Meniscal Root Injury
The root attachments of the posterior horns of the medial and lateral meniscus play a critical role in maintaining joint health. When these attachments are torn, it can lead to increased joint loading, similar to having no meniscus on the affected side. Consequently, patients may be at risk of early-onset arthritis, bony edema, insufficiency fractures, and potential failure of concurrent cruciate ligament reconstruction grafts. As a result, extensive research has been conducted on meniscus root repairs in recent years.
What's the process of Meniscal Root Repair?
The process of performing a meniscus root repair involves the isolation of the root, placement of at least two sutures in the remaining meniscal attachment, and an attempt to reposition it to a more anatomically correct location. In certain cases, the meniscus posterior horn may require release from scar tissue to enable repositioning. This step is crucial as current technology makes these repairs delicate, thus it’s important to place the meniscus in a position where there is minimal tension on the repair during knee range of motion.
Following the arthroscopic placement of sutures into the meniscal attachment, a small-diameter tunnel, usually around 5 millimeters in size, is created to the meniscal root attachment site. The sutures are then pulled down the tunnel and tied over a button on the anterior cortex of the tibia. At this point, it’s essential to assess the range of motion that can be safely performed to prevent excessive flexing during this time frame.
Post-Operative Protocol for Meniscus Root Repair
The post-operative protocol for meniscus root repair involves a more restricted progression of range of motion compared to standard meniscus root repairs. Typically, patients are limited to a range of motion of 0-60 or 0-90 degrees for the first 4 weeks, with a gradual increase in range of motion as tolerated. Weightbearing can be initiated at 6 weeks, but patients should avoid significant squatting, lifting, or sitting cross-legged for at least 5-6 months. They may begin using a stationary bike and gradually wean off crutches starting at 6 weeks post-operatively.
Literature findings suggest that meniscus root repairs have yielded encouraging results, but there is still room for improvement. These repairs have shown potential in delaying or improving the presence of bony edema and early-onset arthritis in many patients. Research has indicated that a single suture for the repair is not as effective, emphasizing the need for a minimum of 2 sutures to optimize meniscal healing. Ongoing studies in our research laboratory are focused on further understanding meniscus root tears and radial root tears to enhance the treatment of these complex issues.
Symptoms of a Meniscus Root Repair
- Pain and discomfort around the knee joint
- Swelling at the surgical site
- Difficulty bearing weight on the affected leg
- Limited range of motion in the knee
- Sensitivity or numbness around the incision area
- Muscle weakness in the leg
- Stiffness in the knee joint
Faqs For Meniscus Root Repair
What is meniscus root repair?
Meniscus root repair is a surgical procedure aimed at repairing the torn meniscus root, which is the point where the meniscus attaches to the tibia bone in the knee joint.
How is the meniscus root repair performed?
The procedure is typically performed arthroscopically, where small instruments and a camera are inserted into the knee joint through small incisions. The surgeon then reattaches the torn meniscus root using sutures or anchors to stabilize and heal the area.
What are the benefits of meniscus root repair?
Meniscus root repair aims to restore the function and stability of the meniscus, potentially preventing further damage to the knee joint and reducing the risk of developing osteoarthritis in the long term.
What is the recovery process like after meniscus root repair?
The recovery process can vary depending on the extent of the repair and individual factors. Patients may be required to use crutches and wear a brace for a period of time. Physical therapy is often recommended to regain strength and mobility in the knee.
Are there any risks associated with meniscus root repair?
As with any surgical procedure, there are potential risks, including infection, blood clots, and stiffness in the knee. It’s important to discuss these risks with your healthcare provider before undergoing meniscus root repair.