The meniscus plays a decisive role in distributing the load on the joint, providing support and stability to the knee during flexion, extension and rotation.

What is a meniscus?

The most complex musculoskeletal system in the musculoskeletal system, the knee joint, contains two mobile, fibrous, C-shaped cartilage layers called the meniscus. The meniscus plays a decisive role in distributing the load on the joint, providing support and stability to the knee during flexion, extension and rotation. In addition, the elastic elements protect the hyaline cartilage of the articular bones, which prevents damage and reduces the likelihood of arthritis. The location of the fibrous cartilage bodies is between the thigh bone and shin bone.

The meniscus, as specific cartilage structures of the knee joint, performs a shock-absorbing and stabilising function when the knee is supported. In appearance, they resemble small cartilage pads between the articular ends of the thigh and shin bone.

How do I know if my meniscus is damaged?

Meniscus having a function of cushioning pads, which protect the knee joint structures from forceful shocks, increased friction and destabilisation of the joint as a whole, are often the first to be hit, in the literal sense of the word. Although they have special properties of elasticity, extensibility, and resistance to mechanical stress, the meniscus can easily be damaged under unfavourable circumstances. 

Meniscus cartilage tissue damage may occur during sports activities, falls, unphysiological twisting and abrupt bending and unbending of the knee, rotating movements of one leg, rotation of the limb in a bent or half-bent position with the fixed foot, accidental fall from a high place, etc. Consequently, cartilage damage may occur as a result. This can cause the cartilage fibres to tear and inhibit the function of this joint.

 Meniscectomy is often necessary for the partial or total removal of the meniscus, its fusion or prosthetics. A conservative approach is only advisable for minor injuries.

What is a meniscectomy?

A meniscectomy is performed when the cartilage is damaged and causes pain or problems with knee movement. The most popular surgery method is arthroscopic meniscectomy, in which the menisci are accessed through small punctures into the joint cavity. The surgery is performed directly into the joint cavity using endovideosurgical techniques. This minimally traumatic operation ensures a short rehabilitation period and fast recovery of joint function.

The meniscectomy is performed in case of the following indications:

  • Pain in the knee joint associated with meniscus damage and not treatable by other methods
  • Recurring joint blockages – inability to fully move the joint (can occur due to trauma or due to the so-called discoid meniscus)
  • Total tear of the meniscus in its non-vascular part
  • Meniscus cysts

Complete removal of the meniscus of the knee joint is unavoidable if the diagnosis shows a tear in most of the body or a fragmentation of the cartilage layer. Fortunately, this is extremely rare. Organ-sparing surgery, which is predominantly performed, involves partial removal of the meniscus of the knee joint, i.e. resection of only the non-viable part. As for conservative medicine, it is suitable for treating minor fibre tears, micro-traumas, and structural degenerative-dystrophic changes, provided these do not cause impingement or joint instability.

Doctors say that patients do not always go to the hospital immediately but years later after they have experienced the injury. So what seemed like an ordinary contusion before, after a while, leads to severe complications. As the cushioning pad does not have a sufficient network of blood vessels, there are practically none; some tears in certain areas cannot heal on their own – they must either be removed or stitched.

After meniscectomy rehabilitation and physiotherapy

Rehabilitation after a meniscectomy is no less important than the surgery itself. Therefore, after a meniscectomy, everything depends not on the hands of the surgeon but patient’s responsibility and actions. Thus, the patient’s first support should be orthopaedic, physiotherapist, trauma and exercise specialists.

Since the joint is immobilised after surgery, restoring the patient’s usual walking pattern is vital after removing the immobilisation bandage and allowing them to return to their routine. The rehabilitation programme after meniscus resection includes massage, physiotherapy and physical therapy. The choice of procedures is individual and depends on the complexity of the surgical intervention. Meniscus rupture, removal and implantation of meniscus implants imply different terms and complexes of rehabilitation.

The postoperative treatment of a partially or completely removed meniscus is considerably easier than if the structures are stitched together. The therapeutic after-meniscectomy programme is planned individually for each case. After rehabilitation, there are no restrictions on physical activity. But it is important that the doctor’s orders are strictly adhered to. Failure to comply with the treatment and rehabilitation programme may lead to severe consequences, ranging from infection and thromboembolism to re-traumatisation of the internal structures of the knee.

Physiotherapy after the operation reduces swelling and speeds up healing, and the follow-up measures are usually aimed at improving knee joint mobility and preventing possible complications.

The first physiotherapeutic procedures are prescribed while the joint is still immobile. They stimulate tissue regeneration, improve blood circulation in the joint and reduce inflammation. After the cast is removed, the prescribed physiotherapy restores muscle tone and increases the effectiveness of massage and therapeutic exercise. 

Professional massage normalises blood flow and relieves muscle spasms, which is usual with similar injuries. All this significantly improves joint recovery, increases the range of movement, and reduces pain and swelling.