Arthroscopie du genou

Each knee has two menisci: the medial meniscus (on the inner side of the knee) and the lateral meniscus (on the outer side of the knee). Meniscus tears are common knee injuries that can result from trauma, sports activities, or degenerative changes over time.

Meniscus repair aims to preserve the meniscus and restore its function to maintain the knee’s stability and longevity. The procedure is typically performed arthroscopically, using minimally invasive techniques. The surgeon makes small incisions around the knee joint and inserts an arthroscope to visualize the meniscus. The tear is then visualized and sutures are placed to repair the damaged meniscus.
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Meniscus tears can be of different severity, depending on the extent of structure involvement. Moderate meniscus tears, often partial and less severe, can sometimes be treated with conservative methods or simple surgical repairs, addressing localized pain and minor functional impairment. Conversely, complex meniscus tears involve multiple planes or extensive damage, leading to significant knee instability and typically necessitating advanced surgical interventions for effective management.

As it is typically performed arthroscopically, a meniscus repair is usually considered a safe procedure. However, as with all surgeries, it carries risks, including:
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● Cartilage or meniscus injury
● Failure of meniscal repair
● Nerve or blood vessel injury
● Injection of the knee or surgical wound
● Joint infection
● Knee stiffness or loss of motion
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General minor risks associated with surgery and anesthesia include nausea, vomiting, headaches, sore throat, and urinary retention. Major general risks include blood clots, potentially leading to heart attack or stroke, allergic reactions, and pneumonia. Your surgeon will make sure to discuss the relevant risks with you prior to your surgery and take precautions to minimize the risk of any complications.

Before the surgery, your surgeon will have a discussion with you and examine your knee. Then, thorough presurgical workup will be conducted, including X-rays or MRI of your knee to visualize the extent and location of joint damage, with potential blood tests as needed to ensure the surgery is right for you. The surgeon will discuss the type of graft and technique to be used, as well as the anesthesia options, which may include general or regional anesthesia.
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Once the procedure is completed, your knee will be covered with a dressing during the early stages of your recovery to optimize your wound healing and avoid some complications. To manage your pain effectively after the surgery, a multimodal pain control strategy is employed, which consists of combining different modalities to treat your pain, including acetaminophen (e.g. Tylenol), NSAIDs (e.g. Advil, Aleve), opioids (e.g. oxycodone), and potentially nerve blocks, a minor procedure where a regional nerve gets frozen with the injection of a local anesthetic medication.

After an outpatient meniscus repair, you can typically expect to go home the same day, provided your surgeon determines that your recovery is on the right track. Your postoperative care will consist of pain management, early mobilization, and physical therapy. Any postoperative pain you may experience will be managed with medications, and you may wear a knee brace to protect the repair. Crutches are often used for the first few weeks after the surgery to aid in mobility.
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Physical therapy usually begins soon after surgery, starting with gentle range-of-motion exercises and progressing to strengthening, agility, and balance exercises. The goal of therapy is to restore full knee function and prevent future injuries. Recovery time varies depending on the severity of the tear and the repair technique used, but most patients can return to daily light activities within the first one to two months, with full recovery often taking up to six months provided an appropriate physical therapy regimen is followed.
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Your follow-up visits with your surgeon and physical therapist will help monitor your recovery progress and ensure you are on track for a full recovery.