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What is Meniscal Centralization?

Meniscal Centralization is a surgical technique that aims to reduce meniscal extrusion and restore the load-distributing function of the meniscus. The meniscus, a crescent-shaped cartilage in the knee, plays a crucial role in stability and load distribution. Centralization refers to the displacement or migration of the meniscus from its normal position, often accompanied by various clinical implications. Meniscal extrusion can be caused by various factors, such as meniscus root tears, meniscectomy, aging, or osteoarthritis.

What is the Anatomy and Function of the Meniscus?

The menisci are two wedge-shaped structures in the knee joint, namely the medial meniscus and lateral meniscus. They act as shock absorbers, providing stability, load distribution, and lubrication to the knee joint during movement.

What are the Preparations for Meniscal Centralization?

Before the surgery, you may need to undergo some tests, such as blood tests, X-rays, or magnetic resonance imaging, to assess the condition of the knee and the extent of meniscal extrusion. You may also need to stop taking certain medications, such as blood thinners, anti-inflammatory drugs, or herbal supplements, that may increase the risk of bleeding or infection. You should inform the surgeon about any allergies, medical conditions, or previous surgeries. You should also arrange for someone to drive you home after the surgery and help you with daily activities for a few days.

What is the Procedure of Meniscal Centralization?

The surgery is usually performed under general or regional anesthesia. The surgeon makes small incisions around the knee and inserts an arthroscope, which is a thin tube with a camera and a light, to visualize the inside of the joint. The surgeon then uses special instruments to repair the torn meniscus root using a transtibial pullout technique, which involves passing sutures through the tibia and tying them over a button or a washer on the skin. 

The surgeon also performs a centralization technique, which involves suturing the meniscus-capsule complex to the edge of the tibial plateau using suture anchors. The surgeon then closes the incisions with stitches or steri-strips and applies a bandage and a knee brace.

What is the Aftercare of Meniscal Centralization?

After the surgery, you will be taken to a recovery room, where you are monitored for any complications, such as bleeding, infection, or nerve damage. You may feel some pain, swelling, or stiffness in the knee, which can be managed with ice packs, elevation, and pain medications. You may also need to use crutches or a walker for a few weeks to avoid putting weight on the operated knee. 

You should follow the surgeon’s instructions on wound care, physical therapy, and activity restrictions and wear a knee brace for up to six weeks to protect the repaired meniscus and prevent excessive knee motion. You may also need to attend regular follow-up visits to check the healing progress and the outcome of the surgery. The recovery time may vary depending on your age, health, and the severity of the meniscal injury, but it may take up to six months to return to normal activities

What are the Complications of Meniscal Centralization?

Some possible complications of meniscal centralization include are:

  • Infection
  • Bleeding
  • Nerve damage
  • Thromboembolism
  • Failure of repair
  • Osteoarthritis