Meniscus :

Posterior horn medial meniscus tear - - Posted by ariel (ariel), 19 January 2005

Hi all - does anyone know whether, when a surgeon operates on the posterior horn of the medial meniscus, do they have to temporarily "dislocate" your knee joint to get access to it, ie force the joint inwards or outwards to try and get access to the posterior part.

Just wondering if anyone's surgeon told them afterwards that they had to force/break the joint temporarily to get access to the posterior part or whether the surgeon could get access to the posterior part quite easily without having to "dislocate" the joint.

Thanks.
Posted by sienna (sienna), 20 January 2005

HI,
I had my posterior horn on the medial side repaired.  It was no easy task and the os had to make a 2 in incision on the medial side of my knee as well as the normal portholes just to get at it.  
He repaired it successfully.  Unfortunately he hit the nerve which runs down the medial side of your leg and now I have nerve damage.  
This is a risk of this type of surgery and it is the same for the lateral side.  There is always a danger of hitting a nerve but  mostly it doesn't happen.  I was unlucky.

Don't let your os say it can't be done because it can.  If your current os doesn't believe it can be done then go get another opinion.  
As for dislocating the knee during the op, I don't know.  I never read my op instructions.  I doubt that they could dislocate your knee because of the extra ligament damage they would end up doing.  I guess you'd have to ask your os that question.  And each os would have different ways of tackling the prob.

Make sure you ask lots of questions.  There is more info here on the front page about the meniscii.  Very interesting.  and there are links you can follow, too.

Good luck and let us know how you go.
Posted by ariel (ariel), 20 January 2005

Thanks Sienna - that's what worried me a bit when I read up on meniscus tears off the front page here:

http://www.kneeguru.co.uk/html/steps/step_04_meniscus/tears.html

"" The posterior horn is hard to reach because the bones of femur and tibia are in the way. The surgeon reaches this part by asking his assistant to force the knee into a knock-knee or bow-leg position, and then approaches it around the bulky cruciate ligaments through the notch of the femur or under the rounded end of the femur. ""

So - does anyone know what:

"asking his assistant to force the knee into a knock-knee or bow-leg position"

means? - that worries me a bit because I don't have any stability problems at all - my knee's luckily rock solid at the moment and I don't want to risk having my knee weakened stability wise just to clear out some meniscal tear/scratching/irratation etc etc.

So, just wondering if anyone else has had a posterior horn tear cleared up or repaired and did they have to twist your knee to the side to get to it.

Thanks

Posted by andrewc (AndrewC), 20 January 2005

hi Ariel

NO....The surgeon does NOT dislocate your knee to reach the posterior horn of the medial meniscus  

Quote:

means basically that your leg gets put in a bent position...nothing more.

I had surgery to repair a serious tear to the posterior horn of my lateral meniscus (i.e. All of it!) and was awake during the op. All that happened is manouvring of the leg into a bent position though it was totally gone from the spinal!

The medial meniscus is a bit trickier to get to this area than the lateral. But both are inherently possible via arthroscopy and NO knee dislocations involved  


All the best

I watched my last 2 ops.  To open up the joint space, the thigh is put against a padded bar, then your ankle is pulled out sideways.  No dislocation, just pulled outwards to make easier access to the area.

Hope this settles your mind a little

Heather

Thanks guys/gals, that's re-assured me somewhat - I've read in other places that they just apply some "valgus" or "varus" force to open up the space a little - not sure what the difference is exactly but presumably they're alluding to putting slight presure in the "inwards" or "outwards" direction.

Some good news though - just got the NHS MRI appointment through for early February - yip-ee - for interest - it's been around a 5 month wait for this.

This old Forum was so valuable that we have kept it as an archive. It is just for reference. If you want to ask questions or offer advice, there is also a current Bulletin Board which you can access from our home page.