Meniscus Repair

A meniscus tear is a tear or damage to this cartilage. A tear can lead to catching and locking the knee during movement. Fifty percent of people with an ACL tear also have a meniscus tear. A meniscus tear can alter the forces in a knee joint and lead to arthritis.

Tears can be caused by trauma, typically associated with a sport like football, basketball, or soccer. The injury typically involves twisting or rotating the upper body while the foot is planted and the knee is bent or a rapid change in direction. Nonathletes can also suffer a meniscus tear due to a sudden twist or turn or as part of an injury to the anterior cruciate ligament. Degenerative tears result from a weakened meniscus that can be torn by standing from a sitting position or a slight twist, especially those at the meniscus root.

Symptoms of a meniscus tear include knee pain, swelling, stiffness, reduced range of motion, a popping or clicking sound when the knee is moved, a catching or locking, and knee instability.

A physical exam diagnoses a tear, and Dr. Waterman will use a special diagnostic test called the McMurray test to determine if you have a meniscus tear. X-rays will rule out fractures or advanced arthritis; when appropriate, an MRI will reveal the details of a tear and the extent of damage.

Meniscus repair surgery is a procedure that treats a torn meniscus in the knee by suturing the torn pieces back together. The goal of meniscus repair is to preserve the meniscus’s function and prevent long-term complications from a damaged meniscus, including knee arthritis and future knee replacement.

Meniscus repair is preferred whenever possible, especially for younger patients and certain types of tears (in the red-white or red-red zone) with a higher chance of healing successfully. However, other tears, such as those involving the meniscus root, may occur in older individuals aged 40-70 and should also be considered for surgery without arthritis.

Meniscus repair surgery is a minimally invasive outpatient procedure performed arthroscopically. It requires only a few small incisions around the knee. In those incisions, the arthroscope—a thin tube with a small camera—is inserted to view the inside of the joint on a monitor.

Dr. Waterman evaluates the tear and determines how to repair it. Specialized instruments are used to clean the tear site and suture the torn edges of the meniscus. Depending on the tear location, pattern, or tissue quality, different techniques, such as inside-out, outside-in, all-inside, or trans-osseous methods, may be used. When repair is complete, the incisions are closed, and the knee is bandaged.

After surgery, the knee is typically placed in a hinged brace to limit full movement and protect the repair. Crutches are necessary to avoid putting weight on the operated knee.

Physical therapy is crucial for a successful recovery. It focuses on gradually restoring the knee’s range of motion, strength, and stability. The rehabilitation program is tailored to the individual’s needs and progress.

Recovery time can vary. Generally, the initial healing takes about 4-6 weeks, but it may take several months to regain full function. Return to sports or high-impact activities is usually permitted after 4-6 months, depending on the surgeon’s assessment and the patient’s adherence to rehabilitation protocols.

Meniscus repair surgery has a success rate, particularly in younger patients, those with tears in the vascularized outer portion of the meniscus, and alongside ACL surgery. As with any surgery, risks include infection, blood clots, and anesthesia-related complications. Specific to meniscus repair, there is a risk of incomplete healing or re-tearing.

Preserving the meniscus can help maintain knee function and reduce the risk of degenerative changes in the joint, such as osteoarthritis, which is especially important for young athletes and nonathletes.