Partial meniscectomy

Partial meniscectomy is where the damaged part of the meniscus is removed during arthroscopic surgery.


Are there any risks from this type of surgery?

Complications following meniscal surgery are rare. However, they can include:

Infection
The chance of infection is less than 1% and can usually be treated effectively with antibiotics. Usually only the skin is affected, but if bacteria get into the knee itself then it may be necessary to have a further arthroscopy to wash the knee out with saline solution and give stronger antibiotics via a drip

Deep vein thrombosis (DVT)
The risk of this is less than 1% and is unusual if you move around as much as possible after surgery. Symptoms include pain, swelling, warmth and redness of the calf. Less commonly, a DVT can also present in the thigh area

Swelling
A small amount of swelling is very common after meniscal surgery, often just above the kneecap or around the incision sites. If the swelling becomes painful, you should contact the Fortius Clinic for advice
    
Stiffness
Most people experience some stiffness in the joint after an operation, but this should improve with exercise and physiotherapy
Follow-up appointments
Everyone is different, so healing and post-operative programmes vary from person to person. However, the follow-up appointments below are typical:
Two weeks: wound check and removal of stitches
Six weeks: this appointment is usually only necessary for patients who have had a meniscal repair
If there are any complications with your rehabilitation your physiotherapist may refer you back to your consultant for a further review and will liaise directly with the consultant about any issues
If you are worried about any aspect of your recovery, contact the Fortius Clinic

Getting back to normal

Following the operation you will have a small dressing around your knee
You will be allowed up once you have recovered from the anaesthetic
If you have had a partial meniscectomy you will be allowed to fully weight-bear as pain allows straight away
If you have had a meniscal repair you may not be able to fully weight-bear to start with
Following a meniscal repair you may need to wear a brace to restrict movement in your knee while it heals
You may need to have crutches to help you to walk
Your knee may be swollen and bruised so you should keep your leg elevated (raised) when you are not walking or exercising
A physiotherapist will give you some simple exercises to help with your recovery
The phases and goals for both partial meniscectomy and meniscal repair are the same, although the expected timescales are approximately doubled following a meniscal repair, meaning a full recovery will take a little longer. If you have had a meniscal repair your surgeon or physiotherapist will advise you about returning to your usual activities including, for example, temporary restrictions on how much to bend your knee.

Phase 1 – Early (approximately 0-2 weeks)
Goals (to be achieved by the end of this phase):
• Control swelling in the knee and allow the knee to settle down
• Full movement of the knee (unless advised otherwise), especially straightening the knee
• Walking short distances without a limp both on flat ground and using stairs
• Starting to regain good strength in the operated leg and good ‘core control’
• Equal balance when standing on one leg with eyes open/eyes closed

Phase 2 – Middle (2-4 weeks)
Goals (to be achieved by the end of this phase):
• Minimal swelling and pain in the knee
• Improved flexibility, strength and balance in the operated leg
• Good ‘core control’
• Begin low impact sports, for example cycling
• Increase distance walking and a return to most everyday activities

Phase 3 – Late (4-8 weeks or more)
Goals (to be achieved by the end of this phase):
• Continue to develop strength and confidence in the operated leg
• Improve fitness levels and work towards a return to all usual sports
• Good agility and coordination in preparation for a return to sport
• Be confident and mentally prepared for a return to sport and manual work

When can I drive?

When considering a return to driving following surgery it is essential that you consider the safety of yourself and other road users.
Left knee: it is usually safe to return to driving after one week, provided you have regained sufficient mobility and strength in the knee to use the clutch pedal
Right knee: it may take two to four weeks for the right knee to be strong enough and react quickly enough to use the brake pedal in an emergency stop.

Although your specialist will advise you about when it is safe to start driving again, you should also check with your vehicle insurer to confirm you are covered
When can I return to work?

This depends on the type of work you do and how quickly you recover. As a general guide, if your job involves sitting down for most of the time, you should be able to return to work a few days after surgery. If it involves being on your feet for longer periods of time, but does not require manual duties such as heavy lifting and kneeling, you may return to work within two to three weeks.
Jobs that require a greater degree of manual work and physical demand, for example lifting and running, may require four to six weeks or more following partial meniscectomy and up to three months or more following meniscal repair.

When can I return to sport?

People recover at different rates for many reasons so returning to sport will be based on how ready you are both physically and psychologically, rather than on a set timeframe.
Following a partial meniscectomy you may be able to return to road cycling at two to four weeks and jogging or light individual sports, for example non-competitive golf, at four to six weeks. These timeframes are doubled following meniscal repair.

The time it takes to return to high performance/contact sports, for example rugby, football and skiing following partial meniscectomy will be six to eight weeks or more. Again, this timeframe will be doubled for meniscal repair

Am I more likely to get osteoarthritis after meniscal surgery?

One of the important roles of the menisci is to spread your body weight over as big an area of your knee joint lining as possible. If the menisci are injured and can no longer do this properly, then areas of your joint lining are put under more load. Sometimes the lining is put under too much load and can slowly deteriorate over time eventually leading to loss of the lining of the knee. This is called osteoarthritis (OA).

The risk of developing OA in later life may increase if you have a meniscal injury while you are young or if the injury means a large amount of meniscus is lost. Wherever possible, your surgeon will try to preserve as much meniscal tissue as possible to minimise this risk.

 

ACL reconstruction is when a piece of tissue from a tendon is used to replace a torn tendon
The knee joint consists of the lower end of the thigh bone (femur) and the top of the shin bone (tibia). At the front of the knee is the knee cap, also known as the patella. The patella moves up and down in a groove on the front of the femur as the knee bends and straightens.
Sometimes the meniscus can be repaired using small sutures (stitches)
Partial meniscectomy is where the damaged part of the meniscus is removed during arthroscopic surgery.