The operation to remove the meniscus

Meniscatectomy is an operation to remove a meniscus. Most often, this remedy is used in such trauma as a meniscus rupture. As a rule, if the meniscus rupture is small, it can heal itself, but if two thirds of the inner zone is damaged, then there is no independent healing. In this case, if the fragment of the meniscus is separated - this leads to blockage of the joint and the appearance of strong pain sensations. With these symptoms, a full or partial meniskectomy is prescribed.

Open meniscectomy

With open meniscectomy, the patient's knee is cut layer by layer using a small incision from below. In this case, the knee joint must be kept bent. After cutting the synovial membrane of the knee, the surgeon searches for a torn meniscus. Once it is found, it is removed. In this case, the specialist who conducts the operation holds the front horn and cuts with the scalpel all the points of attachment of the damaged meniscus. After that, the cut is sewn back in layers.

Endoscopic meniscectomy

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This type of meniscectomy does not require a long incision, it is less traumatic and minimizes possible complications after surgery. Also, with this type of meniscetomy, the surgeon can best examine the cavity of the knee joint. For this operation, you need an arthroscope, a device consisting of three tubes, one of which introduces a sterile liquid into the joint, the second performs a surgical procedure, the third is used to examine the meniscus, combining a light source and a video camera.

During the operation, three( according to the number of tubes) of a small cut are made. Further, they introduce tubes of an arthroscope. Sterile fluids that are injected into the joint cavity help to increase the area of ​​the operation, which greatly simplifies the work of the surgeon. If the meniscus rupture is not very large, it is sutured, and the removal of the meniscus does not differ technically from the same with open meniscectomy. After the completion of all surgical procedures, the fluid is removed from the cavity, the arthroscope tubes are removed and a bandage is applied.

If the meniscus is completely removed, then no matter how the operation is performed, the development of arthritis of the knee is inevitable.

When comparing endoscopic and open meniscectomy, the former has many advantages, which the second is devoid of. First, it provides a more accurate diagnosis. Secondly, you can more accurately see the picture of the anatomy of the joint. Thirdly, the tissue of the meniscus is less damaged in this operation. Fourth, it allows reducing the time of postoperative recovery, it is less painful than open, which opens the possibility of using active rehabilitation, reducing the time of patient's stay in the hospital.

The use of endoscopic meniscactomy allowed surgeons to see what the operations on the knee joint lead to, namely, that with complete removal of the meniscus, deforming arthrosis inevitably develops. Gradually, the doctors came to the conclusion that for better preservation of the cartilage of the joint, it is necessary to ensure its stability by restoring the original condition of the ligaments. Thus, arthroscopy changed the attitude of doctors to the joint to a more gentle one, replacing the idea of ​​the complete removal of the meniscus on the idea of ​​their restoration. This theory has many supporters among specialists and researchers.

There are already several types of implants for the restoration of meniscus, from a variety of materials, among which there are also absorbable. At the present time, the development of new methods of fixing with the use of new materials continues. However, it is obvious that the results of implantation of new implants can be assessed only by careful processing of long-term results of treatment and with a detailed description of all unsatisfactory and negative outcomes of treatment. Now the importance of endoscopic meniscactomy is rapidly increasing along with the process of improving the technique used in arthroscopy, the emergence of new ways of fixing the fragments of the meniscus and restoring the functionality of the knee.