Surgical treatment of meniscal ruptures

Arthroscopy or arthrotomy – which type of surgery is better for a medial meniscus rupture?

I have a ruptured medial meniscus and am undergoing surgery. I was offered arthroscopy or arthrotomy. How are these two treatments different and which one should I choose? ~ lkamil

Arthroscopy differs from arthrotomy in the way of surgical access. Classic surgical technique in the case of indications for the correction of the meniscus requires arthotomy – that is, a more or less extensive incision of the joint capsule. The advantage of this procedure is the possibility of a good visualization of the meniscus, as well as adjacent structures, and a relatively low degree of difficulty of the procedure performed. Cutting a joint capsule is an additional injury that superimposes the dysfunction caused by damage to the meniscus. Other disadvantages of incision of an articular capsule include a longer healing time, risk of joint infection, and the need for relative immobilization of the joint. Arthroscopy is a procedure performed with the use of a complex system and requires the high technical skills of the treatment team. Access is made by means of a few small incisions through which the tip of the vision system and small manipulators are inserted into the joint, enabling the necessary interventions. The limited field of view and the lack of direct opening of the joint cavity make it easier to overlook the damage associated with meniscus disease when using endoscopic surgery, while the procedure of excision or reconstruction of the structures inside the joint is technically difficult tasks. However, after arthroscopy, the hospital stay is short – sometimes for one day; You can also start improving faster – sometimes after a week it is possible to return to non-strenuous work.

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