What are the other Names for the Procedure?
- Complete Meniscectomy
- Partial Meniscectomy
- Partial Meniscus Removal
What is Meniscectomy surgical procedure?
- Meniscectomy is a surgical procedure that involves the removal of a torn meniscus, within the knee
- The knee joint has two cartilage discs, called meniscus, which help in reducing friction between the bones of the knee joint and disperse weight evenly, during movement
What part of the Body does the Procedure involve?
The Meniscectomy procedure involves the knee and all surrounding parts of the knee.
Why is the Meniscectomy surgical procedure Performed?
A Meniscectomy surgical procedure is performed for the following reasons:
- Preventing permanent damage to the knee joint
- To stop the knee joint from locking-up
- To alleviate pain and swelling within the knee
What are some Alternative Choices for the Procedure?
Medical management with drugs, usage of crutches to avoid bearing weight on the injured knee, and the use of compression bandages, may be advised for a small tear, with a stable knee joint.
What are the Recent Advances in the Procedure?
Use of advanced arthroscopic techniques is the recent advancement in Meniscectomy procedure.
What is the Cost of performing the Meniscectomy surgical procedure?
The cost of Meniscectomy surgical procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.
In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.
When do you need a Second Opinion, prior to the Procedure?
- It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding Meniscectomy procedure and what needs to be done
- If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
- Also, if the procedure involves multiple surgeries or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently
What are some Helpful Resources?
Complete Guide to Symptoms, Illness & Surgery; Written by H Winter Griffith, M.D.; Revised and updated by Stephen Moore, M.D. and Kenneth Yoder, M.D.; The Berkley Publishing Group, 5th Edition, New York, 2006
http://orthoinfo.aaos.org/topic.cfm?topic=a00358 (accessed on 08/20/2014) http://www.kapiolani.org/docs/orthopedic/Arthroscopic%20Meniscectomy.pdf (accessed on 08/20/2014)
Prior to Meniscectomy surgical procedure:
How is the Meniscectomy surgical procedure Performed?
- The procedure may be performed under general or local anesthesia
- The orthopedic surgeon uses an instrument, called an arthroscope, to perform the procedure
- This instrument has a tube fitted with a camera and it is inserted into the knee joint through a small incision, to visualize the joint structures. Other surgical instruments may be introduced through small incisions
- The damaged meniscus is either removed partially (Partial Meniscectomy) or completely (Total Meniscectomy). The edges of the remaining meniscal tissue are shaved to make them smooth
- After removing the instruments and the arthroscope, the skin incisions are sutured
Where is the Procedure Performed?
A Meniscectomy procedure is usually performed in an out-patient surgery center facility or a hospital. Normally, the individual can go home, once the procedure is completed.
Who Performs the Procedure?
An orthopedic surgeon performs a Meniscectomy procedure
How long will the Procedure take?
Meniscectomy could take up to 2 hours.
What do you need to tell your Physician before the Procedure?
It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the Meniscectomy surgical procedure and helps avoid unnecessary complications.
- Provide a complete list of medications you are currently, taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
- If you are allergic to any specific medication or food items
- If you are taking blood thinners, such as aspirin, warfarin, herbal supplements, or any other such medications
- If you or your family members, have a history of bleeding disorders, or if there is a tendency to bleed more than normal
- If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
- If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
- If you have a history of frequent bone fractures (this may affect bone-healing, if bones are involved as part of your procedure)
- A list of all previous surgical procedures you have undergone, like for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.
What Preparations are needed, prior to the Procedure?
- The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
- Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
- Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
- Inform the physician if you are allergic to any local anesthetics, lidocaine, etc
- Avoid application of any cosmetics, deodorant, or topical medicines on the area, prior to the procedure
- It is advisable to quit smoking and the use of any nicotine based products, for a while, before the surgery
- Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
- The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
- For persons suffering from diabetes, it is important that the blood sugar stays within the normal range; if not their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines
What is the Consent Process before the Procedure?
A physician will request your consent for Meniscectomy procedure using an Informed Consent Form.
Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.
You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.
What Tests are needed, before the Meniscectomy surgical procedure?
Before a Meniscectomy procedure, the patient has to undergo certain tests, such as:
- Routine blood and urine analysis
- X-rays of the affected knee
- Magnetic resonance imaging (MRI) scan
- Arthrogram: A procedure, in which a dye is injected into the joint, to visualize the insides of the knee joint
What are some Questions for your Physician?
Some of the basic questions that you might ask your physician are as follows:
- What is a Meniscectomy procedure?
- Why is this procedure necessary? How will it help?
- How soon should I get it done? Is it an emergency?
- Who are the medical personnel involved in this procedure?
- Where is the procedure performed?
- What are the risks while performing the procedure?
- What are the complications that might take place, during recovery?
- How long will it take to recover? When can I resume normal work?
- How many such procedures have you (the physician) performed?
- Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
- What are the costs involved?
During the Meniscectomy surgical procedure:
What kind of Anesthesia is given, during the Procedure?
Spinal anesthesia by injection, local anesthesia by injection, or general anesthesia by injection and inhalation, may be administered, prior to the Meniscectomy procedure. The type of anesthesia chosen depends on the patient’s overall health condition, the patient’s individual choice, and recommendation of the surgeon.
How much Blood will you lose, during the Procedure?
There is only a minimal loss of blood, during an uncomplicated Meniscectomy procedure.
What are the possible Risks and Complications during the Meniscectomy surgical procedure?
There are general factors that increase the risk of getting complications during the surgery and they include:
- Obesity: Generally greater the degree of obesity, greater is the surgical risk
- Smoking: Longer the smoking history (in pack years smoked), greater the surgical risk
- Advancing age
- Poorly controlled diabetes, as evidenced by a high hemoglobin A1c and a high fasting glucose
- Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine
- Poorly functioning liver, as evidenced by increased blood liver function tests
- Hypertension (increased blood pressure), especially if it is poorly controlled
- Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
- Poor lung function, as evidenced by abnormal lung function tests
- History of bleeding disorders
- Longstanding illness, such as autoimmune disorders, chronic infections
- Poor immune system due to a variety of causes
The possible risks or complications that may arise during the Meniscectomy surgery are:
- Anesthetic complications
- Injury to structure around the knee joint
- Excessive bleeding
- Infection surrounding the surgical wound
What Post-Operative Care is needed at the Healthcare Facility after the Meniscectomy surgical procedure?
At the healthcare facility, usually there is no requirement for any post-procedure care, unless any complications arise.
After the Meniscectomy surgical procedure:
What are the possible Risks and Complications after Meniscectomy surgical procedure?
The possible risks and complications that may arise after the Meniscectomy procedure are:
- Excessive bleeding
- Infection in the surgical wound
- Knee joint weakness, possibly resulting in arthritis
What is the Prognosis after the Surgery?
A complete recovery from a Meniscectomy procedure is usually achieved. The prognosis is also excellent, when there are no serious complications.
When do you need to call your Physician?
Do contact your physician if you notice any of the following symptoms:
- Worsening pain and swelling of the surgical wound
- Bleeding or fluid drainage from the surgical wound
- The occurrence of any symptom that causes uneasiness, such as nausea or vomiting
- Noticeable discoloration of toes
- Numbness or cold sensation within the toes
- Signs of an infection
- Muscle aches, headache
- Fever, feeling sick
- Complications associated with prescription medications used in treatment
What Post-Operative Care is needed at Home after the Meniscectomy surgical procedure?
At home, the following post-operative care is recommended, after a Meniscectomy procedure:
- Slowly resume regular/daily activities as soon as possible, which aids in faster recovery
- Begin using crutches or a cane, under the direction of your physician. Avoid standing for extended periods of time
- Use a heat pad or warm compress to relieve pain, due to the incision
- Apply ice to the knee approximately 4-5 times a day, in order to decrease swelling within the knee
- Elevate legs while resting, to prevent the formation of blood clots and reduce the possibility of swelling. At night, keep the affected leg elevated, under a pillow, which can help decrease any additional pain and swelling
- Follow rehabilitation procedures and physical therapy to hasten recovery
- Resume showering and keep the wound clean and dry. Gently wash the surgical wound with mild or unscented soap
- Replace the dressings on the surgical wound after showering
- Complete the course of prescribed medication, as advised by your physician
- Individuals may take medication to relieve pain, under the physician’s advice
- Avoid all activities that are physically strenuous for 4 weeks, after the surgery
- Resume driving 3 weeks after being discharged from the healthcare facility (or as advised by your physician)
- Individuals are advised to have to clear liquids immediately after the surgery, until the gastrointestinal tract begins functioning properly. Then, the individuals are advised to have a well-balanced diet, which can aid in a faster recovery
How long does it normally take to fully recover, from the Procedure?
Recovery from a Meniscectomy surgery depends on the extent of the injury and the type of surgery performed. It may take anywhere between 2-4 weeks or longer, in order to achieve a complete recovery.
What happens to tissue (if any), taken out during the Procedure?
The tissue is taken for further examination and later disposed as per the standard medical procedure.
When should you expect results from the pathologist regarding tissue taken out, during the Procedure?
- The meniscus tissue removed is processed in the laboratory under a pathologist's supervision
- Slide(s) are prepared once the tissue is processed and is examined by a pathologist and a pathology report issued
- Depending on the complexity of the case, issue of the report may take anywhere between 72 hours to a week's time
Who will you receive a Bill from, after the Meniscectomy surgical procedure?
It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.
Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:
- The outpatient facility or a hospital
- An anesthesiologist (if anesthesia was administered)
- An orthopedic surgeon
- A pathologist
- A radiologist
The patient is advised to inquire and confirm the type of billing, before the Meniscectomy surgical procedure is performed.
Thanks and Gratitude:
We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.
Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA