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Arthroscopic Knee Surgery : Partial Menisectomy

What is a Partial Menisectomy?

A partial menisectomy is a surgical procedure performed via keyhole surgery to remove a piece of torn cartilage in the knee joint. The meniscus (cartilage) is important in protecting the knee from wear and tear by providing shock absorption, improving the knee's stability and assisting lubrication. It can often become torn through repeated forces causing degeneration, or by trauma through sport. The torn piece of meniscus can often get trapped within the knee joint and can cause locking of the knee and pain, as well as other symptoms. The procedure involves removing the torn portion, trimming the surrounding edges to render the meniscus smooth. Only a small piece of the meniscus is usually removed (the torn portion) to preserve the knee joint as much as possible.

Menisectomies can be performed to the inner (medial) and/or the outer (lateral) meniscus depending on the location of the tear. Tears in the medial meniscus are more common as this side of the knee joint is the most weight bearing.

This procedure may be combined with a chondroplasty to encourage formation of cartilage on the joint surfaces. 

Post operative Care

The main focus following your surgery is to:

Encourage a normal walking pattern.
Manage any surgical pain.
Reduce swelling to the joint.
Restore normal range of movement.

Walking:

You will be issued with a pair of elbow crutches by your Physiotherapist. It is likely you will need to use these crutches for up to 10 days, this may vary depending on your surgery so you will need to check with your Consultant or Physiotherapist. It is very important that you use the crutches until advised to wean off them by your Physiotherapist.

Pain Control:

It is normal to expect some degree of discomfort from your surgical procedure. It is however important to manage your pain. You will be given a 5 day supply of pain relieving medication on the ward. You will need to continue taking pain-relieving medication for the next few weeks, so consider over-the-counter medication before you finish your supply, or request a repeat prescription from your GP. It is advisable to take pain-relieving medication, even if you think you don't need it.

Swelling:

Swelling is often associated with surgery as an inflammatory product. Excessive swelling can reduce joint movement; alter muscle control and joint awareness (proprioception). To reduce and prevent swelling, use a bag of frozen peas wrapped in a tea towel and place on the knee every 2-3 hours for 30 mins.

Movement:

It is important to encourage the restoration of normal movement. As tissue heals within joints is has a low elastic property. By performing some gentle exercises this will encourage the tissue to become more flexible as it heals. Moving a joint also promotes healthy joint nutrition, which can facilitate healing. The following exercises are designed to restore normal range of movement, and encourage some basic muscle control. Your Physiotherapist will progress these when appropriate.

Approximate Milestones

Weeks 1 - 3   Reduce post operative swelling and control pain
Weeks 3 - 4   Restore normal walking unaided
Weeks 3 - 4   Full active range of movement Start open chain strengthening
Weeks 6 - 8   Return to swimming
Progress to closed chain single leg strengthening
Weeks 8 -12 Dynamic / Sports specific rehabilitation
Week 12 +    Return to sports -Running, Racquet Sports, Team sports, Golf

Exercises following your knee arthroscopy

These exercises are to help restore knee movement and muscle power. Exercise within a pain free range. There may be some discomfort after completing the exercises, this should settle within ˝ hour. If it does not, reduce the number of exercises you are doing.

Active Knee Flexion
Start Position: Lying on back leg straight.
Action: Slowly bend your knee, sliding your heel towards your bottom. Bend your knee as far as you are comfortable with.
Repeat: 6-10 times 3 x per day. Increase as able.

Static Quads
Start Position: Lying on back leg straight.
Action: Brace your thigh, firmly pushing the back of your knee into the bed.
Repeat: 6-10 times x 3 per day. Increase as able.

Inner Range Quads
Start Position: Lying on back rolled towel behind knee.
Action: Brace your thigh muscle and push the back of your knee into the towel, straightening the knee.
Repeat: 6-10 times x 3 per day. Increase as able.

Straight Leg Raise
Start Position: Leg straight out in front of you. Brace thigh muscles pushing firmly into bed.
Action: Slowly raise you leg off the bed approximately 3-4 ". Hold and slowly lower.
Repeat: 6-10 times, x3 per day, increase as able.

Walking

You will have been issued with crutches to enable you to take weight through the operated leg. The physiotherapist will have sized them for you. The following information is to remind you how to use them and to help keep you safe.

The crutches are there to assist the operated leg. Place both crutches forward, take a step with the operated leg and then move the unoperated leg forward. Remember not to stride too far, as this will unbalance you.

Continue to use both crutches until you see your Outpatient Physiotherapist.
They will advise you how to progress your walking. You may be advised to remain on your crutches for a little longer, if you have had a Microfracture, Chondroplasty, or lateral release. Your Consultant will advise you of this and your Physiotherapist will be able to offer further written advice.

Stairs

When using crutches on the stairs it is worth remembering the following rhyme:

"Good leg up to heaven; bad leg down to hell!"

Going up stairs:  The good leg (unoperated) steps up first, followed by the operated leg to the same step and then the crutches.

Going down stairs: Crutches first, followed by the operated leg, then unoperated leg (reverse of going up). If a handrail is available, place both crutches in the free hand like this:












Driving

For your own safety and the safety of others, do not drive until you can fully bend your knee, your pain has settled and you feel capable to perform an "emergency stop". Please ask your Consultant when they are happy for you to resume driving.

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T: 02392 352 206

 
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