Name of the Procedure:

Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial OR lateral

Summary

Arthrotomy with excision of semilunar cartilage, commonly known as a meniscectomy, is a surgical procedure where a surgeon removes part or all of a damaged meniscus from the knee. The meniscus is a piece of cartilage that acts as a cushion between the femur (thigh bone) and the tibia (shin bone).

Purpose

Medical Condition or Problem Addressed

• Meniscus tears

Goals or Expected Outcomes

• Relieve pain and swelling
• Improve knee joint function
• Prevent further joint damage

Indications

Symptoms or Conditions

• Knee pain, swelling, and stiffness
• Locking or catching sensation in the knee
• Limited range of knee motion

Patient Criteria

• Patients with confirmed meniscus tears via MRI or other imaging
• Non-responsive to conservative treatments like physical therapy or medication

Preparation

Pre-procedure Instructions

• Fasting for 8 hours before surgery
• Temporary discontinuation of certain medications like blood thinners

Diagnostic Tests

• MRI or X-ray of the knee
• Blood tests and physical examination

Procedure Description

1. Anesthesia: General or regional (spinal/epidural) anesthesia is administered.
2. Incision: A small incision is made in the knee joint to expose the meniscus.
3. Excision: Damaged parts of the meniscus are carefully removed using surgical instruments.
4. Closure: The incision is closed with sutures or staples, and a sterile bandage is applied.

Tools and Equipment

• Surgical knives and scissors
• Arthroscope for visual guidance (if using minimally invasive techniques)

Anesthesia Details

• Administered and monitored by an anesthesiologist

Duration

Typically, the procedure takes about 1 to 2 hours.

Setting

Performed in a hospital or outpatient surgical center.

Personnel

• Orthopedic surgeon
• Surgical assistants
• Anesthesiologist
• Nursing staff

Risks and Complications

Common Risks

• Infection
• Bleeding
• Swelling and stiffness

Rare Risks

• Damage to surrounding nerves or blood vessels
• Blood clots
• Adverse reaction to anesthesia

Management of Complications

• Use of antibiotics for infection
• Regular follow-up appointments

Benefits

• Pain relief often within a few weeks
• Increased knee stability and function
• Rapid return to normal activities

Recovery

Post-procedure Care

• Rest and elevation of the knee
• Icing to reduce swelling
• Physical therapy for rehabilitation

Recovery Time

• Typically 4-6 weeks, with some restrictions on activities

Follow-up

• Scheduled appointments to monitor healing progress

Alternatives

• Physical therapy
• Corticosteroid injections
• Knee brace or support
• Alternative surgical techniques like meniscus repair

Pros and Cons of Alternatives

• Non-surgical options have lower risk but may be less effective in severe cases
• Meniscus repair is less invasive but requires longer recovery

Patient Experience

During the Procedure

• No pain felt due to anesthesia
• Minimal awareness if under general anesthesia

After the Procedure

• Mild to moderate pain managed with painkillers
• Swelling and bruising around the knee
• Discomfort for a few days, gradually improving with recovery

Pain Management and Comfort Measures

• Prescription pain medications
• Cold packs and elevation
• Supportive care from medical staff and physical therapists