Meniscal tears – repair or replace?
There’s no better tissue than what God gave you. James Newman, knee specialist with Yorkshire Knee Clinic, explains why experienced knee surgeons work hard to ensure you keep the menisci in your knee.
Your knee has two menisci. They’re the c-shaped pieces of cartilage-like material that cup the thighbone where it meets the shinbone and help spread the load through the knee joint. A torn meniscus can cause symptoms ranging from general knee pain to the feeling that your knee is catching. You may also be unable to straighten your knee because the torn portion of meniscus is blocking normal joint movement.
The menisci are important pieces of tissue, but all too often there’s a tendency to whip them out rather than repair them – and that can only store up trouble for the future.
Why remove the meniscus?
At present, the only forms of meniscal replacement are at experimental stages. So if you tear a meniscus, you’re left with two alternatives: repair it or remove it.
Removing it can seem like an immediately attractive option. A repair takes longer to heal than a removal, so if you’re an elite athlete eager to get back to your sport, it can seem like the most obvious solution – and it’s hardly surprising that coaches will encourage it.
Then there’s the availability of knee specialists with the technical ability and experience to carry out a meniscal repair. Whilst all the knee surgeons at Yorkshire Knee Clinic have a lengthy track record of successful meniscal repairs, these are not run of the mill procedures and some surgeons will be far more familiar with meniscal removal via keyhole surgery than the alternative.
Knee replacement in your thirties?
Remove the lateral meniscus on the outside of the knee and you’ll probably begin to develop arthritis within five years. You’ll almost certainly have an arthritic joint within ten years. If you are an older patient, that may not be of great concern, as a knee replacement can address the problem and is increasingly likely to last the rest of your life.
But what if you’re a footballer in your early twenties? Removing the menisci at such a young age almost inevitably means consigning you to arthritis by the time you reach 30 – and that’s an extremely young age to be considering a knee replacement. It also means you’ll need multiple knee replacements during your lifetime.
That’s something any knee surgeon would prefer to avoid.
3 steps to a healed meniscus
If you damage your knee and suspect a torn meniscus – and particularly if you’re active in high level sport – follow these steps.
1. Seek treatment fast. The quicker you’re seen, the greater the likelihood the repair will be successful
2. Choose a knee specialist. Not all knee surgeons who could operate on you are specialists in meniscal repair
3. Don’t sacrifice long-term knee health for short term gain. If you’re presented with a choice between meniscal repair and meniscal removal, choose repair every time
Are you worried that you’ve torn your meniscus? Talk to the knee specialists at Yorkshire Knee Clinic.