Meniscal Tears: What You Need to Know About Arthroscopic Surgery

Meniscal injuries are among the most common knee problems, affecting both young athletes and less active people. Whether it is a traumatic or degenerative injury, pain and functional limitation can become disabling, negatively affecting the quality of life. The good news is that arthroscopic surgery offers effective and minimally invasive solutions: selective meniscectomy and meniscal suturing. But which approach is best for you?

In this article, we explore the two main surgical options, helping you understand what to expect and how to make the best choice.

What is a Meniscal Tear and Why Does It Hurt So Much?

The menisci are two C-shaped fibrocartilaginous structures located between the femur and the tibia. They act as shock absorbers, redistributing the load and improving the stability of the knee. When one of them breaks, either due to trauma (often related to sports or intense activities) or wear and tear related to age, pain, swelling and difficulty in daily movements can occur.

Varie tipologie di lesione meniscale: ad ognuna il suo trattamento

Surgical Solutions: Selective Meniscectomy vs. Meniscal Suture

1. Selective Meniscectomy: Remove Only What Is Necessary

Selective meniscectomy involves removing the damaged portion of the meniscus, preserving as much healthy tissue as possible. This technique is primarily indicated in cases of degenerative meniscal lesions or in situations where the tissue is irreparably compromised.

• When is it indicated?

Meniscectomy is often chosen in patients with small or degenerative lesions, where the residual tissue is unable to heal on its own.

• What are the benefits?

It is a short procedure, with recovery times generally quicker than meniscal suturing. After the procedure, many patients are back to walking without pain within a few days.

• What does science say?

According to a study published in Arthroscopy: The Journal of Arthroscopic and Related Surgery (Papalia et al., 2022), selective meniscectomy significantly improves symptoms in the short term, especially in patients with advanced degenerative lesions.

2. Meniscal Suture: Repair to Preserve

Meniscal suture, on the other hand, involves repairing the meniscus using advanced suturing techniques. This approach aims to preserve the natural function of the meniscus, reducing the risk of early osteoarthritis.

• When is it indicated?

It is the ideal choice for young patients with traumatic lesions localized in the “red zone” of the meniscus, that is, the well-vascularized peripheral area that has a high healing potential.

• What are the benefits?

Preserving the meniscus reduces the risk of long-term joint wear. This is especially important for those who want to maintain an active lifestyle and prevent future problems.

• What does science say?

A 2021 review in The American Journal of Sports Medicine found that patients who underwent meniscal suture showed better long-term functional outcomes than those treated with meniscectomy, especially in patients under age 40 (Noyes et al., 2021).

Come appare una sutura meniscale di una lesione radiale

What Would You Like to Hear as a Patient?

If you have a meniscal tear, it is normal to feel worried about the surgery and recovery time. Here is what I want to tell you as an orthopedic surgeon with years of experience:

1. Every knee is unique. The best treatment will depend on your age, activity level, and type of injury.

2. Arthroscopic surgery is safe and effective. It is a minimally invasive procedure that uses a camera and precision instruments to operate without damaging healthy tissue.

3. Recovery is your ally. With a well-structured rehabilitation program, most patients return to daily activities and, often, sports.

Historical Facts and Curiosities

The development of arthroscopic surgery dates back to the 1950s, but it became a standard in the 1980s thanks to the miniaturization of cameras. Interestingly, the term “arthroscopy” comes from the Greek arthron (joint) and skopein (to observe). Today, thanks to technological advances, these techniques allow us to treat meniscal injuries with extraordinary precision and with recovery times that were unthinkable just a few decades ago.

Conclusions: Which Option is Best for You?

The choice between selective meniscectomy and meniscal suture depends on multiple factors. It is essential to discuss thoroughly with your surgeon, weighing the pros and cons of each option in light of your specific needs.

If you would like more information or a personalized consultation, visit my website or book a visit. Your knee deserves the utmost attention and care!

Come appare una lesione traumatica su Risonanza Magnetica

Cartilage Lesions: An Unexpected Discovery

During arthroscopic surgery for a meniscal tear, cartilage lesions that were not visible on MRI may also be identified. These lesions, often located in the same area as the pain, can significantly contribute to the patient's symptoms and discomfort. Cartilage, which is essential for joint function, does not have nerve endings, but its deterioration can cause inflammation and biomechanical changes that lead to pain and stiffness.

This finding is not uncommon, especially in patients with degenerative or long-standing meniscal tears. Arthroscopic surgery allows these tears to be treated concurrently, with techniques such as cartilage debridement, microfracture, or the application of cartilage substitutes, thus improving the overall clinical picture. Recent studies have shown that treating cartilage tears during meniscal repair can significantly improve functional outcomes and reduce residual pain (Widuchowski et al., Knee Surgery, Sports Traumatology, Arthroscopy , 2020).

For this reason, it is important to rely on an expert surgeon who knows how to evaluate and treat any associated pathologies to ensure a complete and lasting recovery.

Bibliography

1. Papalia R et al. “Selective meniscectomy: Indications, outcomes, and complications.” Arthroscopy . 2022;38(3):432-441.

2. Noyes FR et al. “Meniscus repair versus meniscectomy: A systematic review.” The American Journal of Sports Medicine . 2021;49(2):452-461.

3. Logerstedt DS et al. “Meniscal injuries: Evidence-based surgical management.” Journal of Orthopedic Research . 2021;39(5):935-945.

Want to know more? Click here.