Introduction
If the inner meniscus is torn, there are several possibilities to operate on it. All operations (surgery) are usually performed minimally invasive by means of knee arthroscopy. The meniscus can be sutured or removed. If it is decided to remove the meniscus, this can be done partially or completely (meniscectomy). In this case the meniscus must be replaced.
Knee joint endoscopy (arthroscopy)
In a knee arthroscopy (arthroscopy = surgery), a small incision is first made at the edge of the knee joint to create access to the knee joint gap. This serves to introduce the camera. A second access is then created under visual control, which is used as a working access for instruments.
In addition, a small tube is used to irrigate and suction the knee joint in order to maintain visibility. Once the accesses have been created, the knee joint and the inner meniscus are first closely examined in the operating room. The stability and extent of the injury must be assessed in order to decide on the best treatment method.
The duration of a knee arthroscopy depends on the underlying damage to the inner meniscus. The inner meniscus can be rejoined (sutured) with the help of a special thread (refixation). The material consists of high-quality suture material or meniscus arrows of absorbable material.
However, it is not possible to preserve the meniscus or to perform an inner meniscus suture for every injury pattern. Especially in the inner part of the inner meniscus, the blood supply is not sufficient. In this case, there is the danger that the meniscus suture will not grow together sufficiently at this point.
In the outer third of the inner meniscus, on the other hand, the blood supply situation is very good, if the damage is not too great. To optimize the chances of healing, the tear zone is first freshened up. This increases the blood circulation and enables better healing. Since the rehabilitation of a meniscus suture takes a relatively long time, a lot of patience and a slowly building up load is necessary to avoid damaging the inner meniscus again. Usually an inner meniscus suture can be loaded again after 6 weeks, a good result can be expected after 12 weeks at the earliest.
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