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There are many ways you can help children and their families get the care they need.
Boston Children's Hospital's Orthopedic Center provides patients with comprehensive care—including evaluation, diagnosis, consultation, non-surgical therapies, surgery and follow-up care.
Initial self-aid for a torn meniscus usually involves “R.I.C.E.” (rest, ice, compression and elevation), as well as medications to help control pain and swelling:
If your child's knee is stable and does not lock, the R.I.C.E. formula combined with nonsteroidal anti-inflammatory pain medication may be all that's needed to treat his torn meniscus. Blood vessels feed the outer edges of the meniscus, giving that part the potential to heal on its own. So, small tears on the outer edges often heal themselves with rest.
Additional measures to support this conservative approach to treatment can be:
If your child's meniscus tear doesn't heal on its own and his knee becomes painful, stiff or locked, it may need surgical repair. The goal of meniscal surgery is to obtain a stable, smooth rim of meniscal tissue that doesn't rub abnormally on the cartilage surfaces of the knee. (Patients may still have an increased risk of arthritis in the knee after a meniscal tear, even if surgery is performed.)
Depending on …
… the surgeon may recommend surgery using an arthroscope to:
Children's orthopedic surgeons have spent many years developing highly specialized arthroscopic techniques to repair meniscus tears. Our deep experience allows us to repair not only small “simple” tears—but also complex, multi-component tears, which most physicians elect to remove.
Arthroscopic treatment of meniscal tears
[photo courtesy of the American Academy of Orthopaedic Surgeons]
Because many of our patients are young, we emphasize trying to repair not only small meniscal tears, but also large, complex tears. Although the success rate is lower for complex tears (80 percent) compared to simple tears (98 percent), we feel that it's worth the time and effort to try to save the meniscus—in order to keep as much of the normal shock absorber in the knee as possible.
In some cases, the torn part of the meniscus is either so small that it's impractical to repair, or so damaged that the repair is likely to fail. In these cases, this tissue is simply trimmed out to leave a stable rim of meniscus and to minimize further damage within the knee.
Surgical treatment is usually advised for patients with symptoms of unstable meniscal tears, including pain, locking, giving way or catching in the knee. But non-operative management of isolated meniscal tears may be indicated for patients:
If your child is to have arthroscopic surgery to treat his meniscal tear, he may need a complete physical with his pediatrician before surgery to assess his health and rule out any conditions that could interfere with his surgery.
Before surgery, tell your child's doctor about any medications that he's taking. You will be informed which medications he should stop taking before surgery. This typically includes aspirin and anti-inflammatory medications, which should be stopped 10 days before surgery.
Your doctor may also order tests, such as blood samples or an echocardiogram, to help prepare for your child's procedure.
After surgery, you and your child will be given written instructions, pictures of his surgery, a prescription for therapy and a copy of our rehabilitation guidelines. A cast or brace will immobilize the knee for a period of time after surgery, and your child will use crutches for four to six weeks.
Your child will need to complete a course of rehabilitation exercises before gradually resuming his activity. He'll meet with the physical therapist, who will instruct your child in exercises, wound care and how much weight he should place on the operated knee. The therapist will work with your child to help set goals for rehabilitation; the entire rehab process will probably take four to six months.
Throughout the rehab period, your Children's team will be available for questions, concerns and help.
Your child's doctor will give you guidance regarding how long your child's knee should be rested in order for it to heal. The good news is that 98 percent of patients with simple meniscus tears are able to return to sports and regular activities without knee instability.
After your child's knee has healed, and after his strength and stability have returned through physical therapy, he should be able to return to his previous sports and activities—usually within six months. (But his doctor may recommend lifestyle changes for him if he has joint changes such as arthritis or instability that couldn't be corrected even with surgery.)
Your child's rehab team will help him relearn normal movements and pain-free activities. After he has successfully eliminated most of his discomfort and has returned to his normal routine, it's important for him to continue to be involved in some form of orthopedic fitness to ensure continued good physical health and well-being.
At Boston Children's Hospital, we understand that a hospital visit can be difficult, and sometimes overwhelming. So, we offer many amenities to make your child's—and your own—hospital experience as pleasant as possible. Our Center for Families staff will give you all the information you need regarding:
In particular, we understand that you may have a lot of questions when your child is diagnosed with a meniscal tear. Will this affect my child long term? When can he return to his sports and activities? Children's can connect you with extensive resources to help you and your family through this stressful time, including:
With a long history of excellence and innovation and a team of clinicians and researchers at the forefront of orthopedic research and care, Children's is home to many treatment breakthroughs:
We are also:
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”