- How long does it take before you can get back to work?
Meniscus repair is a very intricate surgery, it is not suitable for everybody, and it depends on the blood supply to the meniscus. Therefore, how long it takes to heal depends on how the meniscus is repaired, and more importantly, where the meniscus was torn. If the torn part of the meniscus was near the blood supply, the healing process is usually very successful. However, if the meniscus tear is away from the blood supply and has been longstanding, it may take a long time to recover.
Typically, following a simple repair, the patient can return to work to after approximately 6 – 8 weeks following surgery. However, for a more complex meniscus repair, it will take a lot longer.
- What about getting back into sport?
I would not recommend returning to sport for at least 6 to 9 months. Again, this depends on the patient’s biology, and also the way the meniscus was repaired.
For a low impact sport such as cycling, the patient can return usually at around 6 months. However, for complex sports that involve cutting and turning such as rugby, football or Aussie rules football, it may take a bit longer, typically about 1 year.
Each meniscus tear is very different. The position of a meniscus tear has a huge influence on how soon a patient can return to sport. For example, if the tear of the meniscus is towards the back of the knee, we would advise the patient to avoid deep flexion of the knee, but on the same token, by fully extending the leg and walking on it, can help to push the meniscus to heal better.
Meniscus repair is a very complex topic and each patient should be treated individually. I think the most important part of the recovery process is to understand where the meniscus is torn and how it was torn. With this knowledge, we can specifically tailor movements or create a programme which can be prescribed to help recovery.
- What symptoms are normal in the recovery period?
Meniscus surgery is usually done via keyhole surgery. It is usually carried out as a day case and recovery depends on the amount of work which has been done within the knee. Pain is usually managed by simple painkillers such as paracetamol. It is to be expected that the knee will be swollen for approximately 3 – 6 months. The immediate swelling will reduce after 2 weeks, but the general swelling on the whole leg can last a while longer, which is completely normal.
Some symptoms depend on the rehabilitation programme prescribed by the surgeon and any subsequent physiotherapy. The knee may become stiff during the recovery process, which is completely normal. The aim of the meniscus repair is to allow the healing process to progress and a stiff knee can be dealt with after the healing process has happened. A clicking and crunching sensation could be normal during the recovery process. Swelling around the knee and feeling of ‘fluid’ within the knee up to a certain extent could also be normal.
Following meniscus repair surgery, I would strongly recommend avoiding non-steroid anti-inflammatory medications such as Ibuprofen, Diclofenac and Naproxen. These are very powerful painkillers and their effect can delay the wound from healing and potentially delay the meniscus repair. Of course, if the pain is unbearable, these type of painkillers can be used to treat breakthrough pain.
- What symptoms should I be worried about?
During the recovery process, if you feel that your knee suddenly gives way or any clunking or locking within the knee that does not settle down within 24 hours, it is important to seek medical attention. If your knee is locked in a certain position do not try to force it straight. This could indicate that the repair of the meniscus has failed, and I would advise the patient to seek medical advice as soon as possible.
Although it is common for the keyhole wound to leak blood-stained fluid, if you have a temperature or fever associated with this, I would advise for you to seek medical advice immediately. Although it is very rare, a patient can develop deep vein thrombosis following this type of surgery. This can depend on your surgeon, a tourniquet may or may not have been used, and this will also have an influence on your recovery.
- What proportion of patients will need revision surgery?
Generally speaking, a meniscus repair is a very successful surgery. If the indication is correct with the correct candidate, the success rates of meniscus repair would be over 80%. However, if the repair is more complex or the biological response is less, the success rate could be down to 50%.
During surgery, we can stabilise the meniscus, reduce it back to place and potentially augment it with some biological stimulation. Whether the meniscus continues to repair itself would be down to the patient’s biology, their diet, and the way they load the knee following surgery. Therefore it is very important to work with your surgeon and have a full understanding to maximise your chance of success.
- Will I completely regain my previous mobility or will there be a permanent change?
If your meniscus repair is successful and there is no other associated damage, it is highly likely that you will be able to return to your previous state of strength, range of movement, as well as your performance. However, it is important to understand that each meniscus repair is very different and it requires some specialist knowledge. Generally speaking, it is not advisable to repair a meniscus for a patient aged over 50 without any biological supplementation. It is important to talk to your surgeon and based on your MRI scan, discuss and understand your prognosis.
Recently at MSK Doctors, we have employed a needle arthroscopy technique. This will help improve the accuracy of our diagnosis to give a more precise prognosis of the meniscus condition in terms of inside, and how the general condition is within the cartilage inside the knee. This will give a much better indication and prognosis of how any surgery will respond. We are proud to say that MSK Doctors is the first clinic to adopt this technique in the United Kingdom.