(Disclaimer: This article is for scientific use only, and the relevant information in the following content has been processed to protect patient privacy)
Abstract: This patient suffered a knee sprain during basketball, causing a tear of the lateral meniscus. An outpatient MRI revealed a tear of the posterior horn of the lateral meniscus. To restore meniscal stability and protect joint function, arthroscopic surgery was considered to suture the lateral meniscus. After 7 days of hospitalization, the lateral meniscus of the knee was initially restored and the patient’s symptoms were relieved.
Basic information】Male, 40 years old
Disease Type】Lateral meniscus tear
Hospital】Harbin First Hospital
Date of consultation】February 2022
Treatment plan】Arthroscopy + meniscus suture + rehabilitation exercises
Treatment Period】7 days of inpatient treatment, 3 months of outpatient follow-up
Results】The lateral meniscus was sutured, the knee pain was relieved, and the joint interlock disappeared.
I. Initial consultation
The patient, a 40-year-old male, suffered a tear of the lateral meniscus due to the rotation of the knee in flexion while playing basketball, and the meniscus completed both flexion-extension displacement motion and rotation displacement motion, resulting in contradictory motion. After rest and braking and cold compress treatment, the swelling and pain were relieved, but the symptoms of joint interlocking still appeared and affected normal walking and the knee joint was tender. After examination, the patient was recommended to undergo arthroscopic surgery. Through minimally invasive surgery, the posterior horn of the lateral meniscus was sutured to restore the stability of the meniscus and protect the articular cartilage and joint function, and the patient agreed.
II. Treatment history
Subsequently, arthroscopic examination was performed, and a tear of the posterior horn of the lateral meniscus was found. The tear was not severe, and the meniscus was fixed with sutures after the tear was freshly opened with a meniscal file. Two sutures were placed at 3-4 mm intervals. The popliteal tendon was clearly observed and protected during the suturing process to avoid suturing the popliteal tendon to affect joint function. After suturing, the circumferential knee was flexed and extended under arthroscopic surveillance, and no reappearance of joint interlocking symptoms was observed. The patient was immobilized with a hinge brace postoperatively and knee rehabilitation exercises were started. The patient was instructed not to flex the knee more than 90° until the meniscus had completely healed to avoid compression of the lateral meniscal suture site, which could lead to failure of the meniscal suture.
III. Treatment effect
By treating the posterior horn of the lateral meniscus with sutures, the integrity and continuity of the meniscus were restored, and the protection of the knee cartilage was carried out to avoid serious impairment of the knee function. The patient’s symptoms of swelling and pain were significantly relieved 3 days after surgery, and he was able to start active knee flexion training. 7 days after surgery, he gradually resumed knee extension exercises to strengthen the quadriceps muscle, correct the symptoms of quadriceps atrophy, and restore knee stability. The patient was discharged and instructed to follow up with the clinic for 3 months after the operation.
IV. Notes
We are glad that the patient’s lateral meniscus recovered normal function after surgical suturing. However, it should be noted that the trauma itself caused some damage to the knee cartilage, so the patient needs to focus on the changes of knee symptoms such as pain swelling and flexibility recovery after the surgery. Furthermore, patients need to keep their weight under strict control and minimize weight-bearing activities in the knee joint. Regular follow-up visits to the orthopedic department will confirm the rate of degenerative knee disease and changes in knee stability. Note that short-term swelling and pain in the knee joint is a normal phenomenon caused by surgical trauma, which usually disappears completely in about 2 months and will not have any adverse effects on the patient’s future life.
V. Personal insight
A torn lateral meniscus can have a serious impact on the knee joint and can lead to serious damage to the articular cartilage once symptoms of joint interlocking occur. Therefore, it should be diagnosed early and treated as soon as possible with minimally invasive arthroscopic surgery, and usually, as in this patient, the symptoms will improve significantly after treatment. However, it is important not to stand or walk with weight until the meniscus has fully recovered, as this can easily damage the articular cartilage, and once the articular cartilage is severely damaged, it is usually impossible to repair it completely, and can affect the function of the knee joint, such as producing a severe valgus deformity of the knee.