If your tear is on the outer edge of the meniscus, where there is still blood flowing to help with healing, repair is an option. The surgeon uses the same arthroscopic technique to examine the knee and repair the meniscus by suturing the torn edges back into place.
In both cases, the minimally invasive approach offers numerous benefits including less muscle and tissue trauma, less bleeding, less pain and a faster recovery. Patients usually return home the same day.
The meniscus is a rubbery, C-shaped piece of cartilage that cushions the knee, provides stability and helps distribute body weight across the knee joint. Each knee has two menisci, one at the outer edge (the lateral meniscus) and one at the inner edge (the medial meniscus). A torn meniscus can prevent the knee from functioning normally. Left untreated, it can lead to early arthritis of the knee joint.
Acute tears result from any activity that forcefully twists or rotates the knee. Tears often occur with injury to the anterior cruciate ligament (ACL). In older adults, the cause is usually degenerative changes in the knee. Aged, worn tissue is more prone to tears.
When is surgery recommended?
The type of treatment for a meniscus tear depends on where the tear occurs (outer edge or inner edge), its severity and whether other parts of the knee, such as the ACL, are injured.
If your meniscus tear is acute or you want to return to high-level athletics as soon as possible, surgery is necessary. Repair is only an option when the tear is on the outer edge of the meniscus where there is still blood flow to help with healing. When it’s an inner-edge tear, with no blood flow, the damaged tissue must be removed. The vast majority of patients have their meniscus removed rather than repaired.
If your tear is small and on the outer edge of the meniscus, it may not require surgery. As long as your symptoms do not interfere with daily living and your knee is stable, conservative treatment – such as rest, activity modification and non-steroidal anti-inflammatory drugs (NSAIDs) – may be all you need.
What is the recovery time?
Specific recovery time varies depending on the type of surgery you have. Recovery from arthroscopic meniscal tear surgery is relatively quick, and most patients are able to resume normal activities within a few weeks. If you have a meniscal repair, the recovery time and rehabilitation period may be longer – up to six weeks in a knee brace or with crutches.
Can you repair the meniscus tear?
Most tears are not repairable based on poor blood supply to the tissues. Repair is usually an option when the tear is on the outer edge of the meniscus where there is still blood flow to help with healing.
What does it mean if you have to take out pieces of the meniscus?
The most common surgery for meniscus problems is to remove a portion of the meniscus. This is called a partial meniscectomy. If you have a tear on the inner edge of your meniscus, where there is virtually no blood flow, the damaged tissue must be removed.
Can't you replace lost meniscus with something artificial?
Although certain cartilage cells can be grown and reproduced in a lab, current biotechnology does not allow these cells to function effectively in vivo to replace torn meniscus tissue. In short, biologic replacement of torn meniscal tissue is not widely available. However, in special circumstances, allograft (cadaver) transplantation of meniscal tissue is possible.
What is recovery like?
Specific recovery time varies depending on the type of surgery you have. Recovery from arthroscopic meniscectomy is fairly quick, with most patients resuming normal activities within a few weeks. If you have a meniscal repair, the recovery time and rehabilitation period may be longer — up to six weeks in a knee brace or with crutches.
Will I need physical therapy?
No, most patients don't need formal physical therapy after straightforward meniscal surgery.
When can I work out again?
Generally, you can resume low–impact activities such as swimming and exercise machines a few weeks after surgery. Cutting and jumping activities are usually restricted for several months after meniscal repair surgery.