- Meniscus tear: causes and course of the disease
- When is surgery necessary for a torn meniscus?
- What happens before surgery to treat a torn meniscus?
- How is the operation performed at the Gelenk Clinic?
- What type of doctor performs surgery for a torn meniscus?
- What type of anesthesia is used for surgical treatment of a meniscus tear?
- Post-operative care, rehabilitation and aids after meniscus tear surgery?
- Will I feel pain after surgery?
- What are the conditions of stay at the Gelenk Clinic?
- What should you pay attention to after surgery for a torn meniscus?
- Cost of arthroscopic knee surgery in Germany
- How can a foreign patient make an appointment for surgery for a torn meniscus?
Surgical treatment of an injured meniscus is carried out using two techniques.
A meniscectomy involves removing part of the damaged meniscus to smooth out the joint surface. During arthroscopic surgery, meniscus injuries are treated using surgical sutures. Thus, the knee joint is freed from blockades that damage the articular cartilage. Arthroscopic suturing is only possible if the tear is located near the base of the meniscus, which is well supplied with blood. © Alila Medical Media A meniscus tear is one of the most common knee injuries. Any fall or accident that results in a dislocation or other injury to the knee can result in a torn meniscus. Often, a bruise to the knee joint occurs during a fall. How dangerous the injury is and the rupture itself depends on how much weight is placed on the knee, as well as on the degree of activity of the person. The more the knee moves inward, and the more the metatarsophalangeal joint of the first toe is curved, the higher the risk of meniscus tear. Every person's knee joint has both an internal and an external meniscus. In this case, we are talking about cartilaginous structures of soft tissues, shaped like a crescent, serving as shock absorbers between the tibia and femur of the knee. Acute injuries and tears of the knee meniscus immediately cause severe stabbing pain, swelling and limit the mobility of the knee. In this case, the joint seems to jam and the person experiences difficulty bending and straightening the leg. Over time, the meniscus wears down, leading to severe pain after exercise and changes in activity levels.
Sometimes complaints associated with a meniscus tear can go away on their own, with the help of immobilization, physical rest and accompanying physical therapy. If the pain has become chronic and the joint is sometimes immobile, a meniscus tear is treated with surgery.
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Meniscus tear: causes and course of the disease
A meniscus tear can occur when the ankle is severely dislocated or injured. Simple overload of the knee joint after jerking loads (start/stop) or sudden rotational movements can lead to overstrain and, as a consequence, to a meniscus tear.
Meniscus tear and sports
A meniscus tear is a common pathology in people involved in skiing, namely when the skis tilt to the side. If a skier is moving at full speed, the kinetic energy of his body can provoke a dislocation of the knee joint and a torn meniscus. Football, basketball, as well as other so-called contact sports associated with strong acceleration and often with excessive uncontrolled external force (for example, an opponent) can cause injury of this nature.
Meniscus tear during the working day
Some categories of professions subject the knee joint to particularly heavy loads. Such activities include squatting work (eg tilers). Excessive flexion of the knee joint, as well as the impact of the entire body weight on the leg, negatively affects the knee joint and causes severe pain.
The next difficulty is lifting a heavy load from a squatting position. As a rule, the position of the back recommended by doctors during such work actually puts a lot of stress on it. And if the knee has already been damaged, then you need to choose whether to overstrain the meniscus or the intervertebral discs.
Degenerative meniscus tear in elderly patients
Most often, in older patients, the connective tissues of the cartilaginous structure of the knee lose their elasticity and become less mobile. Since the meniscus is cartilaginous tissue and wears out quickly, its rupture can be caused by minor injuries.
Pre-existing injuries of this nature are taken into account by our specialists when drawing up a treatment plan. Complete restoration of a degeneratively injured meniscus can only be achieved with long-term treatment.
In younger patients, meniscal rupture occurs after severe traumatic exposure. Elderly patients simply need to turn carelessly or trip.
Meniscus tear: Orthopedic aspects of the disease
Any regular strain on the knee joint can lead to a weakening of the meniscus. Therefore, excess weight is one of the main criteria for the occurrence of its rupture or degeneration (wear). Violation of the axis of the lower extremities, due to valgus (X-shaped) or varus (O-shaped) deformation of the legs, negatively affects the forces acting in the knee joint and thus can accelerate the process of wear of its individual parts.
A previous rupture of the cruciate ligament also creates a certain load on the menisci. In addition, it is worth noting that the cruciate ligaments are located in the cavity of the knee joint and are responsible for centering the femur and tibia. They also have signal receptors through which they transmit information to the leg muscles about the expected occurrence of injury. When the cruciate ligaments rupture, all tangential, inertial, and braking forces directly impact the meniscus to such an extent that they lose their role as a seat belt inside the knee joint.
If the meniscus ruptures, contact an orthopedist as soon as possible: after all, such an injury often leads to pinching, irritation and impaired motor functions of the knee joint. A visual signal of a meniscus tear is a painfully swollen Baker's cyst in the popliteal cavity (popliteal cyst), which is caused by inflammatory irritation of the joint capsule. Often, surgical treatment is necessary to avoid pathologies such as joint wear and arthrosis. Only an experienced diagnostician and specialist in the treatment of knee diseases will be able to assess the condition of the patient’s knee joint and tell whether the injury will heal on its own.
Rehabilitation after knee replacement and arthroscopy
Rehabilitation after knee arthroscopy determines the future prognosis. Her program determines how long the patient will need to fully recover.
In the early postoperative period, it is important to remove swelling in the knee area. For this purpose, non-steroidal anti-inflammatory drugs and cold are used on the area of the operated knee. Sometimes lymphatic drainage is prescribed to eliminate swelling.
Swelling may increase with movement of the knee area immediately after surgery. Orthoses are used to ensure knee joint immobility. The early postoperative period varies from 3 to 7 days. Usually during this time the unpleasant symptoms disappear. Full recovery after knee arthroscopy takes longer. Its duration can vary from six months to a year.
The main role in the development of the knee joint belongs to physical therapy exercises.
Physiotherapy
Exercise therapy after arthroscopy begins on the first day. Active development of the knee in the first period is prohibited due to postoperative swelling and pain.
On the first day, only exercises for isometric contractions of the thigh muscles and movements in the ankle joints are allowed. On the second day, passive movements in the knee joints are allowed, which do not cause pain in patients. Active movements are carefully introduced. If arthroscopic removal of the meniscus was performed, then active movements can begin by the end of the first day.
During the first three weeks, the following exercise therapy exercises are performed:
1. Isometric contractions of the thigh and gluteal muscles.
2. Active painless movements in the knee joints. It is important that your heels do not lift off the surface when performing these exercises.
3. Slowly raising the leg in a lying and standing position.
4. Water exercises for physical therapy – in the pool.
From the end of the first month, it becomes possible to walk in a brace, without a cane. Flexion and extension at the joint should be painless and exceed 90 degrees. Basic gymnastic elements - to strengthen the thigh muscles.
The second or third month of rehabilitation requires exercise on an exercise bike, active swimming in the pool, and exercises with a platform. Walking is allowed without restrictions, but with an orthosis. In the future, the patient is offered regular jogging.
Sports activities are limited to six months, then they are resolved using a knee brace.
Team games, which significantly increase the risk of knee injury, are banned for an average of a year.
Removing the meniscus requires a special approach. After this operation, the development of the joint should be enhanced to reduce the risk of arthrosis and stiffness. If arthroscopic treatment is ineffective and degeneration progresses, endoprosthetics is performed.
Knee replacement
Endoprosthetics is the replacement of a destroyed joint with a synthetic one. For the knee, prosthetics are performed in cases of severe forms of arthrosis or serious injuries. The goal of this operation is to restore the range of motion in the knee as much as is necessary for the patient’s active life. Endoprosthesis replacement is a more serious operation than arthroscopy.
After knee replacement surgery, the following activities come to the fore:
· fight against pain syndrome;
· elimination of postoperative edema;
· prevention of infectious complications.
As after arthroscopy, painkillers and decongestants, cold therapy, lymphatic drainage, antibiotics are prescribed for this purpose.
Exercise therapy
Development of the knee joint after arthroplasty is extremely important due to the high risk of contractures and stiffness. The following physical therapy exercises are widely used:
1. Passive movements in the knee joint. Used in the early recovery period.
2. Active movements. They are performed with assistance - using the healthy leg, the operated leg is bent and extended.
3. Squats with a ball. The patient holds the ball behind his back and leans on it and on the wall.
4. Active flexion of the operated joint from a sitting position.
5. Exercises with a rubber shock absorber. After joint replacement, exercises in which knee extension is carried out without lifting the heels from the surface have a good effect. This is called a closed kinematic chain.
6. Ascent and descent of stairs. The legs alternate. It is important to avoid falling on the affected side.
The duration of recovery after surgery depends on the extent of the intervention. Physical therapy exercises should be constant and long-term. You cannot stop exercising when a positive result is achieved, otherwise the risk of stiffness will again arise.
Rehabilitation after arthroscopy and endoprosthetics is no less important stage than the operation itself. All of the above rehabilitation measures are carried out in our clinic by qualified experienced specialists. You can get more detailed information about the types of treatment offered by our clinic, make an appointment or consultation by phone, by email or by filling out the feedback form on the website
When is surgery necessary for a torn meniscus?
A torn meniscus is not always treated surgically. The pathology can go away without the intervention of a surgeon. However, this depends on the shape, size, as well as the position of the tear, the age of the patient and the condition of the meniscal tissue.
A meniscus tear is operated on only if the nature of the damage clearly indicates that it cannot be treated with physiotherapy. The goal of the operation is long-term pain-free, stable and functional knee joint. Surgery should help the patient return to his previous lifestyle and enable him to play sports as before. In addition, a healthy and functional joint prevents (arthrosis), that is, degenerative changes due to overstrain of the cartilaginous surfaces of the knee joint.
Meniscus surgery: How is a torn meniscus treated in young patients?
For young patients with a traumatic meniscus tear, there are fairly clear indications for surgery:
- long-term knee pain after a torn meniscus
- blockades in the knee joint
- patchwork gap
- damage to the internal (intermediate) area of the meniscus
Surgery for degenerative meniscal tears in mature patients
The situation is more complicated with degenerative changes. Depending on the intensity of the complaints and the degree of limitation of mobility, specialists at the Gelenk-Klinik will try to delay the operation using conservative techniques. In case of a meniscus rupture caused by degenerative changes, that is, due to wear and tear, it is necessary to level the articular surface and free the knee joint from blockades that damage the articular cartilage before arthrosis occurs
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Arthroscopy of large joints
Arthroscopy is a minimally invasive operation aimed at diagnosing and treating pain and damage to structures in the joint. The difference between the minimally invasive method and traditional open surgery is that the joint is not completely opened. Instead, only two small holes are made - one for insertion of the arthroscope, the other for surgical instruments.
Arthroscopy: both research and treatment
In situations where difficulties arise in making a diagnosis based on examination and photographs, this is the main indication for performing diagnostic arthroscopy of the joints of the shoulders, knees or ankles.
Today, joint arthroscopy is usually performed to treat and restore damaged joint structures. Arthroscopy is also performed simply for diagnostic purposes, however, recently it has mainly been replaced by MRI.
Sometimes diagnostic arthroscopy of the shoulder or knee joint helps to completely relieve the patient of pain, since during it excess joint fluid or traumatic particles are removed.
Who is indicated for arthroscopy?
- Suspicion of ligament rupture, meniscal or cartilage damage
- Limitation of joint mobility
- Arthrosis
As a therapeutic and diagnostic intervention, it is prescribed for:
- Baker's cyst
- Ligament and meniscus tears
- Arthrosis
How is arthroscopy performed for a torn meniscus?
During the operation, the doctor receives an image of the joint from the arthroscope camera on the monitor: with its help, the degree of damage to the joint is determined and the question of treatment methods is decided - conservative or surgical.
Arthroscopy is performed under local or general anesthesia, epidural or spinal anesthesia through small (approximately 0.5 cm) skin incisions in the area of the joint being examined.
Therapeutic arthroscopy of joints is carried out in the same way, but with the use of additional surgical instruments, depending on the meniscus tears and other injuries detected during diagnosis. To wash the surgical field, an irrigation fluid – sterile saline solution – is injected into the cavity.
One of the most common operations on the knee joint is meniscus arthroscopy (meniscus tear): this cartilage pad inside the joint is inactive, and therefore is especially easily injured - a meniscus tear occurs. The main method of treating his injuries is to completely remove the cartilage or just some damaged part of it.
Arthroscopy takes from half an hour to two, depending on the complexity of the injury and access to the damaged area.
After the operation, the patient, depending on the type of anesthesia, can move freely using a cane the next day.
- Does not require any special preparation - taking medications, diet a few days before the scheduled intervention
- Does not leave rough scars on the skin
- Performed on an outpatient basis or with a short hospitalization (no more than three days)
- Does not deprive mobility and ability to work for a long time
This is why arthroscopy is so widely used in traumatology: rehabilitation after it is easier and faster due to minimal trauma to the diseased joint.
How to behave after knee arthroscopy?
- Outpatient treatment for 3-7 weeks (depending on the damaged structure)
- Applying a cold bandage on the first or second day to relieve swelling and pain
- Using a fixation bandage during recovery
- Limitation of movements in the form of joint fixation (orthosis)
- Mobility with support until the condition improves (5-8 weeks)
- Physiotherapy
Shoulder arthroscopy
Diagnostic and therapeutic arthroscopy of the shoulder joint is performed if:
- Inflammatory diseases – bursitis, arthritis, periarthritis
- Shoulder dislocations, subluxations, sprains
- Chondromatosis
- Ruptures of the labrum and biceps tendons
- Rotator muscle tear
Rehabilitation course
After an operation such as arthroscopy: rehabilitation also involves cycles of physiotherapeutic procedures (massage, electrical heating), physical therapy exercises at all stages of recovery. After the first two months and further, physical activity is gradually increased: walking without support and swimming are allowed.
What happens before surgery to treat a torn meniscus?
A knee injury visualizes a clear horizontal tear of the meniscus along its longitudinal axis (yellow marking on the left).
The other meniscus of the knee joint (right) is intact, as evidenced by the larger darkened area. © joint-surgeon Before the operation, the doctor conducts a comprehensive clinical examination. Typically, an experienced knee specialist will be able to diagnose a tear during a history and physical examination of the patient. During a clinical examination, the doctor checks the mobility of the knee joint in different positions, evaluates gait, and also tests how the leg bends and extends. Especially in the joint space area, a meniscus tear causes distinct pain, which is a fairly accurate confirmation of the diagnosis from a clinical point of view.
For knee pain, patients are always referred for an x-ray, as this examination helps the doctor more accurately assess the condition of the knee joint. An x-ray taken in a standing position gives an idea of the thickness of the cartilage tissue. Thus, the specialists at our clinic can rule out that the cause of the stabbing pain in the knee is arthrosis of the knee joint. Concomitant injuries to sprains, twists or dislocations of the knee joint can also be bone injuries. Using an X-ray, orthopedic specialists at the Gelenk Clinic will be able to exclude the presence of fractures.
Unlike X-rays, which primarily show bones, MRI (magnetic resonance imaging) provides precise images of all soft tissue structures. This way, your doctor will be able to assess the condition of the tendons, ligaments and cartilaginous menisci. The ability to obtain detailed images of a meniscus tear makes this examination particularly valuable. Using MRI, you can see the exact position of the tear, as well as determine its length and course.
What research methods are used for knee injuries?
First of all, an x-ray of the knee joint. Although X-rays will not show damage to the menisci and articular cartilage, they must be taken because it is necessary to exclude, first of all, a fracture of the bones that form the joint. In some cases, cartilage detachment occurs along with the bone plate - this can be seen on x-rays. Ultrasound of the knee joint is not very informative; its reliability is about 20–25%. Another method is magnetic resonance imaging, which allows you to see the condition of the ligamentous apparatus, menisci, and cartilage layer by layer, which helps to find out which part of the joint has which pathology. This study is prescribed mainly when the clinical picture is not clear enough. But only arthroscopy can provide 100% certainty. Any intervention using arthroscopy always begins with an examination of all joint structures, carrying out an accurate diagnosis to decide on the need for a particular treatment.
How is the operation performed at the Gelenk Clinic?
A knee specialist performs an arthroscopy ©Viewmedica
If a torn meniscus causes severe knee pain and limited mobility, immediate surgery is necessary. Surgical interventions on the meniscus are always performed arthroscopically, that is, using a minimally invasive technique. During this operation, the surgeon makes small incisions on both sides of the knee joint in the area of the kneecap, through which a camera is inserted using narrow tubes. Laparoscopic surgery speeds up the wound healing process and also reduces the likelihood of postoperative complications.
Basically, patients are offered two options for treating a meniscus tear: suture or partial removal.
Arthroscopic suture
With fresh ruptures - primarily in the area of the joint capsule, where the blood vessels supplying it (base) enter the thickness of the meniscus - healthy tissue can be preserved using minimally invasive intervention. Ideal arthroscopic sutures, especially in the anterior and lateral areas, are achieved using modern surgical techniques and special sutures. When choosing a suture technique, the surgeon takes into account the size and position of the tear.
Even with more serious types of rupture, so-called “hand-and-water” injuries, our surgeons will try to preserve the meniscus using an arthroscopic suture and thus reduce the risk of arthrosis of the knee joint.
How long does rehabilitation last after arthroscopic suture?
Movement in the first days after meniscus tear surgery should be limited for approx. six weeks. The patient is allowed to put full loads on the knee joint only if the leg is in a fully extended position. As soon as the knee joint bends, any load is contraindicated, otherwise the seam may tear under the influence of shear forces.
This position is ensured by a special splint (orthosis), which can be fixed to prevent the impact of gravity on the knee joint. If the patient wants to bend the knee or sit up, the block can be released and the leg can be flexed without straining. It is recommended to stop playing sports for 6-8 weeks. Sports that involve stress on the knee joint can be resumed no earlier than after 6 months only in agreement with the surgeon.
Meniscus resection: Partial removal
If the shape and position of a meniscus tear indicate failure of conservative treatment and arthroscopic surgery, it is necessary to resect the torn part. This intervention smoothes the articular surface and increases the effectiveness of articular cartilage. Even with such intervention, it is very important to preserve as much healthy tissue as possible. After all, the larger the preserved component, the longer the meniscus will retain its original function.
How long does rehabilitation last after meniscus resection?
After partial removal of the meniscus, the patient can put weight on the knee on the day of surgery. Elbow crutches will help balance the stress on the knee joint. As a rule, you will be on sick leave for one to two weeks. A longer stay at home may be required only if the patient’s profession involves special stress.
After a week, you can ride a bike and do light sports again. It will be possible to swim only when the wound has healed completely and when the stitches have been removed.
After 3-4 weeks you will be able to play football, tennis or go jogging again.
Meniscus tear: transplantation and synthetic implant
Donor material can be used for transplantation. In younger patients with more serious injuries, this method is often the only option to prevent wear and tear on the knee joint. Transplantation of an artificial implant is also possible.
Both transplantation and the use of artificial material are emergency interventions that are performed after previously unsuccessful operations during which it was not possible to preserve the function of the meniscus.
Very often the operation is performed earlier than necessary and more tissue is removed than the situation actually requires. The results of surgery with the introduction of synthetic implants are encouraging, but the long-term effect of the operation is not yet available.
Therefore, these interventions should not be considered as the main methods of treating meniscal tears. Therefore, after an injury, patients should contact a knee joint specialist as soon as possible, who will conduct the necessary diagnostics and make the right decision regarding further therapy. No matter what, the goal of any treatment for a torn meniscus should be to preserve the actual tissue, preserve the natural function of the meniscus, and thus avoid graft surgery.
Meniscus transplant: surgery for a torn meniscus with the help of a donor
Sometimes arthroscopic surgery is not considered by surgeons as a treatment option for a torn meniscus. This may be due to the size, unfavorable location of the tear, or extensive tissue loss. In this case, doctors often use donor material, which helps prevent the initial stages of arthrosis, as well as ruptures of articular cartilage in young patients.
During this surgery, both the inner and outer menisci can be replaced. As part of the diagnosis, it is very important to determine the exact size and position of the injured meniscus. The necessary donor material is supplied to the Gelenk-Klinik in Gundelfingen from the international transplant center. Although sometimes patients have to wait quite a long time for a suitable donor. Due to various bureaucratic obstacles, there is no uniform donor system for meniscal tissue in Germany. Mostly material for transplantation is imported from the Benelux countries. Fortunately, when transplanting donor menisci, there is no rejection reaction, as sometimes happens with transplantation of other organs.
Since the implant is removed and tested for germs under sterile conditions, the risk of infection is minimal.
The minimally invasive procedure, during which the surgeon inserts the prepared implant through a microscopic approach and then sews it in the desired location, lasts approximately two hours.
Synthetic meniscus transplantation
Synthetic fabrics are used primarily to compensate for partial tears of the inner and outer meniscus. Due to its porous structure, the recently developed sponge material is particularly suitable for this type of operation. Blood vessels grow into its dense structure, which in turn contributes to the formation of endogenous tissue. As soon as the new tissue begins to perform its function, the implant dissolves in the body. And in this case, surgeons resort to arthroscopy through a small incision and subject to maximum preservation of healthy tissue.
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To do or not to do?
Before the advent of the arthroscope, all operations on the knee joint were performed in an open manner. Of course, this was accompanied by damage to surrounding tissues and an increased risk of complications. Other advantages of arthroscopy include:
- absence of large scars and cicatrices;
- fast recovery;
- the opportunity to solve a huge number of problems related to the diagnosis and treatment of the joint.
This operation is often performed on professional athletes, for whom knee joint injuries are a common occurrence, but there is very little time for recovery.
What type of doctor performs surgery for a torn meniscus?
One of the features of the Gelenk Clinic is the trusting relationship between doctors and patients. That is why your attending physician will take care of you from the first examination until the operation of the meniscus tear. He will also monitor your condition after the operation. This way you will have a contact person at the Gelenk-Klinik whom you can contact at any time convenient for you. The best and highly qualified specialists in the treatment of diseases of the knee joint are Prof. Dr. Ostermeier and privatdozent M.D. Dr. Markvas.
Why should the meniscus be treated surgically rather than conservatively?
The meniscus is a crescent-shaped cartilage shock-absorbing pad. When it ruptures, the torn part can become pinched in the knee joint and cause pain and limited movement. Conservative methods will not help and will not lead to the torn piece growing back; it will only interfere with movement and damage the articular cartilage. An analogy can be drawn with a bearing: if sand is poured into it, it will not spin; if you lubricate it with oil, it still won’t spin; Therefore, it must be washed and then lubricated with oil.
What type of anesthesia is used for surgical treatment of a meniscus tear?
Typically, surgery for a torn meniscus is performed under general anesthesia. To avoid risk, there is the possibility of spinal anesthesia. To do this, the surgeon injects an anesthetic into the spinal canal of the lumbar spine. In this case, the patient is fully conscious. What type of anesthesia is most suitable for the patient is determined during a conversation with the anesthesiologist. Our doctors are true masters of their craft, who during your appointment will offer you the best method that meets all the indicators of previous examinations.
Post-operative care, rehabilitation and aids after meniscus tear surgery?
During the first week after surgery for a meniscus tear, the knee is immobilized using a special splint. In order to relieve tension from the knee joint, you will need to use elbow crutches. Then the load on the knee will be gradually increased. As long as the patient only partially strains the knee, thrombosis prophylaxis (eg Hepoarin/Enoxaparin) is mandatory. You should also wear compression stockings until your doctor allows you to put full weight on your leg. After the operation, we will provide you with everything you need.
What are the conditions of stay at the Gelenk Clinic?
Private room at the Gelenk Klinik - Gundelfingen, Germany
During your stay at the Gelenk Klinik, you are usually in a private room, which has a shower and toilet. In addition, we provide towels, bathrobes and slippers. You can also use a safe and minibar. All rooms are equipped with TV. You only need to take medications, comfortable clothes and nightwear with you. Patient care is provided around the clock. The medical staff and physiotherapists at Gelenk Clinic will always answer all your questions. Generally, the length of hospital stay is 3 days. Your relatives can stay at a nearby hotel. Our staff will be happy to take care of your room reservation.
What should you pay attention to after surgery for a torn meniscus?
Immediately after surgery, the knee should be kept elevated and a cooling compress applied. After about 5 days, the stitches will be removed and you will be able to shower again.
To avoid complications, monitor your movements for several weeks. The duration of sick leave depends on the type of your professional activity and can last up to six weeks. Prevention of thrombosis is also mandatory. Comprehensive physiotherapeutic treatment at this stage is very important, as these procedures prevent muscle destruction and help restore the functions of the knee joint.
A return ticket should be booked no earlier than 7 weeks after the operation. However, we recommend staying in the Gelenk Clinic for at least 10 weeks.
- Inpatient treatment: 3-4 days
- Recommended length of stay in the clinic: 10-14 days
- When can you go home: 7 days after surgery
- When recommends leaving the clinic: 10 days after surgery
- When is it permissible to shower: after 5 days
- How long is it recommended to stay on sick leave: 2-6 weeks (depending on professional activity)
- When the stitches are removed: after 5 days
- Outpatient physical therapy: 2 weeks
- When can you drive again: after 6 6 weeks
- Light sports activity: no earlier than after 8 weeks
- Habitual sports activities: after 6 months
Does arthroscopy help with arthrosis of old people?
Osteoarthritis is the wear and tear of articular cartilage. It has various stages. The effectiveness of the intervention is determined by the stage of the disease. In the later stages of arthrosis, arthroscopy as a therapeutic agent will no longer help. If arthrosis is accompanied by gross destruction of cartilage and proliferation of osteophytes, then joint replacement is advisable.
Why are there situations when arthroscopy needs to be done more than once?
The fact is that when performing arthroscopy, we solve the problem that exists at the moment. If a person suffers a new injury in the future, the damage, for example to the meniscus, may occur in a different area. This is not a flaw in the doctor or an imperfection in the method. When performing a resection of the meniscus, only that part of it that interferes with movement is removed, while the meniscus is preserved as much as possible. Repeated arthroscopy is also done if the patient has signs of damage to the meniscus and anterior cruciate ligament with severe limitation of movement in the joint (so-called blockade). The indication for anterior cruciate ligament reconstruction is not the rupture itself, but instability of the knee joint. In this case, the first stage of arthroscopy is to resection the meniscus, after which the person begins to walk, but if he feels instability in the knee joint while walking, then the second stage is an arthroscopic ligament repair operation.
Removal of the meniscus is required if there are tears in several areas or the area of rupture and complete fiber separation spreads throughout the entire meniscus. There are a lot of people who have undergone a similar operation and feel great. The fact is that if this is not done, then fragments of the meniscus will interfere with movement and in the future this can lead to the destruction of articular cartilage, and this is the path to the early development of arthrosis. After all, if you compare the coefficient of friction when cartilage rubs against cartilage or exposed bone, it will increase 10 times, and in the future both movement restrictions and severe pain will arise. So in cases where the entire meniscus is torn, it must be removed.
Cost of arthroscopic knee surgery in Germany
In addition to the cost of surgical treatment of a torn meniscus, it is worth considering the additional costs of diagnostics, doctor's appointments and aids (eg elbow crutches), amounting to approximately 1,500 to 2,000 euros. If you are planning to undergo outpatient physical therapy treatment after meniscal tear surgery, we will be happy to provide you with an estimate of the costs.
Information regarding the cost of hotel accommodation and possible additional treatment at a rehabilitation center can be found on the corresponding website.
Complications during arthroscopy
As with any surgical intervention, there is a certain risk of developing inflammatory complications. Damage to articular cartilage and other structures may occur with the instrument, most often in novice doctors. The main thing is purulent-inflammatory complications. After surgery, there may be hemarthrosis, because we also work on those structures that are well supplied with blood. In principle, this cannot even be called a complication, you just need to warn the patient that the day after the operation he may have blood accumulate in the joint - this is normal. Synovitis is a complication in which synovial fluid begins to accumulate in the joint in increased quantities. This is also possible.
Our clinic provides one-stage, comprehensive care to the patient. The patient immediately after an injury or in the near future, bypassing queues at the emergency room and clinic, turns to us. Where a complete x-ray and laboratory examination takes place. After the examination, the patient is given all the necessary treatment. Which can include all types of traumatological and orthopedic care, ranging from external immobilization with modern polymer bandages to osteosynthesis with the best metal structures. This significantly improves the quality of treatment, not to mention the fact that it greatly simplifies the life of the patient, eliminating the need to visit overcrowded outpatient and inpatient treatment facilities. If necessary, sick leave certificates are issued and maintained.
If an accident has happened to you or your loved ones, first of all, do not be discouraged or upset, because trauma is a part of life, something that can happen to any of us, and always at the wrong time. I haven’t heard of anyone preparing for this in advance, postponing business or important meetings. Therefore, you need to contact specialists in time and return to duty as soon as possible.
How can a foreign patient make an appointment for surgery for a torn meniscus?
To begin with, Gelenk Clinic specialists will need current MRI and X-ray images to assess the condition of the knee joint. Once you submit the required documents to us through our website, we will send you patient information and cost estimates within 1-2 days. .
Foreign patients can make an appointment for meniscus tear surgery in a short time. We will be happy to assist in obtaining a visa after the advance payment indicated in the estimate has been received into our account. If a visa is not issued, the amount received is returned to you in full.
Due to sometimes long flights, we try to keep the time between the first examination and surgery to a minimum. During outpatient and inpatient treatment of the knee joint, you will be able to use the services of qualified medical personnel who speak several foreign languages (eg English, Russian, Spanish, Portuguese). Payment for a translator (for example, into Arabic) is carried out separately. We also organize transfers, we can book a hotel room and tell you how to spend time in Germany for you and your relatives.
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Prognosis after arthroscopy
In the vast majority of cases, arthroscopy has a favorable outcome. During the first day, patients notice pain in the joint, which quickly passes. In addition, there may be limited mobility of the knee and swelling.
But if mistakes are made during the operation, more serious complications are possible:
- bleeding due to damage to the vessel;
- inflammatory process due to infection;
- blood clot formation;
- damage to joint structures;
- inflammation of the scar.
You can avoid them if you entrust the operation to a qualified specialist.
In general, arthroscopy is a popular and effective procedure that allows accurate diagnosis, if the clinical picture is blurred, and surgical intervention on the joint. And for the outcome of the operation to be favorable, it must be performed by an experienced surgeon using modern equipment.
If you are concerned about joint pain or the treatment of joint pathologies has not yielded results, make an appointment at the “Available Doctor” clinic. Our specialist will conduct an examination, establish an accurate diagnosis and select an effective therapeutic program.
Basyul Vladimir Valerievich
Orthopedist-traumatologist, Surgeon
- On Lukyanovskaya, st. Kudryavskaya, 31/33
Cost of admission: 450 UAH.
Make an appointment
Thoracic, abdominal and general surgery, surgical correction of orthopedic problems.
