Meniscal Repair: Difference between revisions

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== Description  ==
== Description  ==
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add links to case studies here (case studies should be added on new pages using the [[Template:Case Study|case study template]])<br>  
add links to case studies here (case studies should be added on new pages using the [[Template:Case Study|case study template]])<br>  
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== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==


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== Recent Research  ==
 
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== References<br>  ==
== References<br>  ==

Revision as of 21:54, 22 May 2009

Original Editor - Rachael Lowe

Lead Editors - Your name will be added here if you are a lead editor on this page.  Read more.

Description[edit | edit source]

An arthroscopic meniscectomy is a surgical procedure to cut out part or all of the knee meniscus via keyhole surgery.  A complete meniscectomy is where all of the meniscs right up to and including the meniscal rim is removed.  Partial meniscectomy describes the procedure where not all of the meniscus is removed which may vary from minor trimming of a frayed edge to anything short of removing the rim.  This is a minimally invasive procedure often undergone as an outpatient.




Indication
[edit | edit source]

Meniscal tears that are not suitable for meniscal repair.

Clinical Presentation[edit | edit source]

  • joint line tenderness and effusion
  • symptoms are frequently worsened by flexing and loading the knee, activities such as squatting and kneeling are poorly tolerated.
  • complaints of 'clicking', 'locking' and 'giving way' are common

Diagnostic Tests[edit | edit source]

  • Joint line tenderness has been reported to be the best common test for meniscal injury[1].
  • McMurray's test positive if a pop or a snap at the joint line occurs while flexing and rotating the patient's knee.
  • Appley's test performed with the patient prone, and with the examiner hyperflexing the knee and rotating the tibial plateau on the condyles.
  • Steinman's test performed on a supine patient by bringing the knee into flexion and rotating.
  • Ege's Test is performed with the patient squatting, an audible and palpable click is heard/felt over the area of the meniscus tear. The patient's feet are turned outwards to detect a medial meniscus tear, and turned inwards to detect a lateral meniscus tear.
  • Imaging

Pre-Op[edit | edit source]

add text here relating to the pre-operative advice

Post-Op[edit | edit source]

The goal of rehabilitation is to restore patient function based on individual needs.  It is important to consider the type of surgical procedure, which meniscus was repaired, the presence of coexisting knee pathology (particularly ligamentous laxity or articular cartilage degeneration), the type of meniscal tear, the patient's age, preoperative knee status (including time between injury and surgery), decreased range of motion or strength, and the patient's athletic expectations and motivations.

  • control the pain and inflammation - cryotherapy, analgaesics, NSAIDs,
  • restore ROM - ROM exercises within any limts in range that the consultant has requested
  • restore muscle function - specific strengthening exercises including qudriceps, hamstrings, calf, hip
  • optimize neuromuscular coordination - propriocetive re-education
  • progress weight bearing - weight bearing and joint stress are necessary to enhance the functionality of the meniscal repair so should be progressed as indicated by the consultant.  Excessive shear forces may be disruptive and should be avoided initially.

Key Evidence[edit | edit source]

add text here relating to key evidence with regards to any of the above headings

Resources
[edit | edit source]

Timothy Brindle,John Nyland and Darren L. Johnson (2001) The Meniscus: Review of Basic Principles With Application to Surgery and Rehabilitation. Journal of Athletic Training, 36(2), 160–169.

Case Studies[edit | edit source]

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Recent Related Research (from Pubmed)[edit | edit source]

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References
[edit | edit source]

  1. ↑ Meserve BB, Cleland JA, Boucher TR. (2008) A meta-analysis examining clinical test utilities for assessing meniscal injury. Clinical Rehabilitation, 22(2), 143-61.
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