The meniscus has an extremely important function in the knee joint as a shock absorber. In the case of meniscus tears, this function can no longer be performed, which, if left untreated, leads to consequential damage to the cartilage (osteoarthritis) and misalignments in the joint. For this reason, a meniscus tear should be treated surgically in most cases.
State-of-the-art, particularly gentle microsurgical techniques, some of which we developed ourselves, which do not injure tendons, bones or surrounding tissue, make the operation much more comfortable for our patients:
No post-operative bleeding or major swelling:
We can prevent post-operative bleeding by avoiding the use of burrs and the intraoperative treatment of very minor bleeding. This significantly reduces the pressure on the joint capsule and means much less, and in many cases even no, significant pain after the operation.
Often no crutches:
The gentle surgical technique also means that our patients can usually walk normally on the 1st day after knee surgery and therefore do not need crutches.
No drainage:
We can always dispense with the insertion and subsequent removal of a drain.
No stitches necessary:
Theuse of cosmetic sutures means that our patients do not need to remove stitches. No tourniquet during the operation and thus protection of the thigh muscles:
As we work so gently that we do not have to apply a tourniquet to your thigh, we significantly protect the thigh muscles, which means faster regeneration after the operation.
The meniscus is only well supplied with blood at its base in the area of the joint capsule and can be sutured very successfully here in the case of fresh injuries so that no meniscus tissue needs to be removed.
In the part of the meniscus that is not supplied with blood, there is no good chance of the suture site healing together. In this case, the damaged part of the meniscus must be removed.
Depending on the type and location of the tear, different suturing techniques are used to provide patients with the best possible treatment. All suturing techniques are performed arthroscopically, meaning that no large incisions are required.
If there is minor bleeding in the joint, this is detected directly during the minimally invasive operation and sealed again using special instruments. In the vast majority of cases, these new arthroscopic techniques allow patients to move their knee joint again shortly after the operation, as there is little or no swelling of the joint.
Depending on the shape of the tear and the type of meniscus tear (outer meniscus or inner meniscus), movement must usually be avoided for a certain period of time after meniscus suturing, which is ensured by appropriate orthoses.
To reduce the strain on the fresh suture and ensure optimal healing, it may be advisable to use walking sticks for a maximum of 6 weeks, depending on the shape, size and location of the tear.
Donor menisci or synthetic meniscus tissue can now even be used to replace the natural meniscus.
This complex operation can also be performed arthroscopically nowadays. However, in this case, the knee joint needs to be relieved and movement restricted for a longer period of time to ensure complete healing.
Depending on the type of tear, between 20 and 30 minutes.
Between 30 and 60 minutes for a meniscus suture, depending on the time required.
If only a small part of the meniscus tissue (a small flap tear) has been removed, full weight-bearing is normally possible again just a few hours after the operation. Walking sticks are only required for 1-2 days for better dosage and safety.
We recommend walking sticks for 3-6 weeks after meniscus suturing, as this allows the load on the sutured meniscus to be better dosed.
As soon as your leg can bear normal weight again, you can drive again.
This will be discussed with you individually, but is usually possible again after 2-3 days at the latest following partial meniscus removal.
If you have had a meniscus suture and are not allowed to put full weight on your leg for a few weeks, you may also have to refrain from driving for up to 6 weeks.
In the case of a partial meniscus resection after 3-6 weeks.
In the case of a meniscus suture between 8 and 12 weeks after the operation.
In the case of a clear meniscus tear with swelling and blockages, even a non-athlete needs surgical treatment, as otherwise the signs of entrapment can lead to cartilage abrasion, cartilage damage and the development of osteoarthritis.
If the meniscus, and therefore the knee's shock absorber, is damaged, the cartilage is overloaded. This can lead to the development of osteoarthritis. Constant pinching also leads to increased tension on the meniscus, which in turn means that in most cases the meniscus tear becomes larger and larger and even more tissue has to be removed during a later operation.
With today's special minimally invasive techniques, complications are extremely rare. The worst and extremely rare complication would be a joint infection, in which case an antibiotic would also have to be administered. It may be necessary to rinse the knee joint again.
Short-term relief and anti-inflammatory medication can reduce minor irritation.
A one-off cortisone injection often helps with spontaneous, severe swelling of the knee. However, this only alleviates the symptoms and does not tackle the cause of the problem. Overall, however, we are very cautious about injecting cortisone into the joint, as this can also hinder natural healing processes. Likewise, in the case of structural damage, the patient is led to believe that the knee joint is healthy again after the cortisone injection, although there is still structural damage that could lead to cartilage damage and later to osteoarthritis. The decisive factor in our treatment is not short-term success, but long-term healing and maintaining the normal joint for as long as possible.
Cortisone infiltration is covered by all health insurance companies.
Hyaluronic acid is used for additional cartilage damage in order to prevent the development of progressive osteoarthritis. However, if there is structural damage in the form of a meniscus tear, which is also symptomatic (causes discomfort), hyaluronic acid should be used with caution so as not to only improve the cartilage, which could still be damaged by the meniscus tear. The structural damage (the meniscus tear) should be treated first and then the resulting cartilage damage should be addressed in order to prevent further progression of osteoarthritis.
Acupuncture can be used very well as supportive pain therapy and to reduce the tendency to swell in osteoarthritis.
1x - 2x per week for 10 weeks
