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Meniscectomy

Meniscectomy means 'cutting out the meniscus'.

The term can encompass different degrees of tissue removal -

Complete meniscectomy

Removing a complete meniscus, that is a medial or a lateral meniscus, right up to and including the meniscal rim is called 'complete meniscectomy'.

Partial meniscectomy

The term 'partial meniscectomy' is actually used rather loosely in medical reporting. There may be a wide variation in the actual amount of meniscus removed, from minor trimming of a frayed edge to anything short of removing the rim. It is important to ask your surgeon exactly what was/will be removed, and any video record should be kept for later reference.

Meniscectomy and arthritis

Now, there is one big issue about 'complete' meniscectomy that you must understand - losing the cushioning rim around the outer edge of the meniscus in a complete meniscectomy is a one-way ticket to arthritis!

Removal of the all-important meniscal rim causes the following consquences -

  • shock absorption is lost forever
  • since the spacer on the one side of the joint is missing, more forces are transmitted through that side of the joint
  • the joint surfaces of the femur (thighbone) and tibia (shinbone) are going to become stressed, softened, and eventually break down ('arthritis') and there will be arthritic pain
  • the leg may demonstrate 'bow legged ness' or 'knock-knees', due to the collapse of the joint on the one side (one 'compartment')
  • the knee may seem to thrust outwards with each step, further stressing the joint ('lateral thrust')
  • the bone may attempt to try to heal the problem - causing totally unhelpful bony outgrowths called 'osteophytes' ('bone mushrooms'). These may form at the joint line or in the notch where the cruciate ligaments reside.
  • eventually the cruciate ligaments may become incompetent and rupture

Knee surgeons will generally try to preserve this external rim at all costs. However, part of the meniscus may have to be removed in a partial meniscectomy, particularly if there is a large bucket handle tear where the torn fragment is large and the fibres disrupted, so unlikely to heal.

Modern techniques of meniscal transplantation (allograft) and collagen meniscus implants now allow restoration of meniscal function, but these are only available in certain centres as the techniques are not yet mainstream.

Updated: 16 Apr, 2013
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