Cartilage tears usually result in knee pain and swelling. While they are sometimes caused by one specific injury, they can also occur with every day use.
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PHYSICIAN: DR. PAGNANI
MENISCUS (CARTILAGE) TEAR INJURIES AND TREATMENT
A healthy meniscus acts as a shock absorber and provides a smooth surface for your knee to glide on. A meniscal tear prevents your knee from rotating causing pain and locking. You should consider seeing a specialist if you have persistent knee pain that lasts longer than 3 weeks or any swelling in the knee.
If you are experiencing pain in your knee, see our Questions and Answers section below and call our office at (615) 329-2520 for a consultation.
PROCEDURES: CARTILAGE MENISCAL REPAIR
Introduction
A healthy meniscus acts as a shock absorber and provides a smooth surface for your knee to glide on. A meniscal tear prevents your knee from rotating causing pain and locking.
Incisions
Small incisions (portals) are made around the joint. The scope and surgical instruments will go into these incisions.
Visualization
The scope is inserted into the knee. Saline solution flows through a tube (cannula) and into the knee to expand the joint and to improve visualization. The image is sent to a video monitor where the surgeon can see inside the joint.
Repair
A surgical instrument is inserted into the knee to mend the tear. The tear will be closed with suture or a resorbable tack-like device that dissolves over time.
End of Procedure
Closing the tear allows the meniscus to heal. The surgical instruments are removed and the procedure is completed.
PROCEDURES: MICROFRACTURE
Introduction
Articular cartilage is a firm rubbery tissue that covers the ends of bones. It provides a smooth gliding surface for joints and acts as a cushion between bones. Damage to these surfaces is the main problem with arthritis.
When the Procedure is Performed
Cartilage can break down due to overuse or injury. This can lead to pain and swelling and problems using your joint. Your treatment will depend on the size and location of the defect This procedure is performed on people who have a specific cartilage defect typically due to an injury. The injury usually involves a fairly small area of cartilage. Microfracture is not done when cartilage loss is much more extensive.
Incisions
Small incisions (portals) are made around the joint. The scope and surgical instruments will go into these incisions.
Visualization
The scope is inserted into the knee. Saline solution flows through a tube (cannula) and into the knee to expand the joint and to improve visualization. The image is sent to a video monitor where the surgeon can see inside the joint.
Cartilage Removal
The damaged cartilage is removed from the joint using a specialized surgical instrument.
Microfracture
After the damaged cartilage is removed, a drill or awl is used to make small holes in the exposed bone. Making these small holes will help bring new blood supply that will help to heal the damaged area. After the holes are drilled, it is important to keep weight off of the leg or healing of the surface will not occur.
End of Procedure
After the drilling is finished, the surgical instruments are removed and the procedure is completed.
PROCEDURES: OATS PROCEDURE
Introduction
Articular cartilage is a firm rubbery tissue that covers the ends of bones. It provides a smooth gliding surface for joints and acts as a cushion between bones.
When the Procedure is Performed
Cartilage can break down due to overuse or injury. This can lead to pain and swelling and problems using your joint. Your treatment will depend on the size and location of the defect. This procedure is performed on people who have a specific cartilage defect typically due to an injury. The injury usually involves a fairly small area of cartilage. OATS is not done when cartilage loss is much more extensive.
Incisions
Small incisions (portals) are made around the joint. The scope and surgical instruments will go into these incisions.
Visualization
The scope is inserted into the knee. Saline solution flows through a tube (cannula) and into the knee to expand the joint and to improve visualization. The image is sent to a video monitor where the surgeon can see inside the joint.
Repair
A plug of healthy bone and cartilage is taken from a non-weight bearing, less important section of your femur. The damaged area is prepared and the new tissue plug is inserted into the site.
Repairing Extensive Damage
Depending on the size and shape of the defect, additional tissue plugs may be taken and inserted into the site to completely fill the damaged area with new cartilage.
End of Procedure
After the tissue is in place, the surgical instruments are removed and the procedure is completed.
PROCEDURES: TRIMMING OF TORN CARTILAGE (MENISCUS)
Introduction
A healthy meniscus acts as a shock absorber and provides a smooth surface for your knee to glide on. A meniscal tear prevents your knee from rotating causing pain and locking.
Incisions
Small incisions (portals) are made around the joint. The scope and surgical instruments will go into these incisions.
Visualization
The scope is inserted into the knee. Saline solution flows through a tube (cannula) and into the knee to expand the joint and to improve visualization. The image is sent to a video monitor where the surgeon can see inside the joint.
Trimming
A surgical instrument is inserted into the knee and used to trim the torn piece of meniscus.
End of Procedure
After the trimming is finished, the surgical instruments are removed and the procedure is completed.
PROCEDURES: LATERAL RETINACULAR RELEASE
Introduction
The patella is a flat triangular shaped bone that protects the knee joint and helps the muscles move your leg more efficiently. A healthy patella glides up and down a grove at the end of your femur, pain free.
Conditions
There are a number of conditions that can cause pain when your patella moves. The best treatment for you is based on your specific condition.
Incisions
Small incisions (portals) are made around the joint. The scope and surgical instruments will go into these incisions.
Visualization
The scope is inserted into the knee. Saline solution flows through a tube (canula) and into the knee to expand the joint and to improve visualization. The image is sent to a video monitor where we can see inside the joint.
Misaligned Patella
This view shows the muscle and tissue that surround the patella. The patella will get off track when the fibrous band on the outside of the patella, called the retinaculum, pulls to the side incorrectly.
Repair
A surgical instrument is inserted into the joint and the band that is pulling incorrectly is cut. When the band is cut, it releases the patella and helps it to properly glide in its track.
End of Procedure
The surgical instruments are removed and the procedure is complete.
QUESTIONS AND ANSWERS
1. How do I know if I might have a tear?
Cartilage tears usually result in knee pain and swelling. While they are sometimes caused by one specific injury, they can also occur with every day use. You should consider seeing a specialist if you have persistent knee pain that lasts longer than 3 weeks or any swelling in the knee.
2. What might have caused the tear?
Often, the cartilage simply weakens with age and can tear with little or no trauma. In other cases, a twisting injury may result in a cartilage tear.
3. How long does the procedure last?
The operation to manage a torn cartilage generally takes around 30 minutes in our hands.
4. Will I have to go under general anesthesia?
Usually. However, in some cases, spinal or epidural anesthesia is used.
5. Will I have to stay in the hospital overnight?
No. Cartilage surgery is performed on an outpatient basis.
6. What will the aftercare be?
You may remove your bandage 48 hours after surgery. You can expect to be on crutches for a couple of days.
7. How long will I be in physical therapy?
Most patients can rehabilitate themselves at home without the need for physical therapy. If physical therapy is required, most patients will be expected to attend for around 3 weeks.
8. How long will I be out of work?
You can expect to be out of work for a week or so after surgery for a torn cartilage. You may be out for a longer period of time if your work requires heavy lifting, working at heights, running, or jumping.
9. How long until I can resume normal activities?
After cartilage surgery, most patients can resume normal activities after 2 -6 weeks. The recovery will be longer (8-10 weeks) in patients in whom the torn cartilage is repaired rather than removed.
10. How long before I can play sports?
Generally, 2-6 weeks are required before athletes can return to sports after cartilage surgery. Again, the recovery is longer (8-10 weeks) in patients who require cartilage repair instead of removal.
9. Are there any additional resources I can reference?
Yes! Please see the American Academy of Orthopaedic Surgeons information on Meniscus (Cartilage) Tears and Treatment:
https://orthoinfo.aaos.org/en/diseases--conditions/meniscus-tears/