arthrosis or arthritis of the knee joint.

Complete resection of a damaged meniscus is rarely performed. If the meniscus is removed, the consequences can eclipse the entire effect of surgical manipulation.

When the suturing operation is performed, a postoperative consequence, such as a repeated meniscus rupture, is possible.

The sooner the treatment starts, the more opportunities to avoid surgery and further unwanted complications.

Next, we will describe in more detail the possible consequences during the recovery process.

Recovery after surgery

The rehabilitation period after the operation on the meniscus depends on the severity of the injury, the type of surgery, and for an individual patient it will be individual.

After surgery, the following complications are possible:

  • can develop inflammation due to infection in the cavity;
  • trauma of blood vessels (rare cases), and the occurrence of blood clots;
  • pinching the nerve fibers of the periarticular region;
  • allergic reactions after anesthesia.

The listed complications are possible, but they do not happen often.

To restore the motor activity, it is necessary to adhere to medical appointments in the postoperative period at the meniscus of the knee joint.

When the cartilage plate is removed, it is necessary to protect the limb for a week, avoiding loads. To move around, it is recommended to take crutches to reduce the load, and because a limb is superimposed on the limb.

Perform special gymnastics for recovery after a meniscus injury begin already from the second day after surgery. Specific activities are selected for each patient.

Regardless of the method of operation at the knee joint meniscus during the postoperative period, traditional treatment is prescribed.

To exclude postoperative pathologies, anti-inflammatory medications are prescribed, simultaneously eliminating edema and normalizing blood flow.

Anesthetic drugs are prescribed in the first days after the operation.

It is necessary to observe the following, the basic rules for the rehabilitation and recovery of a meniscus after a rupture and an operation:

  1. in the first week, when driving, be sure to use the support (cane or crutches);
  2. to give a load on the operated limb should be gradually. For this, special exercises are carried out to restore the muscle tissue and ligaments of the joint;
  3. it is necessary to use special knee locks (orthoses). Orthopedic products protect the fragile limb from damage, and support the knee in the correct position;
  4. more complex physical exercises can be started after a lapse of 6 or 7 weeks after surgery.

If resection of the knee joint meniscus is performed, the recovery after the operation lasts longer, in comparison with arthroscopy.

It happens that the body does not take the implant, and rejects the alien body. To exclude such a serious complication, the patient is under medical control.

Light loads are allowed no earlier than 6 weeks after the operation.

For professional athletes who have received a knee injury, and subsequently operated on, a special reparative technique has been developed. Rehabilitation activities are aimed at developing separate muscle groups. Specially designed exercises are used for this purpose.

Restoration after arthroscopy

Operation by the method of arthroscopy refers to the modern and sparing method of partial resection of the meniscus. The essence of manipulation lies in the following surgical aspects:

  1. in the articular cavity several incisions are made, through which an optical device is inserted;
  2. With the help of the inserted probe, the torn off part of the cartilage is eliminated;
  3. the edges of the pointed fabric are gently sewn;
  4. at the last stage of surgery, the remaining elements of the meniscus are fixed to the joint capsule.

Gentle technique allows you to exclude postoperative complications, and with further adherence to the regimen, return to the old way of life.

During the recovery time after arthroscopy, the following rules must be adhered to:

  • full restoration of the knee joint is possible after 3 months or a year. The recovery period is calculated according to the individual characteristics of the organism, and the severity of injury;
  • starting from the second day after the arthroscopy, you need to perform special exercises. Walk with crutches at least 3 weeks, and then the same time with a special fixator (orthosis);
  • any, full physical exercise or sports activities are resolved after a lapse of six months from the date of the operation. If the patient was engaged in a game sport before the injury, then the training is allowed no earlier than 9 months.

During the entire rehabilitation period it is necessary to perform medical appointments. Usually prescribed massage sessions, physical therapy courses, special physical training. To restore joint tissues, a course of medications is prescribed.

Rehabilitation after stitching of a torn meniscus

In the first postoperative days, any movement is carried out only with crutches. A small, partial load is allowed in a month.

Normal, everyday loads are resolved at week 5.

If you received a medical clearance, then you can do exercises after 2 months, as the recovery measures will end. Extended, long-term training is allowed after six months from the date of surgery.

Any person can get injured limbs in the knee. But, if you take elementary care and perform preventive measures, you can avoid injuries.

If you are engaged in professional sports, you should definitely use special, fixing knee protectors, which protect the knee from impact, and prevent injury when falling.

In ordinary, everyday life, it is recommended to wear comfortable shoes to keep the feet comfortable.

A moderate, physical load is necessary. Among sports activities it is better to give preference to such as biking, walking, jogging. With such sports, the knee will be strengthened, and the likelihood of injury will be minimal.

With increased physical activity, there is always the possibility of damage to the knee joint.

A source: http://sustavec.ru/reabilitatsiya/posledstviya-udaleniya-meniska-kolennogo-sustava-i-matodiki-vosstanovleniya/

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