Meniscus tear: how is it repaired?

Treatment for a meniscus tear depends on the location and the pattern of the tear. If surgery is required in your case, then the goal is to preserve the meniscus by repairing or removing the torn part. Here, one of our highly experienced orthopaedic surgeons Mr Rohit Jain discusses the possible treatment options for a meniscus tear and what you can expect from meniscus surgery.
 

What are the non-surgical treatment options for a meniscus tear?

A meniscus tear will be treated non-operatively, especially if it is small and not causing any major mechanical symptoms, such as clicking, locking or giving way.

Out of these three symptoms, the one that we look for is locking of the knee. If the meniscus tear is large, then as the knee moves through its range of movement it is likely to get stuck and will jam and lock. If this is the predominant symptom then by and large the treatment is surgical.

We usually treat pain using the acronym RICE (Rest, Ice, Compression, Elevation) protocol. This is the initial treatment along with advising the patient to take anti-inflammatories, such as Ibuprofen to reduce pain and swelling.
 

What does surgical repair involve?

The meniscus is classified into two zones, the red zone, which has a sufficient blood supply and is likely to heal, and the white zone, which has a poor blood supply and often requires surgery.

In surgical treatment, we either resect or repair the meniscus. If the tear is in the part of the meniscus that will heal, such as the red zone, then we would like to repair that tear. We usually trim the torn part away if it is in the white zone.

Most of the meniscal surgery is keyhole and done as a day case. Patients come in on the day of surgery and are put to sleep with a general anaesthetic. A couple of small cuts are made into the front of the knee to allow a camera inside the joint. We can then visualise all of the structures and confirm the findings. Then depending on where the tear is and how big it is, we either repair or resect. 
 

What happens during recovery?

After surgery, we stitch the small cuts and place a bandage on top that stays on for three days. We get patients moving straightaway after the general anaesthesia has worn off. They then go through a period of physiotherapy. After partial meniscal resection, the recovery is three to four weeks. If we have had to repair then the recovery is around three to four months, which is much slower and requires a controlled rehab.
 

What are the possible complications of surgery?

The complications with keyhole surgery are low. The procedure takes around 20-30 minutes, depending on the complexity of the tear. Patients are mobilised very quickly. The possible complications may include:
 

• Pain
• Bleeding
• Infection
• Damaging nerves and vessels
• Clots in legs and lungs
• Joint stiffness.
   

Is a meniscus tear possible again in the future?

Following surgery, there could be some residual symptoms. We are trying to retain as much soft tissue as possible, however, it does not give any immunity from having any other further tears. The meniscal tissue is still there and is prone to it being torn again. The patient could go back into the same working environment which may require heavy lifting or twisting, for example, and a meniscus tear could happen again.

Read more on the signs of a meniscus tea

If you would like Mr Jain’s expert opinion on your knee pain, do not hesitate to make an appointment with him via his Top Doctor’s profile here.