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Meniscal Cyst Surgery and Recovery: removing the cyst

Do you know what a meniscus is? It is a wedge-like cartilage fragment among your knee bones. It acts as a cushion to shield bones while moving. Each of your knees features two menisci: internal and external meniscus. A healthy meniscus looks similar to a crescent moon.

In contrast, a torn meniscus loses its shape. However, when the torn cartilage gets filled with joint fluid, a cyst may form. This article will focus on meniscal cyst surgery and recovery. 

A meniscal cyst might not show any symptoms. Sometimes, it might cause pain, inflammation, or mechanical problems with the knee. This condition usually occurs in males aged 20-30 years. It is a particular type of meniscal tear, referred to as a horizontal cleavage tear. If your knee gets over-rotated or gets directly hit, a cleavage tear is likely to form. So, in this situation, you should immediately visit a doctor.

What are the Symptoms?

If you have developed a meniscal cyst, likely, you might not feel any symptoms. However, if the symptoms appear, the commonest ones include:

  • Pain behind the knee while standing
  • Sensitivity directly over the knee joint line
  • A bump or swelling at the cyst position (the cysts form close to the lateral meniscus exterior side of the knee)
  • A cyst that becomes noticeable when the knee outspreads, though the bump might be painless
  • The cyst may fluctuate in size, though it might remain unaffected.
  • Knee joint inflammation or locking.

What are the Causes?

The cyst might develop due to deterioration of your meniscus. It happens due to age, arthritis, or direct hits to the front or side of your knee. A knee over-rotation or uneven force on the knee (when you run on rough surfaces) can cause a tear. It enables the synovial fluid to seep out of the joint.  

So, the meniscal lump is not an actual cyst. It is just a bulge of displaced synovial joint fluid. So, it is a part of your body’s natural healing process responding to the damage.

So, your body is continually generating synovial fluid and absorbing an extra amount. Though, when the fluid outflows the joint, it might amass and develop a pouch known as a meniscal sac.

So, your tendon tear may perform like a one-way valve where the fluid outflows the joint and enter the cyst, but it does not escape from the other side. So, this is the reason the cyst continues to amass fluid.

What are the Risk Factors?

Some of the risk factors for meniscal pouch encompass:

  • Former knee injury or damaged meniscus
  • Involvement in contact sports or any sports with recurrent knee twisting like football, tennis, etc.
  • Aging or osteoarthritis.
  • Related tendon injuries like torn anterior cruciate ligament (ACL).
  • Poor muscle strength and flexibility

How to Diagnose?

If you feel any symptoms or notice a cyst in your knee, you should immediately visit a physician. The consultant may inquire about some questions linked to the knee pain, pop noises, current injuries, or impact to the knee. It will help the doctor determine whether it’s a meniscal tear or not. So, a meniscal sac can usually be palpated, so your doctor may test your knee’s range of motion (ROM) to ascertain that no ripped cartilage fragments are stuck in the joint.

Standard lab tests to diagnose meniscal problems include the McMurray test, Payr’s test, Apley test, Childress’ sign, Steinmann I test, and Ege’s test. Your physician may suggest a magnetic resonance imaging (MRI) test to observe the cyst and parallel tear for a more specific diagnosis.  

What is the Difference Between Meniscal and Baker’s Cyst?

The meniscal sacs resemble Baker’s cyst, but the meniscal is in the backside of your knee joint. Besides, a baker’s cysts are associated with several knee joint issues that may cause fluid build-up or knee swelling. Hence, this fluid build-up can also occur if you have a meniscus tear, osteoarthritis, tendon injuries, and other issues that may cause knee inflammation.

What is the Treatment?

So, if you have pain due to a meniscus pouch, you can try ice therapy and anti-inflammatory medications. However, this may only control symptoms. For removing the cyst, your doctor may drain it in their clinic. Before removing the cyst, it is essential to treat the underlying cause of the tear, or it may return.  

Surgical Treatment

A surgical procedure is not always crucial to treat meniscal problems. However, if your physician recommends it, you don’t need to worry. It is a minimally invasive procedure known as arthroscopic surgery. After your physician has successfully performed the surgery, the cyst decompresses and is less likely to regrow. So, addressing the underlying reason for the cyst is more important than removing the cyst itself.

How to Prevent?

If you want to protect your knee and meniscus, you must be careful of the following things:

  • Appropriately warm up and stretch before exercising.
  • Maintain adequate training:
    • Thigh, knee, and leg forte
    • Elasticity and Stamina
  • Shield your suspected joints with supportive items like a knee brace, elastic bandages, or braces when playing contact sports.
  • Use protective equipment and ascertain proper fit.  

What are the Outcomes?

A majority of the meniscus injuries do not recover on their own and may not reveal any symptoms. So, removing the cysts that are not painful do not require treatment. In contrast, the only definitive treatment for meniscal rips is surgery. If you undergo surgery, it may take six weeks for a full recovery.

What are the Possible Complications?

Some probable complications linked to meniscal injury and surgery include:

  • The reappearance of symptoms indicating a chronic condition
  • Frequent knee injuries usually if you don’t let the injury fully recover.  
  • Tear or cyst becomes larger if left untreated.
  • Knee arthritis if you get the tear removed without a surgery
  • Surgery complications include pain, infections, knee locking, knee giving way, bleeding, nerve injury.
  • Joint and bone erosion due to the compression from the cyst
  • Nerve injury due to cyst compression

How is Recovery from Surgery Like?

The recovery period for the surgery is influenced by the surgery type. So, a meniscus tear takes a prolonged time to heal compared to a meniscectomy. However, complete recovery from the meniscus operation for removing the cyst takes up to three months. If you have undergone knee surgery, you may take the following steps to recover fast:

  •         Use crutches to remove any stress from the knees
  •         Wear a knee brace to stabilize your joint during recovery
  •         Pain relief medication
  •         Physiotherapy
  •         Rehab exercise programs to help regain mobility and ROM
  •         RICE (Rest, Ice Therapy, Compression, and Elevation) Method

Does Pain Follow After the Surgery?

You might feel some pain right after the surgery which may continue for some weeks. So, it is normal and nothing to worry about. However, your surgeon will recommend medicines for pain management. This will enable you to follow your rehab exercise routine.

After What Duration You Can Resume Normal Activity?

Many people can walk with the help of crutches immediately after removing the cyst via surgery. However, a majority can resume their normal routine after eight weeks. Your doctor may suggest you avoid high-impact exercises for some time. And if you have a physical job, you may need more time to recover as rest is crucial for recovery.

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