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Meniscectomy - Medical Negligence

A meniscectomy is an orthopaedic procedure done in order to correct a torn meniscus, usually in the knee. Meniscal tears are common injuries to the knee and happen usually in the action of athletics. The orthopaedic surgeon decides on the performance of the meniscectomy based on the patient’s health, age and level of activity.

The surgeon also bases the surgery on the location of the tear, the size of the tear and the pattern of the tear. Sometimes the surgeon needs to get into the surgical space before making the decision as to what kind of meniscectomy to perform. He can then see the strength of the meniscus and its location within the joint.

There are two different locations for meniscal tears. The first is the red zone, which is the outer edge of the circular area. Big tears of this area usually necessitate surgery. Tears in the white zone, which is inner two-thirds of the meniscus, surgery might not be successful and the surgeon may need to do nothing at all. The meniscus may not heal in the end. Sometimes these kinds of meniscal tears can be treated by removing torn pieces of the cartilage. Horizontal tears and flap tears of the meniscus usually require that at least part of the meniscus be surgically removed.

Usually the meniscectomy is done in total—the entire collagenous piece is removed. If the meniscus is partially removed, then attempts are made to take off as little of the meniscus as is possible. If any fragments are unstable or frayed, the entire area is cleaned up and smoothed to the best degree possible. The procedure is done under general or regional discectomy. It can be an arthroscopic procedure or an open procedure.

If the surgery is successful, the patient undergoes rehabilitation to strengthen the muscles around the knee. First you rest until healing has taken place, then you begin an exercise and walking program. Weight bearing can happen within one to two days and normal activities can be resumed within 2 to 4 weeks. Rehabilitation is important to success following surgery.

The orthopaedic surgeon may decide to or not to do the meniscectomy. MRI of the knee or arthroscopy can determine the size, location and quality of the tear. He also looks at your age and level of fitness before the tear. The knee may suffer from osteoarthritis that can make postoperative pain greater. Some symptoms are made better by total removal of the meniscus. Studies involving partial meniscal tears show that 78 to 88 percent of people have good results with decreased pain and instability after the procedure.

Risks & Complications

The meniscectomy is generally believed to be a procedure with few complications. It is always possible for the orthopedic surgeon to damage permanently a nerve within the joint capsule. There can also be bleeding within the joint leading to haemarthrosis.

Arthritis can happen to the knee joint following the procedure. It is generally osteoarthritis, which has no real cure. There can also be a load discrepancy across the joint which makes running, walking or even standing painful and difficulty. This uneven load discrepancy can cause an acceleration of knee degeneration and the beginnings of a chronically painful knee.

Infection can occur if the surgeon does not follow proper sterile technique. There can be problems with bad reactions to regional or general anaesthesia. Arthritic changes are more common with people who have certain heredity and who have certain environmental relationships. Some people have a higher rate of osteoarthritis following meniscectomy than they would if they hadn’t had surgery in the first place.