Name of the Procedure:

Arthrotomy, with Excision of Semilunar Cartilage (Meniscectomy), Knee; Medial and Lateral

Summary

Arthrotomy with meniscectomy is a surgical procedure that involves making an incision into the knee joint to remove damaged or torn meniscal cartilage from both the medial and lateral sides of the knee. This is aimed at alleviating pain and restoring function to the knee.

Purpose

This procedure addresses issues related to damaged or torn meniscal cartilage, which is crucial for cushioning and stabilizing the knee joint. The goals are to relieve pain, improve knee function and mobility, and prevent further joint damage.

Indications

• Severe knee pain that interferes with daily activities
• Meniscal tears confirmed by MRI or other diagnostic imaging
• Knee locking or inability to fully extend or bend the knee
• Swelling or recurrent knee effusions
• Failed conservative treatments such as physical therapy or medication

Preparation

• Patients may need to fast for 8-12 hours prior to the procedure.
• Adjustments to medications, especially blood thinners, as per doctor’s advice.
• Preoperative diagnostic tests, such as MRI, physical examination, and blood tests, may be required.

Procedure Description

1. The patient is administered anesthesia, typically general or spinal anesthesia.
2. An incision is made in the knee to access the joint.
3. Specialized surgical instruments are used to visualize and remove the damaged meniscal cartilage from both the medial and lateral aspects of the knee.
4. The joint is cleaned, and the incision is closed with sutures or staples.
5. A sterile dressing is applied, and the knee may be bandaged.

Duration

The procedure typically takes about 1-1.5 hours.

Setting

This procedure is usually performed in a hospital or a specialized surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist
• Operating room technicians

Risks and Complications

• Infection
• Bleeding
• Blood clots
• Damage to surrounding nerves or blood vessels
• Stiffness or loss of motion in the knee
• Persistent pain or recurrence of symptoms
• Adverse reactions to anesthesia

Benefits

• Relief from knee pain
• Improved knee function and mobility
• Prevention of further joint damage
• Quick return to normal activities generally within a few weeks

Recovery

• Initial rest and limited weight-bearing on the operated leg
• Pain management with medications
• Physical therapy to restore strength and mobility
• Recovery period may range from a few weeks to several months, with full activity often resumed within 3-6 months
• Follow-up appointments to monitor healing progress

Alternatives

• Conservative treatments such as physical therapy, medications, and corticosteroid injections
• Arthroscopic surgery, a minimally invasive alternative
• Pros: Arthroscopy involves smaller incisions and typically has a shorter recovery period.
• Cons: May not be suitable for extensive or severe meniscal damage.

Patient Experience

• Postoperative pain managed with medications
• Mild discomfort and swelling are common but usually decrease within a few days
• Physical therapy plays a crucial role in recovery
• Most patients can return to light activities within a few weeks, with full recovery taking a few months.