A torn meniscus is one of the most common types of knee injuries. Some people may need surgery to partially remove or repair a meniscus tear and restore the function of the knee.

What is meniscus tear surgery?

Meniscus tear surgery is a treatment for pain and instability caused by damage to the meniscus, a pad of cartilage between your femur (thighbone) and tibia (shinbone). Surgery is an option for people whose symptoms have not improved with nonsurgical treatments. Surgery for a torn meniscus is usually a minimally invasive, outpatient procedure.

Does a torn meniscus always need surgery?

A torn meniscus does not always need surgery. If the tear is small and in a location with a good blood supply, the injury may heal on its own. Before considering surgery, your doctor may recommend nonsurgical treatments:

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Physical therapy
• RICE (rest, ice, compression and elevation)
• Steroid injections

You may be a candidate for meniscus surgery if you experience:

• Knee pain and swelling.
• Locking or catching in your knee when straightening your leg.
• Reduced knee mobility.

Types of Meniscus Tear Surgery

There are several approaches to meniscus tear surgery. The type of surgery that is right for you will depend on many factors, including your age, activity level and the severity of your injury. Meniscus surgeries include:

• Partial meniscectomy removes the damaged part of the meniscus.
• Meniscus repair stitches the torn pieces of cartilage back together.
• Meniscal transplant rebuilds the meniscus with a tissue graft from a donor.

Partial meniscectomy

Partial meniscectomy is the most common type of meniscus tear surgery. Your surgeon removes the damaged part of the meniscus, leaving the healthy meniscal tissue intact. People who have partial meniscectomies can usually bear some weight on their knee right after the procedure.

Partial meniscectomy is typically recommended if you:

• Are middle-aged or older.
• Have a meniscus tear due to degeneration.
• Have a meniscus tear in the “white zone,” which is the inner two-thirds of the meniscus. This zone does not have a good blood supply, so it is unlikely that the tear will heal well if it is surgically repaired.

Meniscus repair surgery

The goal of meniscus repair is to stitch the torn pieces of cartilage back together. Meniscus repair may be recommended for people who meet all these criteria:

• Young and very active.
• Have a meniscus tear due to a traumatic injury.
• Have a meniscus tear in the “red zone,” which is the outer one-third of the meniscus. This zone has a good blood supply, so repaired tears are more likely to heal well.

People who have meniscus repair will need to avoid weight-bearing activities for several weeks after the procedure and use crutches. The recovery period after a meniscus repair is longer than that of a partial meniscectomy because the repaired tissue needs to heal.

Meniscal transplant

Meniscal transplant surgery, or meniscal reconstruction, replaces a severely torn meniscus with an allograft (tissue from a cadaver donor). It is not a common procedure. Meniscal transplant may be an option for young, active people whose meniscus is mostly gone or is too damaged to repair.

Arthroscopic Meniscus Surgery

Knee arthroscopy is the most common approach to meniscus repair, meniscectomy and transplant. Arthroscopy is a minimally invasive procedure that uses a special device (called an arthroscope) equipped with a light, camera and magnifying lenses. An arthroscope allows the surgeon to see into the knee joint without creating a large incision (cut). Arthroscopy requires a few small incisions, which minimizes trauma to the tissues around the knee.

Arthroscopic meniscus surgery offers many benefits over traditional open surgery, including:

• Quicker recovery.
• Reduced risk of complications such as blood clots or wound infections.
• Smaller scars.

What happens during meniscus tear surgery?

Torn meniscus surgery usually takes less than an hour. The details vary depending on which procedure you are having (meniscus repair, meniscectomy or transplant). Generally, you can expect:

• Anesthesia: You receive anesthesia before your surgery. Local anesthesia numbs your knee, regional anesthesia numbs your leg and general anesthesia puts you to sleep. Your surgeon will discuss which type of anesthesia is right for you.
• Incision: Your surgeon makes two or more small incisions around your knee and inserts an arthroscope through one of them. The surgeon then uses the video feed from the arthroscope to guide surgical instruments to the problem area.
• Cartilage removal, repair or transplant:
• Damaged cartilage is cut or shaved to perform a partial meniscectomy.
• If you are having meniscus repair, the surgeon stitches together the torn pieces of cartilage. In some cases, the stitches are anchored to bone for added stability.
• During meniscus transplant, the surgeon removes the damaged meniscus and sews and anchors the donor tissue.
• Incision closure: Your surgeon removes the arthroscope and surgical tools from your knee. Each of the two incisions is closed with stitches or adhesive strips before bandaging your knee.

You stay in the hospital or outpatient surgery center for several hours after your procedure. If no complications occur, most people go home the same day as the arthroscopic procedure.

Meniscus Surgery Recovery

Meniscus Surgery Recovery Time

Meniscus surgery recovery time varies depending on the type of procedure you have. Most people need several weeks to return to light daily activities. Full recovery can take up to six months, or longer for meniscus repair or transplantation.

Exercise and Pain Management

After meniscus surgery, your doctor or a physical therapist will ask you to perform exercises. Exercises help you regain strength, flexibility and range of motion in your knee joint. Avoid running, heavy lifting, long flights of stairs and squatting until your health care provider tells you it is safe to do these activities.

Mild swelling and pain after meniscus surgery is normal. But if you have severe pain, notice signs of infection (pus, redness or foul-smelling drainage) or your incisions break open, contact your surgeon’s office right away.

Meniscus Surgery Complications

Potential complications of meniscus surgery include:

• Allergic reactions to anesthesia
• Blood clots
• Chronic knee pain
• Excessive blood loss
• Nerve injury
• Wound infection
• Bleeding
• Stiffness
• Artery injury