Meniscal tears and meniscal repair
Each knee has two menisci: C-shaped cushions of cartilage that absorb shock and protect the joint surface. A torn meniscus is one of the most common knee injuries.
Because the meniscus protects the knee from arthritis, my priority is to save it wherever possible.
Symptoms
- Pain along the inner or outer side of the knee
- Swelling, often the day after injury
- Catching or locking
- Being unable to fully straighten the knee (a “locked knee” needs urgent assessment)
Types of tear
In younger people, tears usually follow a twisting injury. These tears are often suitable for repair, especially if treated early. In people over around 40, tears are often degenerative, meaning part of normal wear. Degenerative tears usually settle with physiotherapy, and keyhole surgery is rarely helpful for them unless the knee is mechanically locking.
Treatment options
- Physiotherapy: first-line treatment for many tears, particularly degenerative ones
- Meniscal repair: the tear is stitched using keyhole surgery so it can heal
- Partial meniscectomy: the torn part is trimmed away, when a tear can’t be repaired and is causing mechanical symptoms
Repair has a longer recovery than trimming, but better long-term protection for the knee.
The operation
Meniscal surgery is keyhole surgery, usually as a day case. The tear is assessed through the arthroscope and either repaired with stitches or trimmed. The final decision is sometimes made during the operation, and I’ll discuss both possibilities with you beforehand.
Recovery after repair
| 0 to 6 weeks | Crutches, with limited bending of the knee to protect the repair. A brace may be required. |
| 6 to 12 weeks | Walking normally, building strength |
| 3 to 4 months | Gradual return to running |
| 4 to 6 months | Return to sport |
After a partial meniscectomy, most people walk normally within 1 to 2 weeks and return to sport within 6 to 8 weeks.
Risks
These include infection, blood clots, stiffness, and the repair not healing, which may need further surgery.
Frequently asked questions
Can every tear be repaired?
No. It depends on the tear’s type, location, blood supply and your age. The best chance of repair is with an early diagnosis.
Will I get arthritis?
Losing meniscus increases the long-term risk of arthritis, which is why repair is preferred where possible.