ARTHROSCOPY-MENISCECTOMY

In recent years, advances in orthopaedic treatment modalities have evolved to the development of minimal invasive operating procedures.  Arthroscopy (also called arthroscopic surgery) is a minimally invasive surgical procedure in which the treatment of damage of the interior of a joint is performed using arthroscope, a type of endoscope that is inserted into the joint through a small incision. The advantage of arthroscopy over traditional open surgery is that the joint does not have to be opened up fully. The surgical instruments utilized are smaller and surgeons can view the joint area on a video monitor and diagnose and repair torn joint tissue, such as ligaments and menisci or cartilage. The advantages of this technique are very small incisions, excellent examination of the lesion under direct visual control, reducing the operating time, limited duration of hospitalization after surgery, reduced post-operative complications and rapid return to activities.

The rupture of the meniscus of the knee is one of the commonest causes of knee pain. The menisci (medial and lateral) are two fibrocartilaginous formations that act as knee absorbers that reduce the carrying loads and protect the cartilaginous articular surfaces. The rupture of the meniscus may be a result of sports injury in young patients or degenerative as a result of the normal aging process as in older patients. The diagnosis is made by clinical examination and confirmed by MRI. The symptoms are usually pain, which worsens during squatting and stairs, swelling of the knee and sometimes ‘ lock ‘ the knee joint. The torn pieces of a ruptured meniscus destroy the delicate cartilage surface of the knee, which gradually led to arthritis.

The treatment of acute traumatic rupture of the meniscus is surgery (meniscectomy). With the help of the arthroscope and two small holes meniscus is stapled or we remove the ruptured pieces. The degenerative tear of the meniscus may initially be treated conservatively, but if the symptoms persist meniscectomy is recommended. The aim is to preserve as much as possible meniscal tissue to reduce the chances of developing arthritis. In young patients with large loss of meniscal tissue, meniscal transplantation is suggested in order to prevent the development of arthritis.