Meniscal Procedures
Meniscectomy
By far the most common procedure to be performed on the meniscus (>90%), meniscectomy refers to removal of torn meniscus tissue that is unstable, causing symptoms such as sharp pain with pivoting, and catching or clicking in the joint.
During this arthroscopic procedure, a fiber-optic camera is inserted through small incisions into the knee joint and the tear is removed, leaving as much healthy tissue behind as possible.
The video on the left demonstrates aspects of the meniscectomy procedure, demonstrating the tear, then initial cleaning of loose flaps with the shaver, followed by trimming.
Meniscal repair
In this procedure, a torn meniscus (buckethandle tear) is arthroscopically repaired with small implanted suture anchors.
The video to the left demonstrates how unstable the meniscus is initially. By pulling with the probe the meniscus can be pulled too far into the joint. This can lead to locking of the knee and further tearing. After repair with several suture devices (pictures below), the meniscus is now stable to probing.
Meniscal Transplantation
Frequently a torn meniscus cannot be repaired and has to be removed instead. Depending on how much meniscal tissue is lost, symptoms of meniscal deficiency can develop where the knee is overloaded locally due to the lack of shock absorption. If symptoms of activity-related pain and swelling persist, meniscal transplantation can be considered. In this procedure, meniscal tissue from an organ donor is carefully chosen to match the size of the required meniscus. The tissue is cleaned and frozen by a transplant organization, then shipped to the hospital before the procedure.
During the procedure, Dr. Gomoll arthroscopically removes any non-functional remnants of the prior meniscus, prepares the knee and then introduces the new meniscus through a small incision in the front of the knee. The meniscus is repaired to the tibia and sutured to the joint capsule through a second small incision on the side of the knee.
Rehab consists of crutches for 3 weeks and a knee brace for the first 6 weeks after surgery.
