Evolution of Technology

Meniscus Repair

The meniscus are a C shaped discs within the knee made of fibrocartilage that essentially provide cushioning and stability to the knee joint. A meniscus tear is a very common injury and finding. Treatment is often with knee arthroscopy, either trimming away the torn menisucs( partial meniscectomy) or repairing it. Todays techniques and technologies have seen a recent revolution in repair and repair or fixation tehcnology. All-inside meniscal repair techniques have gained popularity in recent years as a practical way to repair and secure meniscal tears. The advantages of this technique are that it allows for quicker and more minimally invasive surgeries mitigating the need for those larger accessory incisions seen in inside-out repairs. Repairing the meniscus is very successful to relieve pain and possible prevent the potential for arthritis within the knee.

This technique first begins with the surgeon placing a camera within the joint, called arthroscopy. Once the tear is identified an all-inside meniscus repair device enters the knee via a second small incision. The device will pierce the meniscus cartilage and eject the suture across the tear and into the knee capsule securing the tear and closing down the meniscal defect. Doing so avoids trimming down the meniscus, or cushion, in your knee and possibly preventing increased wear and arthritis.

Evolution of Procedure

Meniscus Surgery

The procedure is done arthroscopically with two small incisions in the front of the knee. However, not all meniscal tears benefit from repair as the blood supply to the meniscus is decreased as you go from the outside to the inside of the meniscus. For this reason, only tears in the more peripheral regions have the optimal blood supply to heal and are the best options for meniscal repair . Repairs consist of putting a suture material through the tear and closing down the defective area. Sometimes large incisions need to be made on the inner or outer portion of the knee to facilitate and secure the meniscal repair, called an inside-out procedure. This inside-out repair technique is associated with more post-operative pain and potential damage to the nearby blood vessels and nerves.

Evolution of Diagnosis

Meniscus Tear

The menisci are two C shaped discs of fibrocartilage within the knee that function to cushion and stabilize the knee during everyday activities. Tears of the meniscus are one of the most common knee injuries affecting the general population. Injury to the meniscus can be the result of trauma, athletic activities, or simply the result of normal wear and tear, what is called degenerative tears. Tears in the meniscus can be significantly debilitating leading to knee pain, swelling, and clicking, locking or popping. Additionally, as the knee loses its protective cushioning there is a risk of developing early osteoarthritis(irreversible joint cartilage damage). Treatment of meniscus tears depends on an individual’s characteristics, tear type, and tear size. Some tears can be treated successfully with conservative modalities such as anti-inflammatories, rest, ice, physical therapy and possibly injections, however a subtype of tears may benefit from surgery and or repair.