A damaged meniscus may not require surgery for a full recovery. There are some cases where patients with tears that do not cause locking of the knee, can improve over time. Differences in the severity and type of injury will affect the treatment, as well as the degree of activity that the patient wishes to pursue after treatment.
Meniscus injuries range from minor tears to complete tears of the structure. Some patients, even those with quite severe injuries, may choose to not undergo surgery. A partially torn meniscus can rebuild itself. However, a more severe tear will require surgery to repair and prevent further damage to the joint.
In order to preserve the entire meniscal cartilage, the torn meniscus is surgically repaired. This repair allows the meniscus to continue functioning as a natural shock absorber and offers a stabilizing receptacle for the end of the femur.
A complete physical examination which provides an assessment of the patient's overall health.
An examination of both the injured and uninjured knee.
Immediately after surgery, as anesthesia wears off, patients will usually feel tired and slightly disoriented, although the effects of anesthesia can vary greatly from patient to patient.
The knee will remain tender and painful after surgery. The most intense discomfort is felt in the first 24-48 hours, after which the pain generally steadily decreases.
POST-OPERATIVE INSTRUCTIONS:
Wear the brace at all times, except when bathing or showering.
Bear weight as tolerated in the brace with the knee locked in full extension.
Use crutches as needed until stability returns.
Ice the knee three times a day for 20 minutes.
Keep the wound dry. The dressing can be removed for showering (with the knee wrapped in plastic kitchen film) after four days.
Three times a day, for 30 minutes each time, sit with a large towel roll under the heel with the brace locked in full extension.
It is normal to have some discomfort and swelling, as well as some blood-tinged drainage, following meniscal surgery. If this becomes severe or the patient develops a fever, calf pain, shortness of breath, or chest pain, contact a doctor immediately.
A surgically treated meniscus which is rehabilitated properly will allow the patient to eventually regain complete strength, stability and motion of the knee.
Patients that are in good physical condition are likely to recover within four to six weeks and will then usually be able to perform at previous levels of intensity.
Patients that are in poorer overall condition will be able to return to previous activity levels, although rehabilitation and physical therapy will tend to be more lengthy and involved.
In all cases, physical therapy is required to restore the muscle strength, flexibility and joint stability due to the injury.
Re-injury to the meniscus is possible if physical therapy or other activities during rehabilitation are overly strenuous.
Risks during and after surgery include problems that may develop in relation to bleeding, the possibility of infection and reactions to anesthesia.
The repaired meniscus is often as healthy as before the injury and will tend to remain healthy if not subjected to abuse.
Initial care will focus on rest and the avoidance of activities that aggravate the condition. Actions that involve any pounding force against the knee, such as running or jumping should be avoided. Physical therapy will focus on increasing the strength and stamina of the quadriceps and hamstrings. Strengthening these muscles will help support the knee.
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