Remember the old children’s song that went, “the knee bone’s connected to the thigh bone”? Those lyrics are a bit misleading. The thigh bone is actually connected to the shinbone; the knee joint rests between these two bones, cushioned by an important portion of cartilage called the meniscus. When this cartilage becomes torn or damaged, it can lead to swelling , pain, restricted movement and arthritic symptoms. Meniscus tears are common injuries. However, the approach to these injuries has changed dramatically in the past decade. Surgeons used to favor “partial meniscectomy,” where they would simply cut out the damaged portion of the meniscus cartilage. In severe cases, they would remove the entire meniscus altogether. Patients tended to do quite well in the short-term with this approach but would suffer early and intense onset of arthritic symptoms. This brought to light the importance of the protective nature of the meniscus, which provides stability and lubrication to the joint and minimizes the load exerted on the knee from the daily grind of standing and walking. Nowadays, most surgeons prefer to fix the tear whenever possible.
The rehabilitation process for this procedure is long and arduous, but it is quite effective when performed properly. After surgery, you will be asked to wear a brace (which will lock your knee in place) for at least a month. Most of the time, physical therapy can begin shortly after surgery. In the initial weeks, it will focus on gentle mobilization to encourage healing of the soft tissues and ensure that you do not compensate by putting too much stress on the other side of your body, which can lead to further problems in the future. After about eight weeks, a more intensive strengthening and stretching rehabilitation program will ensure that knee flexion is equal to that of the uninjured knee. By three to four months, you will be able to resume normal activities and forgo knee protection. A return to sports will be slower, but a properly healed meniscus means that you will no longer have restrictions on motion and will not be required to wear a brace when competing. Whether or not your torn meniscus requires surgery, a well-designed rehabilitation program can make a return to normal life and sports smooth and successful. We will be happy to work with you and your physician to devise an individualized program appropriate to your age, health status and activity level.