The meniscus (menisci for plural) is a C-shaped cartilage disc that cushions and helps stabilize the knee. There are two of these discs in each knee between the end of the thigh bone (femur) and lower leg bone (tibia). The one on the inside of the knee is called the medial meniscus while the one on the outer side is called the lateral meniscus. Tears in the menisci are categorized as either acute or degenerative. Acute meniscus tears occur suddenly, as an injury, usually when the leg is twisted while the foot is planted and the knee is bent. Degenerative tears occur as a result of general wear and tear in the knee joint.

Symptoms of a meniscus tear can vary somewhat depending on the acuity, location, and severity of the tear. Here are some common symptoms of a meniscus tear:

• An audible or felt popping
• Pain in the knee joint on the inside (medial), outside (lateral), or back of the knee
• Swelling
• Catching or locking of the knee joint
• Pain with walking
• Inability to fully bend or straighten the knee
• Pain when twisting the knee
• Feelings of the knee giving out

MENISCUS TEAR SURGERY

While not all meniscus tears require surgery, your surgeon may have recommended you undergo a surgical repair in order to help restore optimal function to the knee. In general the menisci have less blood supply than other structures in the body. Blood is what carries the nutrients and growth factors and carries away damaged cells to help heal an injury. Because the blood supply is reduced, when torn, the meniscus is less likely to be able to heal on its own. Three main surgical approaches exist for managing meniscus tears:

• Arthroscopic Partial Meniscectomy
• Meniscus Repair
• Meniscus Reconstruction

If you decide to work with a physical therapist to help with prehab for meniscal repair surgery, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

PREHABILITATION FOR MENISCUS REPAIR AND RECONSTRUCTION SURGERY

For those who opt to undergo reconstruction or repair of the meniscus, there is often a period of waiting that occurs before the surgery is scheduled. During that time, you may opt to undergo a course of prehabilitation in preparation for the upcoming surgery. There are several benefits to this option that are discussed below:

Prepare you for surgery: Most people expect surgery recovery to be an interruption to their normal life. One way to minimize that interruption is to know what to expect ahead of time. Your PT can help advise you on equipment you may need afterwards so you can gather it beforehand. Ice packs, long handled reachers, a shower chair and so forth, may help you complete your daily activities more easily after surgery. It is also likely that you will spend a period of time in modified weight bearing and with a knee brace, meaning you will need a device such as a wheelchair, crutches or a walker. Learning to use these devices ahead of time, when you are not clouded by anesthesia, is a great idea. Additionally, you will have time to ask family members or friends for assistance if you will need it.

Address pain and swelling: Whenever possible, addressing pain and swelling prior to undergoing surgery is a good idea. Some surgeons may even require that your knee can handle some activity without causing severe swelling before they will perform the surgery, in which case physical therapy can be very helpful. Additionally, if there is going to be a waiting period before you can have your surgery, PT can help you be more comfortable by addressing pain as much as possible.

Strength, range of motion, flexibility and gait training: Some strength and flexibility losses are expected in response to surgery and the time period afterwards when you are not able to bear full weight or move the knee through its full range of motion. Because many people have undergone a waiting period between initial injury and surgery wherein they may have reduced their activity level and already began to experience some stiffness, changes in their gait pattern and ever muscle atrophy, it can take quite a while to recover to full knee function after surgery. Since meniscus repair and reconstruction is typically not an emergency surgery, there is time to work with a physical therapist on a progressive exercise program and even a manual therapy program to restore as much strength, flexibility and normal movement in the knee as possible. This will help shorten the post-surgery recovery time.

Our team of physical therapists at Evolve are here for you on both sides of the operating table. If you are planning to undergo meniscus repair or reconstruction surgery, call our clinic today to learn how we can help you and your knee get ready to recover.