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Meniscus Injury Recovery & Rehabilitation

Dr Andrew Dutton - Meniscus Injury Recovery and Rehabilitation
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Meniscus injuries are common yet often misunderstood knee injuries that can significantly impact a person’s mobility and quality of life. In this blog, we delve into the intricacies of meniscus injuries, focusing on their diagnosis, treatment, and the crucial role of rehabilitation.

By presenting an informed overview of meniscus injuries, including the tear of the lateral meniscus and the importance of articular and knee cartilage in such conditions, we aim to provide readers with a clear understanding of the recovery process.

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What are Meniscus Injuries

The knee joint is a sophisticated structure comprising bones, ligaments, tendons, and cartilage. Central to this anatomy are the meniscus and articular cartilage. The meniscus, a C-shaped cartilage, acts as a shock absorber between the thigh and shin bones. In contrast, the articular cartilage covers the ends of these bones, facilitating smooth joint movement. Injuries or wear to these components can lead to pain, swelling, and reduced mobility, highlighting their critical role in knee health.

Types of Meniscus Injuries

Meniscus injuries are primarily categorised based on their location and the tear pattern. The most commonly discussed is the tear of the lateral meniscus, situated on the outer side of the knee. This type of tear can range from minor, where only a small part of the cartilage is affected, to severe, where the tear extends to a significant portion of the meniscus. Each type of tear has its implications for knee function and treatment approaches.

Causes and Risk Factors

Injuries to the meniscus can result from various causes, including acute trauma and degenerative processes. Acute injuries are often sports-related, occurring through sudden twists or turns. Meanwhile, degenerative tears are more common in older populations, resulting from wear and tear over time. Risk factors include age, participation in certain sports, previous knee injuries, and occupational hazards.

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Symptoms & Diagnosis of Meniscus Injuries

Identifying a meniscus injury at its early stages is critical to effective management. Common symptoms include knee pain, especially when twisting or squatting, swelling or stiffness in the knee, a sensation of the knee being “locked” or unable to move fully, and sometimes a popping sensation during the injury. These symptoms may vary depending on the severity and type of the tear. It’s important to note that some meniscus injuries may present with mild symptoms initially but can worsen over time if not adequately addressed.

Diagnostic Approaches

Accurate diagnosis of a meniscus injury typically involves a combination of clinical evaluation and imaging tests. A healthcare professional will initially conduct a physical examination, assessing pain, range of motion, and the knee’s structural integrity. They may perform specific tests, such as the McMurray test, to provoke symptoms indicative of a meniscus injury. Imaging tests like X-rays often rule out other knee problems, such as fractures. However, the most definitive diagnostic tool is Magnetic Resonance Imaging (MRI), which provides detailed images of the knee’s soft tissues, including the menisci.

Treatment Options for Meniscus Injuries

Non-surgical treatments are often the first line of approach, especially for less severe injuries. It may include rest, ice, compression, and elevation (RICE) to reduce swelling and pain. Physical therapy plays a crucial role in strengthening the muscles around the knee and improving joint stability and mobility. In some cases, medications such as anti-inflammatory drugs can be prescribed to manage pain and swelling. These treatments are typically recommended for minor tears or patients for whom surgery poses higher risks.

When non-surgical treatments are not effective, or in the case of more severe tears, surgery may be necessary. The most common surgical procedure for a meniscus injury is arthroscopic surgery. This minimally invasive surgery involves making small incisions around the knee, through which an arthroscope and surgical instruments are inserted to repair or remove the damaged meniscus tissue. The specific surgical approach, such as meniscus repair or partial meniscectomy, depends on the tear’s location, size, and the patient’s overall health.

a/professor andrew dutton types of knee replacement surgery infographic

Deciding between surgical and non-surgical treatments involves considering various factors, including the injury’s severity, the patient’s age, activity level, and overall health. Surgery may offer a quicker return to total activity but comes with risks such as infection, blood clots, and potential complications. Non-surgical treatments, while less invasive, may require a longer recovery time and may not always restore the knee’s full functionality, especially in the case of larger or more complex tears.

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Meniscus Repair & Surgery

What happens during meniscus repair surgery? Meniscus repair surgery, typically performed arthroscopically, involves small incisions around the knee through which surgical tools and a camera are inserted. Depending on the tear’s nature and location, the surgeon either repairs or trims the torn meniscus. Repair is preferred to preserve as much of the meniscus as possible, which is crucial for long-term knee health. The surgery usually takes about an hour, and in most cases, patients can go home the same day.

Comparative Table of Meniscus Tear Surgical Options

PROCEDURE
INVASIVENESS
RECOMMENDED FOR

ESTIMATED RECOVERY TIME

Arthroscopic Surgery
Minimally invasive; uses small incisions
Based on individual factors and findings post consultation
Around 6 to 8 weeks
Meniscal Repair
Involves suturing the torn meniscus
Typically younger patients; for tears in outer third with good blood supply
Around 3 to 6 months
Meniscectomy
Removal of torn meniscus portion
Typically older patients; for tears in inner two-thirds with poor blood supply
Around 3 to 4 weeks

* As a rule of thumb, patients usually need to avoid weight-bearing activities for several weeks and engage in a rehabilitation program to restore strength and mobility to the knee. Note that timelines vary based on individual factors such as age, overall health, and the specific type of tear. Consulting with a healthcare provider or surgeon for personalised recovery guidelines is crucial.

Immediate Post-Surgery Care

The immediate recovery phase following meniscus repair is crucial. Patients are generally advised to rest and may need to use crutches to avoid putting weight on the operated knee. Ice and elevation help reduce swelling and pain. Pain management, typically with prescribed medications, is an essential aspect of this phase. Additionally, patients may start with gentle range-of-motion exercises soon after surgery to prevent stiffness.

Long-Term Care & Complications

Long-term care focuses on rehabilitation and gradual return to activities. Physical therapy is vital, restoring knee strength, flexibility, and function. Patients are guided through a series of exercises, progressively increasing in intensity. It’s crucial to follow the therapist’s advice to avoid setbacks. While rare, complications like infection, blood clots, or re-injury can occur, and patients should be aware of these risks. Regular follow-ups with the healthcare provider are important to monitor healing and address concerns.
dr andrew dutton meniscus injury recovery and rehabilitation timeline

Rehabilitation & Physiotherapy After Meniscus Injury

Physiotherapy is essential in the recovery process following a meniscus injury, whether treated surgically or non-surgically. It aims to restore knee function, strengthen the surrounding muscles, and reduce the risk of future injuries. A physiotherapist tailor exercises to the individual’s specific needs, focusing on improving range of motion, strengthening the quadriceps and hamstrings, and enhancing overall knee stability. The therapy also involves educating patients on managing their condition and preventing re-injury.

Key Exercises and Stages of Rehabilitation

The rehabilitation process typically progresses through several stages. Initially, the focus is on reducing pain and swelling, followed by exercises to restore motion and strength. These exercises gradually increase in intensity and complexity, depending on the individual’s progress. Examples include heel slides for flexibility, straight leg raises for stability, and, eventually, more dynamic exercises like squats and lunges. The duration of each stage varies based on the severity of the injury and the patient’s response to therapy.

Returning to Normal Activities

Resuming normal activities, including sports, is a goal for many recovering from meniscus injuries. The timing of this return is crucial and should be based on the knee’s functional ability rather than a predetermined timeline. Factors such as full range of motion, adequate strength, and lack of pain are considered before gradually reintroducing activities. Athletes may require sport-specific exercises to prepare for the demands of their sport. Patients are advised to communicate with their physiotherapist and healthcare provider throughout this phase to ensure a safe and effective return to their desired activity level.

Meniscus Injury Recovery & Rehabilitation in Singapore

The complexity of meniscus injuries underscores the necessity for personalised care and informed decision-making. Recovery from such injuries is not just a physical process but also involves understanding and patience, as each individual’s path to healing can vary. Suppose you’re facing challenges related to meniscus injuries. In that case, seeking advice from an experienced, accredited, and licensed orthopaedic surgeon is crucial.

A/Professor Andrew Quoc Dutton, a Harvard Fellowship-trained orthopaedic surgeon based at Mount Elizabeth Hospital in Singapore, offers over 20 years of professional expertise in orthopaedic care. Specialising in complex arthroscopic and reconstructive joint surgeries, Dr Dutton and his team provide comprehensive services, including diagnosis and surgical and non-surgical treatment options tailored to individual needs. His approach combines up-to-date surgical techniques with personalised care, ensuring that each treatment plan is tailored to each patient’s specific needs. To book an appointment, call (+65) 6836 8000 or fill out the contact form on our website.

A/Professor Andrew Quoc Dutton Orthopaedic & Sports Clinic Insurance

The A/Professor Andrew Quoc Dutton Orthopaedic & Sports Clinic offers minimally invasive and surgical treatments for sports-related injuries and orthopaedic conditions.

To aid in the expenses that you may incur, we accept a number of corporate and international insurance. If you have any of the insurance plans below, please let us know when you book an appointment with us. If you need further assistance, you may drop us an e-mail at info@eliteortho.com.sg or call us at (+65) 6836 8000.

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  • MHC Medical Network
  • NTUC Income
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About A/Professor Andrew Quoc Dutton

A/Professor Dutton, also known as, has been in clinical practice since 1996 after graduating from Marist College, Canberra and the University of New South Wales, Sydney, Australia. A/Professor Dutton has worked at the Prince of Wales Hospital, Sydney, and the St. George Hospital, Sydney, before completing his orthopaedic surgery training in Singapore. He is currently an associate professor of orthopaedic surgery at the National University of Singapore (NUS).

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