Meniscal repair is a surgical procedure aimed at repairing torn or damaged meniscal tissue in the knee joint. The meniscus serves as a cushioning structure within the knee, dispersing pressure and stabilizing the joint. Damage to the meniscus often results in pain, limited activity, and increased risk of degenerative arthritis. This treatment seeks to restore meniscal function, prevent long-term structural damage, and is suitable for specific types of tears.
The surgery is typically performed using minimally invasive arthroscopic techniques, where the surgeon directly repairs the tissue or removes irreparable portions. The goal of treatment is to preserve the physiological function of the meniscus, reduce the likelihood of future arthritis and secondary surgeries, especially in young, active patients.
Mainly divided into "Direct Suturing Repair" and "Biological Healing Promotion Techniques." Direct suturing uses absorbable sutures to precisely align torn tissues, promoting natural healing; biological techniques may incorporate growth factors or scaffold materials to stimulate surrounding tissue repair.
Suitable for vertical or bucket-handle tears in the red zone of the meniscus (area with sufficient blood supply), typically in patients under 40 years old with minimal joint degeneration. Acute injuries (less than 3 months old) and high activity demand patients (such as athletes) are preferred candidates.
Contraindications include tears in the white zone (poor blood supply), severe joint degeneration, or patients with systemic conditions that preclude surgery. Physicians will assess suitability through MRI and clinical examinations, ruling out other joint issues.
The procedure is usually performed under general anesthesia, lasting about 1-2 hours. The surgeon will first evaluate the extent of damage via arthroscopy, then decide on repair or partial removal. Postoperative fixation with braces and physical therapy are required, with recovery taking approximately 6-12 weeks.
The concept of dosage relates to the scope of the surgery and the density of sutures; the surgeon adjusts the number of sutures based on tear length and location. For example, marginal tears may require 2-4 stitches, while central tears may be managed with trimming.
Preserving the meniscus structure maintains joint biomechanics and reduces the risk of early degenerative arthritis by 40-60%. Minimally invasive techniques shorten recovery time, allowing patients to gradually resume daily activities within 3-6 weeks.
Potential complications include infection (incidence about 1-3%), re-tearing after repair (5-10%), and thrombosis risk (requiring anticoagulant therapy postoperatively). A small number of patients may require secondary surgery due to poor tissue healing.
Serious risks: nerve and vascular injury, chronic joint stiffness, foreign body reactions, etc. Surgeons will evaluate patients' coagulation function and metabolic status preoperatively to minimize risks.
Preoperative requirements include discontinuing anticoagulants (such as aspirin) for at least one week and controlling blood sugar and blood pressure. Strict adherence to rehabilitation plans postoperatively is essential, avoiding early weight-bearing or twisting movements.
Contraindications include: white zone meniscal tears, severe osteoarthritis, coagulation disorders, infectious arthritis, or inability to cooperate with rehabilitation.
Compared to traditional partial meniscectomy, repair preserves more tissue but involves longer rehabilitation. It is often combined with physical therapy and intra-articular injections (such as hyaluronic acid), but anticoagulants should be avoided simultaneously.
If combined with patellar cartilage repair, rehabilitation timing must be adjusted to prevent dual tissue damage. Surgeons will evaluate the synergistic effects and cumulative risks of multiple treatments.
Studies show that patients with red zone tears who undergo repair have a 65% lower incidence of arthritis at 10 years compared to those who had meniscectomy. About 90% of patients regain their athletic function within one year postoperatively, but healing success is closely related to tear location.
Randomized controlled trials confirm that the repair group shows a 70% improvement in joint pain scores, superior to conservative treatment at 45%. However, healing rates for central zone tears are only 30-40%, requiring individual assessment.
Conservative treatments include physical therapy and pain medications, suitable for mild symptoms or high-risk patients. Partial meniscectomy can provide immediate symptom relief but may accelerate joint degeneration.
Emerging options include bone marrow stimulation techniques or stem cell therapy, though evidence levels are lower. Physicians will recommend the most appropriate treatment combination based on tear type, patient age, and lifestyle.
Preoperative MRI is recommended to confirm the extent of injury, and anticoagulant use should be adjusted according to medical advice. Avoid alcohol for three days before surgery, and fasting for 6 hours on the day of surgery. Discussing rehabilitation plans with a physical therapist in advance can shorten the postoperative adaptation period.
How can pain be alleviated and joint stiffness prevented in the early postoperative period?Ice packs applied to the affected area for 15 minutes every 3-4 hours within 48 hours post-surgery can reduce swelling. Non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed to control pain, but early weight-bearing should be avoided. Gentle knee flexion and extension exercises for 5-10 minutes daily can prevent joint adhesions.
When can daily activities and sports be resumed after repair?Generally, slow walking and light household chores can be resumed within 2-4 weeks, with the aid of crutches for at least 6 weeks. Full recovery for running or ball sports typically takes 4-6 months, contingent upon imaging confirmation of tissue healing and assessment of muscle strength and stability by the physician.
Can flying or long-distance travel be done during the rehabilitation period?Long-distance travel should be avoided within one month post-surgery, as prolonged sitting may increase thrombosis risk. If flying is necessary, knee movements should be performed every half hour, and compression stockings worn. In later stages of rehabilitation (around three months), short trips are possible, with regular stretching and close monitoring of swelling.
If reinjury occurs after repair, will it affect the original repair outcome?Reinjury with twisting forces may cause the sutures to tear. Patients should avoid high-impact sports within one year post-surgery and continue strengthening the quadriceps and core muscles to stabilize the knee. Regular MRI follow-ups can detect abnormalities early, reducing the risk of secondary injury.
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