Menisectomy

WHAT YOU SHOULD KNOW:

The menisci (me-NIS-keye) are two pieces of cartilage that lie between the tibia and femur bones in the leg. Each meniscus acts like a shock absorber, and helps the knee to move correctly. The menisci also help keep the knee joint from breaking down. A meniscus can stretch or tear, especially when the knee is twisted at the same time it is being extended (straightened). During a meniscal repair or meniscectomy (men-ih-SEK-toh-mee), the menisci can be repaired, or torn pieces can be removed. Your recovery time will depend on the type of surgery you have.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• There are always risks with surgery. You may bleed more than usual or get an infection. You could have trouble breathing or get blood clots. You could have an allergic reaction to medicine used before, during, or after your surgery. Your caregivers will watch you closely for these problems. An instrument used during surgery may cause a burn or damage to your knee tissue and cartilage. If you have a meniscus transplant, your meniscus may tear, shrink, or move out of place. Catching a disease from the meniscus donor is also possible.
  
  
• You may have continued pain or knee stiffness after surgery. You may get joint disease or break down of the cartilage and bones in your knee over time. You may need this surgery more than once, or you may need another type of knee surgery. If you do not have surgery, your knee problem may get worse.

WHILE YOU ARE HERE:

Before your surgery:

• Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
  
  
• An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• MRI: This test is also called magnetic resonance imaging. During the MRI, 3-D (three dimensional) pictures are taken of your knee joint. An MRI helps caregiver see meniscus injuries or disease of the bones, tendons, ligaments, and other tissues in the knee.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
  
  
• X-rays: Before surgery, caregivers may want you to have an x-ray (picture) of your chest. Caregivers use it to see how your lungs and heart are doing before surgery. Caregivers may also take an x-ray of your knee. Caregivers use it to look at the bones and tissue of the knee before surgery.

Anesthesia:

This medicine is given to make you comfortable. You may not feel discomfort, pressure, or pain. An adult will need to drive you home and should stay with you for 24 hours. Ask your caregiver if you can drive or use machinery within 24 hours. Also ask if and when you can drink alcohol or use over-the-counter medicine. You may not want to make important decisions until 24 hours have passed.

• Local anesthesia: This is medicine to make you comfortable during and after surgery. It is a shot of medicine put into the skin. It is used to numb the area and dull your pain. You may still feel pressure or pushing during surgery.
  
  
• Regional anesthesia: Medicine is injected to numb the body area where the surgery or procedure will be done. You will remain awake during the surgery or procedure.
  
  
• General anesthesia: Caregivers use this medicine to keep you asleep and free from pain during surgery. They give you anesthesia through your IV or as a gas. You may breathe in the gas through a mask or through a breathing tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

During your surgery:

• A caregiver cleans your knee and leg with soap and water. This soap may make your skin yellow, but it is cleaned off later. Sheets are put over you to keep the surgery area clean. A rubber cuff may be put around your thigh to slow down blood flow. An elastic bandage may be wrapped tightly around your leg and foot. This helps to keep you from bleeding too much during surgery.
  
  
• You may have open knee surgery, arthroscopic (AHR-thro-skop-ik) surgery, or both. One or more incisions will be made in your knee. If you have arthroscopic surgery, caregivers will put an arthroscope (thin tube with a camera on the tip) inside your knee. When the arthroscope is put into your knee, you may feel pressure or pushing. Caregivers may repair a meniscus using stitches or a tiny device, or remove all or part of your menisci. They may transplant a piece of donor meniscus into your knee to replace what has been removed. Caregivers may also fix other damage to bones, ligaments, tendons or tissue during your surgery. Caregivers will close the incisions with stitches, adhesive tape, or bandages. Your caregiver may take a video of your surgery that you can watch later.

After your surgery:

You will be taken to a recovery room. You will be there until caregivers know that you are okay. You will then be allowed to go home, or you will be taken to your hospital room. A clean dressing and an elastic wrap bandage may cover your stitches. A caregiver may remove the dressing soon after surgery to check the stitches. Do not get out of bed until your caregiver says it is OK.

• Activity: It is important to get moving as soon as possible after surgery. Call your caregiver the first time you get up. Any time you feel weak or dizzy, lie down right away and call your caregiver.
  
  
• Cold therapy: Caregivers may put an ice bag or cold pressure cuff (bandage) on your knee after surgery. These may help to decrease pain and swelling.
  
  
• Continuous passive motion machine: Your leg may be put into a CPM machine right after surgery. CPM stands for continuous passive motion. The machine moves your leg back and forth very slowly without you having to use your muscles. This movement can help decrease pain and swelling, and may help your knee heal faster. Until you can get out of bed, leg exercises should be done with both legs. For example, drawing circles in the air with your toes may keep your legs strong and stop blood clots from forming.
  
  
• Deep breathing and coughing: This will help decrease your risk for a lung infection after surgery.
  
  
  • Hold a pillow tightly against your incision when you cough to help decrease pain. Take a deep breath and hold it for as long as you can. Deep breaths help open your airways. Let the air out and follow with a strong cough. Spit out any mucus you cough up. Repeat the steps 10 times every hour.
    
    
  • You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece into your mouth and take a slow, deep breath. Let out your breath and cough. Repeat the steps 10 times every hour.
  
  
• Medicines: Caregivers may give you antibiotics to prevent infection, and pain medicine to decrease discomfort. You may also be given other medicines.
  
  
• Physical therapy: A physical therapist may help you start special exercises sometime after surgery. These exercises help make your knee stronger and move better.
  
  
• Pressure stockings: These tight elastic stockings keep blood from pooling (staying) in your legs, and forming blood clots. You may need to wear stockings on both legs.