Meniscus root tears are specific type of injuries which accounts for 10-20% of all meniscus tears. Untreated meniscus tears result in meniscus extrusion, increased joint reaction force, bone edema and accelerated joint cartilage degeneration.
Meniscus is a rubbery tissue which provides cushioning to the joint reducing joint raction forces in the joint. Meniscus root is defined as attachment of meniscus horn in to the tibial plateau. About 70% of load transmitted through the knee is supported by medial and lateral menisci, they aid in uniform weight distribution and reduce contact pressures. Meniscus root act as an anchor for menicus tissue and resist the tendency for meniscus extrusion
NORMAL KNEE ANATOMY
MENISCUS ROOT TEAR
- Traumatic – in young and active individuals, sports and occasionaly road traffic injuries
- Non traumatic – degenerative for people over 45 years, predminantly females
EXTRUDED MENISCUS DUE TO MENISCUS ROOT TEAR
- Sudden onset of pain with or without tivial injury like twisting episode while getting in and out of car
- Getting up from sitting posture
- Catching, locking
- Occasional instability
- Pain during nights
- Clinical examination
- X rays to look for osteoarthritis
- MRI scan is diagniostic
Conservative – Non surgical
- in chronic tears
- Age over 55yrs
- Pre existing osteoarthritis grade 3+
- Varus deformities
Meniscus root repair – arthroscopic surgery [key hole]
We do trans-tibial suture pullout in cases with no or very minimum cartilage damage, main goal being to arrest the progression of articular cartilage damage.
Sometimes we do meniscotibial ligament repair in cases of meniscus extrusion of more than 3 mm.
Corrective bony osteotomy procedures are needed in cases of malalignment of knees – high tibial osteotomy
WHEN MENISCUS IS EXTRUDED IT WILL BE REDUCED AND REPAIRED ALONG WITH REPAIR OF POSTERIOR ROOT OF MEDIAL MENISCUS
TORN MEDIAL MENISCUS ROOT FIXED WITH TRANSTIBIAL PULL OUT SUTURE
Post operative protocol
Patient will walk non weightbearing walking form postooperative day 1, exercises rangninng from static quadriceps exercises to ROM exercises upto 6 weeks
Partial weight bearing from 6th week to 10th week, full weight bearing thereafter.
Save your knee from developing dreadful osteoarthritis by addressing your knee issues comprehensively…