Meniscus Repair

Surgery Overview

A meniscus tear is a common injury to the cartilage that stabilizes and cushions the knee joint. Whether or not your tear can be repaired depends on the type of the tear. Radial tears sometimes can be repaired, depending on where they are located. Horizontal, flap, long-standing, and degenerative tears—those caused by years of wear and tear—generally can't be repaired.

Your doctor will likely suggest the treatment that he or she thinks will work best for you based on the zone where the tear is, the pattern of the tear, and how big it is. Your age, your health, and your activity level may also affect your treatment options. In some cases, the surgeon makes the final decision during surgery, when he or she can see the how strong the meniscus is, where the tear is, and how big the tear is.

  • If you have a small tear at the outer edge of the meniscus (in what doctors call the red zone), you may want to try home treatment. These tears often heal with rest.
  • If you have a moderate to large tear at the outer edge of the meniscus (red zone), you may want to think about surgery. These kinds of tears tend to heal well after surgery.
  • If you have a tear that spreads from the red zone into the inner two-thirds of the meniscus (called the white zone), your decision is harder. Surgery to repair these kinds of tears may not work.
  • If you have a tear in the white zone of the meniscus, repair surgery usually isn't done. That's because the meniscus may not heal. But partial meniscectomy may be done if torn pieces of meniscus are causing pain and swelling.

Surgical repair may be done by open surgery. This means that a small incision is made and the knee is opened up so that the surgeon can see inside the knee and repair the meniscus. But more and more surgeons are using arthroscopic surgery to repair the meniscus. The surgeon inserts a thin tube (arthroscope) through small incisions near the knee. This scope contains a camera and a light. It lets the surgeon see inside the knee without making a large incision. Surgical tools can be inserted through other small incisions. The surgeon repairs the meniscus using sutures (stitches) or anchors.

Other knee injuries—most commonly to the anterior cruciate ligament (ACL)—may occur at the same time as a torn meniscus. In these cases, your surgeon will repair your torn meniscus, if needed, at the same time ACL surgery is done.

What To Expect

Your surgeon may recommend that you do not move your knee more than absolutely necessary (immobilization) for 2 weeks after surgery. This may be followed by 2 weeks of limited motion before you are able to resume daily activities.

Physical therapy should begin right after surgery. But heavy stresses, such as running and squats, should be postponed for some months. You must follow your doctor's rehabilitation (rehab) plan for the best healing. Later, you may still have pain and need more physical therapy. Or you might need more surgery.

How soon you can get back to walking, driving, and more vigorous activities will depend on your success in rehab.

How long recovery may take

Surgery to repair a torn meniscus involves rehabilitation. But rehab varies depending on the injury, the type of surgery, and your doctor's preference. In general, meniscus surgery is followed by a period of rest, walking, and selected exercises.

Every recovery is different and depends on many things. But here are some typical times for returning to activities.

Time needed to return to activities

Activity

Uncomplicated meniscectomy

Meniscus repair surgery

Bear weight (put weight on your knee while standing or walking)

Right away, as tolerated

Right away, but only with a brace

Walk without crutches

2 to 7 days

4 to 6 weeks

Drive, if the affected leg is to be used for gas and brake or for clutch

1 to 2 weeks, if:

  • You have regained motion with minimal pain.
  • You are not taking opioids.

4 to 6 weeks

Regain full range of motion

1 to 2 weeks

Bending is typically restricted to not more than 90 degrees for first 4 to 6 weeks to allow the meniscus to heal.

Return to heavy work or sports

4 to 6 weeks, if:

  • You have regained motion and strength.
  • Your knee is not swollen or painful.

3 to 6 months

Why It Is Done

Your doctor may suggest surgery if you still have knee pain after trying other types of surgery.

How your doctor treats a meniscus tear depends upon the size and location of the tear, your age, your health and activity level, and when the injury occurred.

Small tears at the outer edge of the meniscus often heal on their own. Larger tears toward the center of the meniscus may not heal well. That's because blood supply to that area is poor. In a young person, surgery to repair the tear may be the first choice, because it may restore function.

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How Well It Works

After surgery, you may have less pain and a return to normal knee function. Also, you may be able to prevent long-term complications (such as osteoarthritis) with successful surgical repair of your tear. The success rate of a moderate to large tear at the outer edge of the meniscus (red zone) is 85%.footnote 1

Successful repair of meniscus tears depends to a large degree on where the tear is located. Tears at the outer edge of the meniscus (the red zone) tend to heal well. Blood supply to tears that extend into the center of the meniscus (white zone) is questionable. So surgical repair of a tear in this zone may not heal well.

Risks

Risks of the surgery itself aren't common. But they may include:

  • Infection.
  • Damage to nerves or blood vessels around the knee.
  • Blood clots in the leg.
  • Risks from anesthesia.

References

Citations

  1. Beynnon BD, et al. (2010). Meniscal injuries. In JC DeLee et al., eds., DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice, 3rd ed., vol. 2, pp. 1596–1623. Philadelphia: Saunders Elsevier.

Credits

Current as of: July 1, 2021

Author: Healthwise Staff
Medical Review:
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
Patrick J. McMahon MD - Orthopedic Surgery