Repair, trim or rehabilitate?
The menisci distribute load, absorb shock and help stabilise the knee. Treatment depends on whether a tear is traumatic or degenerative, its location and shape, blood supply, tissue quality, symptoms, alignment, cartilage condition and associated ACL injury.
Repair stitches the tear to preserve tissue but needs biological healing and longer protection. Partial meniscectomy removes only unstable damaged tissue that cannot reasonably heal. Many degenerative tears improve with exercise-based care; an MRI finding alone is not a reason for arthroscopy.
Trimming may permit faster early recovery than repair, but removing meniscus tissue increases joint loading. The surgeon should explain why repair is or is not possible.
Who may be considered?
Surgery may be discussed when the history, examination and imaging agree, including:.
- An acute repairable tear in a vascular area, especially in a younger active patient.
- A displaced tear causing true mechanical locking or loss of motion.
- A symptomatic tear combined with ACL reconstruction.
- Persistent focal symptoms after suitable non-surgical treatment.
- An unstable fragment that cannot be repaired and continues to cause symptoms.
What the hospital needs to assess
The clinician distinguishes pain, catching and stiffness from true locking, then examines joint-line tenderness, swelling, motion, ligaments and alignment. MRI defines tear pattern and associated injury; weight-bearing X-rays show arthritis. The final repairability decision may change during arthroscopy when tissue quality is seen directly.
Key points for this treatment
How meniscus surgery is performed
Through small arthroscopy portals, the surgeon inspects all knee compartments. Repair may use sutures placed inside-out, outside-in or with all-inside devices. Root repair may use a tibial tunnel and fixation. The surfaces are prepared to encourage healing while retaining as much healthy tissue as possible.
When a fragment is irreparable, partial meniscectomy smooths the unstable portion rather than removing the whole meniscus. Cartilage findings and knee alignment should be documented because they strongly affect expectations.
Hospital stay and recovery
After partial meniscectomy, weight-bearing and motion often progress relatively quickly. After repair, a brace, crutches, motion limits or delayed loading may be required depending on tear and technique. Root and radial repairs often need stricter protection.
Rehabilitation restores swelling control, motion, strength and movement. Running, deep flexion and pivoting resume only after the repaired tissue and knee function are ready. A repair can fail even with good care, and symptoms may also come from existing cartilage disease.
Risks and realistic expectations
Risks include infection, blood clot, stiffness, nerve or vessel injury, persistent pain, recurrent tear, repair failure and need for further surgery. Removing meniscus tissue can accelerate cartilage wear; repair reduces tissue loss but cannot guarantee healing.
Fever, wound drainage, a rapidly swollen hot knee, calf swelling, chest pain, breathlessness, new foot weakness or a suddenly locked knee requires prompt assessment.