Torn Meniscus

Meniscal Transplant Surgery

Torn Meniscus | Johns Hopkins Medicine

Linkedin Pinterest Orthopedics Knee Surgery

Meniscal transplant surgery is a type of surgery that replaces your missing or damaged meniscus with a meniscus from a cadaver donor. The surgery usually takes place under general anesthesia.

Your knee has 2 wedge-shaped pieces of cartilage, 1 on each side of your knee. Each one of these pieces is called a “meniscus.

” These 2 rubbery menisci act as shock absorbers between your thighbone (femur) and your shinbone (tibia). A different type of cartilage capping the tibia and femur also helps your bones move smoothly.

These 2 menisci help protect the ends of your femur and tibia as they move together.

Sometimes, a twisting injury may severely damage your meniscus. If the damage is severe enough, your surgeon may need to remove your meniscus.

Without this meniscus cushion, the ends of your tibia and femur may start to rub together abnormally. Over time, this can cause persistent knee pain. Eventually, it may cause arthritis.

Your cartilage “cap” degrades and the bones beneath start to scrape together.

Meniscal transplant surgery provides another choice for you. Your surgeon makes a very small incision in your knee. He or she uses special instruments and cameras to access the joint space between your femur and tibia. Next, your surgeon surgically sews the donated meniscus into your joint space.

Grace Herpel was an avid runner with 5 long distance races planned for 2016. But after tearing her left meniscus during a half marathon, she feared she might never run again. Hear how through surgery and rehabilitation, Grace got back to running long distances and living a life in motion.

Meniscal transplant surgery might make sense for you if your meniscus was removed in a previous surgery. (This probably happened if the damage to your meniscus was so bad that surgeons couldn’t repair it in that previous surgery.

) Without a meniscus, you might gradually develop knee pain and arthritis of your joint. Replacing your meniscus may provide significant pain relief. It may also help prevent arthritis in your joint. This can develop when your cartilage becomes frayed and rough.

This surgery is less invasive than knee replacement surgery.

Meniscal transplant surgery might not make sense for you, even if you’ve had your meniscus removed. If you already have arthritis of your knee, the procedure might not help because you may already have too much damage to your cartilage and bone. Another procedure, knee replacement, might be more effective.

You might be a good candidate for meniscal transplant surgery if the following apply to you:

  • You’re younger than age 55.
  • You’re missing more than half your meniscus, or you have a large meniscus tear that is irreparable.
  • You have significant or persistent pain with activity, or you have an unstable knee.
  • You have only minimal arthritis, or none at all.
  • You have a knee with normal alignment and stable ligaments.
  • You are not obese.

What are the risks of meniscal transplant surgery?

Most people have meniscal transplant surgery without any problems. Rarely, complications happen, :

  • Stiffness of the joint after surgery (more common)
  • Incomplete healing. This might need another surgery.
  • Excess bleeding
  • Infection
  • Damage to nearby nerves
  • Complications from anesthesia
  • Getting an infection from the donated tissue (extremely rare)

Your own risks may vary according to your age, your other medical conditions, and the specific anatomy of your knee. Talk with your surgeon about your concerns. Make sure you include the risks that most apply to you.

How do I get ready for a meniscal transplant surgery?

Talk with your healthcare provider about how to prepare for your meniscal transplant surgery. Ask whether you should stop taking any medicines ahead of time, blood thinners. Tell your healthcare provider about all the medicines you take, including over-the-counter medicines aspirin. You’ll need to avoid food and drink after the midnight before your procedure.

Before your procedure, you may need additional imaging tests, X-rays and magnetic resonance imaging (MRI).

You may need to rearrange your living arrangements as you recover because you’ll need to use crutches for several weeks.

You may be able to go home on the day of your surgery. It’s also possible you’ll need to stay in the hospital for a day or two. Talk with your healthcare provider ahead of time so that you can make the necessary arrangements for your recovery period.

Before your surgery, a healthcare provider will carefully screen the donated meniscus for any signs of infection.

Johns Hopkins Medicine Virtual Advisors (Virtual Advisors) is a group of individuals who share their insights about the Johns Hopkins care experience. One to two times per month, Virtual Advisors receive a link to short, interactive surveys. All responses are confidential.

Your healthcare provider can help explain the details of your particular surgery. An orthopedic surgeon will perform the surgery. The whole operation may take a couple of hours. In general, you can expect the following:

  • A healthcare provider (anesthesiologist) will give you medicine so that you’ll sleep through the operation and won’t feel any pain or discomfort during the surgery. (You may receive spinal anesthesia and a medicine to help you relax.)
  • Your vital signs, your heart rate and blood pressure, will be monitored during the operation. You may have a breathing tube inserted down your throat during the operation to help you breathe.
  • After cleaning the affected area, your surgeon will make a small incision through the skin and muscle of your knee.
  • Your healthcare provider will insert a very small camera through this incision, using this camera to guide the surgery.
  • Using very small instruments inserted through the incision, your surgeon will remove any remaining meniscus.
  • Next, he or she will surgically sew the donated meniscus into the joint space. The healthcare provider might use screws or other devices to hold the meniscus in place.
  • Your surgeon will make other repairs, if necessary.
  • The surgeon will close the layers of skin and muscle around your knee.

What happens after meniscal transplant surgery?

Talk with your healthcare provider about what you can expect after your surgery. In some cases, you may be able to go home a few hours after your surgery. (If so, make sure you have someone who can drive you home.) In other cases, you may need to stay overnight at the hospital for monitoring.

You may have some pain right after your surgery, but pain medicines may help to ease the pain. The pain should quickly begin to diminish, and you should have less pain than before your surgery.

After your surgery, you will probably need to wear a knee brace for a few weeks. You might also need to use crutches during this time.

Your healthcare provider will give you instructions about how you can move your knee while you recover. You might need physical therapy for a few months to help you maintain your strength and range of motion.

It may be several months before you can return to all your previous activities.

You may have some fluid draining from your incision, which is normal. Let your healthcare provider know right away if you see an increase in redness, swelling, or draining from your incision, or if you have a high fever, chills, or severe pain.

Make sure to keep all your follow-up appointments, so your healthcare provider can monitor your progress. Following all of your healthcare provider’s instructions may increase your chances for a positive outcome.

Next steps

Before you agree to the test or the procedure make sure you know:

  • The name of the test or procedure
  • The reason you are having the test or procedure
  • What results to expect and what they mean
  • The risks and benefits of the test or procedure
  • What the possible side effects or complications are
  • When and where you are to have the test or procedure
  • Who will do the test or procedure and what that person’s qualifications are
  • What would happen if you did not have the test or procedure
  • Any alternative tests or procedures to think about
  • When and how will you get the results
  • Who to call after the test or procedure if you have questions or problems
  • How much will you have to pay for the test or procedure

Source: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/meniscal-transplant-surgery

How Do Meniscus Tears Affect the Elderly?

Torn Meniscus | Johns Hopkins Medicine

How serious is knee pain? In some cases, general discomfort or stiffness can be relieved with stretching or pain medication but in others, you could be dealing with a meniscus tear.

This injury is relatively common among younger adults, who may twist their knee on the playing field and be diagnosed right away. In older adults, meniscus tears occur gradually as a result of everyday wear and tear.

Recent research involving adults over 50 shows that therapy and physical rehabilitation have similar outcomes to surgery. If you or a loved one is living with sharp knee pain or a doctor has identified a meniscus tear, here’s what you should know.

How Do Meniscus Tears Occur?

The meniscus is a piece of cartilage behind the kneecap that acts as a shock-absorber for the knee joint and provides cushioning between the femur and tibia. Over time, this wedge-shaped area goes through a significant amount of wear and tear.

As the cartilage weakens and thins out, tissue becomes more susceptible to tearing, even during mundane activities climbing stairs.

Older adults experience degenerative meniscal tears that cannot be traced back to one incident. Studies also show that individuals living with osteoarthritis of the knee often have a meniscal tear, too.

Signs of a Meniscus Tear

A mix of swelling, stiffness and pain around the knee joint signifies a meniscus tear. In older adults, these symptoms may also be accompanied by:

  • A sensation of catching, popping, locking or clicking with knee movement
  • Weakness in the joint
  • A sharp pain when you attempt to rotate the knee
  • Knee lockup or buckling when you attempt to move

Meniscus Tear Treatment Options

In the early stages, a doctor may recommend nonsurgical treatment options, including:

  • Extra rest to stay off the joint
  • Anti-inflammatory medications and ice packs to reduce the swelling
  • Physical therapy or short-term rehabilitation to improve the joint’s range of motion

In many cases, patients start to improve after a few months. At this point, a doctor may recommend an arthroscopic partial meniscectomy (APM), a type of surgical knee arthroscopy treatment to repair the torn meniscus.

However, medical researchers have started to question this procedure. Although it offers optimal outcomes in teens and young adults who sharply and suddenly tear the joint, researchers at Johns Hopkins found it has few benefits to those 65 years and older.

Examining data from the U.S. Centers for Medicare and Medicaid Services, researchers compared groups of patients who received APM to patients who were recommended regular exercise and physical therapy. Data showed the physical therapy group experienced fewer complications, were prescribed fewer opioids and spent less time recovering.  

Our short-term rehabilitation programs help elderly patients recover from degenerative meniscus tears. To learn more, contact West Hartford Health & Rehabilitation today!

Source: https://westhartfordhealth.com/news/senior-health/meniscus-tears-elderly/

Meniscus Tear Treatment | Johns Hopkins Department of Orthopaedic Surgery

Torn Meniscus | Johns Hopkins Medicine

The meniscus is a crescent-shaped disc of cartilage found between the bones of the knee (the femur and tibia). Each knee has two menisci that cushion the joint. Depending on the severity of the tear, symptoms of a torn meniscus may include pain, swelling, stiffness, clicking or locking of the knee.

Meniscus Tear Treatment: Why Choose Johns Hopkins

  • Whether you are a serious athlete determined to return to your sport, or you would just to get back on your feet to take care of daily tasks, we are here to help you return to your ideal activity level. 
  • The type of treatment you need for a meniscus tear depends on your symptoms and the type of tear. We will help you choose the best treatment plan to meet your needs.
  • Having torn your meniscus once could make you more ly to experience another knee injury. Our specialists will explain strengthening exercises and other measures to help protect your knee from further injury.

Request an appointment: phone 443-997-2663 (BONE)

Nonsurgical Options

Nonsurgical treatments may include: 

  • Icing
  • Bracing
  • Pain medication
  • Muscle-strengthening exercises

Meniscus Tear Surgery

Our specialists perform meniscus tear surgery arthroscopically, by making small cuts in the knee. After surgery, rehabilitation exercises will help you regain range of motion and strengthen the muscles that support the joint. 

Partial Meniscectomy

The most common type of surgery for a meniscus tear is a partial meniscectomy. During this procedure, the surgeon will trim off the torn part of the meniscus, leaving behind as much of the intact meniscus tissue as possible.

Mensicus Repair

In some cases, the torn part of the meniscus may be stitched back together, depending on the type of tear and condition of the meniscus. This procedure is more common in younger patients.

Because the meniscus tissue needs to heal back together, recovery time is longer for this procedure than a partial meniscectomy. It is common for patients to be on crutches for about two weeks and in a brace for up to six weeks after surgery.

It may be six months or more before it is safe to return to sports activities.

Meniscus Surgery | Grace's Story

Grace Herpel was an avid runner with 5 long distance races planned for 2016. But after tearing her left meniscus during the Ocean City half marathon in April 2016, she feared she might never run again.

Meniscus Injuries | Q&A with Dr. Andrew Cosgarea

Dr. Andrew Cosgarea, chief of the division of sports medicine at Johns Hopkins Orthopaedics, discusses meniscus injuries. He explains how meniscus injuries happen, their signs and symptoms, how they are treated, and how to prevent a meniscus injury.

 

Our Meniscus Tear Specialists

Rely on the expertise of our physicians to help you manage your meniscus tear.

Zikria, Bashir Ahmed, M.D.

      

Source: https://www.hopkinsmedicine.org/orthopaedic-surgery/specialty-areas/sports-medicine/conditions-we-treat/meniscus-tear.html

Torn Meniscus

Torn Meniscus | Johns Hopkins Medicine

Linkedin Pinterest Knee Injuries Knee Surgery What You Need to Know

  • The meniscus is a c-shaped pad of cartilage in the knee that acts as a shock absorber.
  • Each knee has two menisci.
  • Meniscus tears are common knee injuries.
  • Knee arthroscopy is often used to treat meniscal tears.

The menisci sit between the tibia (lower leg bone) and the femur (thigh bone) and protect the lower part of the leg from the shock created by our body weight.

The medial meniscus sits on the inside of the knee and the lateral meniscus sits on the outside of the knee.

Meniscus tears usually take place when an athlete twists or turns their upper leg while their foot is planted and their knee is bent.

Occasionally menisci can develop as a block or disk shape, which is called a discoid meniscus. A discoid meniscus is more ly to tear and commonly presents in childhood.

Symptoms of a meniscus tear may be different for each person, but some of the most common symptoms are:

  • Pain in the knee joint: usually on the inside (medial), outside (lateral) or back of the knee

  • Swelling

  • Catching or locking of the knee joint

  • Inability to fully extend or bend the knee joint

  • Limping

The symptoms of a meniscus tear are similar to other medical conditions or problems. Always see your health care provider for a diagnosis.

After tearing her left meniscus, Grace Herpel feared she might never run again. But her fear was replaced with hope when she was referred to our Women's Sports Medicine Program.

Learn more about Grace’s care at Johns Hopkins.

If a meniscal tear is suspected, your orthopedist will conduct a thorough health history and evaluation of the knee and may also order X-rays and magnetic resonance imaging (MRI) to confirm the diagnosis and further evaluate the knee joint:

X-ray

An X-ray is a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. When a standard X-ray is not accurate enough, a joint X-ray with contrast dye may also be used to examine joints such as the knee or hip.

MRI

An MRI is a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body; can often determine damage or disease in a surrounding ligament or muscle.

Pain or a catching feeling in the knee—could it be a meniscus tear? Andrew Cosgarea, M.D., chief of the division of sports medicine at Johns Hopkins Orthopaedics, answers common questions about meniscus injuries.

Specific treatment for a meniscus tear will be determined by your doctor :

  • Your age

  • Your overall health and medical history

  • How bad your injury is

  • How well you can tolerate specific medications, procedures, and therapies

  • The length of time it will take to heal

  • Your opinion or preference

Treatment may include:

  • Icing

  • Medication, such as ibuprofen

  • Muscle-strengthening exercises

  • Arthroscopic surgery

Knee arthroscopy, a minimally invasive procedure, is often used to treat meniscal tears. During an arthroscopy, a small, lighted, optic tube (arthroscope) is inserted through a small incision in the joint.

Images of the inside of the knee are then projected on a screen allowing the provider to repair or trim out the torn portion of the meniscus.

For young patients, preserving as much of the meniscus as possible is important to preserving knee health.

When the meniscus is repaired, sutures are used to hold the meniscus together while the body heals the site. Pediatric meniscal tears treated with arthroscopy tend to heal better than those managed with other treatment options.

An expert in hip and knee replacement surgery, Savya Thakkar discusses common reasons for knee replacement, the procedure, the types of implants and recovery.

Source: https://www.hopkinsmedicine.org/health/conditions-and-diseases/torn-meniscus