Meniscus Repair

An ideal candidate for meniscus repair is typically a person who has recently suffered a meniscal tear and is experiencing persistent pain, swelling, or limited knee function despite non-surgical treatments like rest, ice, compression, elevation, and physical therapy. Meniscus repair is often more successful in younger patients and in cases where the meniscus tear is on the outer edge of the meniscus (red zone), which has a better blood supply for healing.

Meniscus repair is usually performed arthroscopically, a minimally invasive approach involving small incisions, a special camera (arthroscope), and tiny surgical tools. A couple small incisions are made around your knee and an arthroscope (camera) is used to visualize the structures inside the knee joint. The meniscus tear and the rest of the knee joint is inspected to determine the best treatment option. Depending on the type and location of the meniscus tear, the torn meniscus is either partially taken out, or repaired using sutures. In some cases, another incision may be made on the inside or outside part of your knee to assist in the repair.

Recovery time from a meniscus repair varies depending on the individual and the specific characteristics of the meniscal tear. Typically, patients may return to desk jobs or light activities within a few weeks. More physically demanding jobs or return to sports may require three to six months. This time frame allows the meniscus to heal properly and regain strength and functionality.

Postoperatively, you’ll be moved to a recovery room where you will be monitored as the anesthesia wears off. You’ll go home the same day of the surgery. Your knee will be bandaged and might be immobilized with a brace. Crutches will be used for mobility, and pain medication will be provided to manage any discomfort.

Physical therapy plays a significant role in the recovery process. A typical rehabilitation program might include:

• Early Stage (Weeks 1-2): Focuses on controlling pain and swelling, protecting the repair, and regaining knee extension. Crutch use and limited weight-bearing may be recommended.
• Middle Stage (Weeks 2-6): As healing progresses, you’ll work on regaining knee flexion, gradually increasing weight-bearing, and initiating gentle strengthening exercises.
• Late Stage (Weeks 6 and beyond): You’ll progress to more advanced strengthening and stability exercises, gradually returning to normal activities, sports, or work tasks.

While meniscus repair is generally safe, all surgical procedures carry potential risks:

• Infection: Occurs in less than 1% of cases, and antibiotics are given to mitigate this risk.
• Blood clots: Deep vein thrombosis (DVT) or pulmonary embolism (PE) can occur but are rare (less than 1%). You will be given aspirin to minimize this risk.
• Failure of the meniscal repair: Despite appropriate surgical intervention, the repaired meniscus may not heal properly, leading to continued knee problems. This risk is around 10-15%.
• Stiffness or loss of motion: A small percentage of patients (around 5%) may experience stiffness or a loss of motion in the knee.
• Nerve or blood vessel damage: Very rare but can result in numbness or weakness in the leg.

If it is recommended you get meniscus repair and you choose not to undergo surgery, there are potential risks:

• Persistent knee pain and swelling: An untreated meniscus tear can cause ongoing knee discomfort and inflammation.
• Increased knee instability: This can result in frequent episodes of the knee locking or giving way, potentially leading to falls and injuries.
• Further damage to the knee: Continued instability and abnormal knee motion may lead to damage to other knee structures, leading to early onset of arthritis.
• Limited function: You may be unable to return to your usual level of physical activity, including sports or physically demanding work.