Meniscus Surgery
Meniscus tears are one of the most common types of knee injury, and can cause swelling, inflammation, and sometimes severe instability or wobbliness in the knee if the tear is severe.
These injuries involve damage to one of the C-shaped pieces of cartilage in the knee, which are normally meant to cushion and support the joint between the femur and tibia. A sudden twisting motion is usually the root cause of the injury, but a meniscus can also unexpectedly be torn in other ways, such as during squatting or lifting.
When a meniscus tear is severe, surgery is frequently recommended. Read on to learn a little bit more about whether surgery is right for you, and what you can expect from it.
Is Meniscus Surgery Right For Me?
As with most other orthopedic injuries, our preference is to treat meniscus tears non-surgically if possible.
Meniscus tears are more likely to heal on their own if the tear is less severe and limited to the outer portion of the meniscus. Of course, you’ll need to carefully follow our instructions for immobilization, activity reduction, and rehab to allow it to heal properly.
More serious tears or those that do not respond to conservative treatments, however, will likely require a surgical procedure. If you’re dealing with significant pain, swelling, and a knee that is either unstable or “locked” within a small range of positions, surgery is most likely inevitable.
Surgery may also be recommended sooner rather than later if there’s reason to believe the tear is still repairable, as continuing to walk on the damaged meniscus may cause more extensive damage over time.
The good news is that meniscus surgery can be performed via a minimally invasive, arthroscopic procedure. Serious complications are rare, and the long-term results are very good in the vast majority of cases.
What Are My Surgical Options for a Meniscus Tear?
There are two main surgical approaches for meniscus tears:
- Meniscus tear repair. This is the preferred option whenever possible, but it’s often limited to cases when the tears are in the outer part of the meniscus where blood supply is strong enough for tissue healing. Torn pieces of the meniscus are stitched back together, using “sutures” that will be absorbed naturally by your body over time.
- Partial (or total) meniscectomy. If the meniscus tear reaches the inner, non-vascularized portion of the tissue, the damaged portions of the meniscus will need to be removed in order to take away the pain and allow the knee to function normally again.
Both procedures are arthroscopic, minimally invasive outpatient procedures that can be performed in our office.
Three or four small incisions (1 cm or less) are created to make room for the arthroscope and surgical tools. General anesthesia may be selected if preferred, but the procedure can also be performed under a spinal block to allow you to remain awake and alert during the operation.
The procedure itself typically takes about 60-90 minutes, plus any necessary preoperative prep and 1-2 hours in post-operative recovery. Overnight stays are usually not required. Please have someone with you to drive you home.
Pros and Cons of Repair or Removal
Even though we’d always prefer to save as much of the meniscus as possible, it’s important to understand that the short-to-medium-term results of both procedures are quite good, and typically allow a complete return to full activity once healing and rehabilitation are complete.
The main downside to removing rather than repairing the meniscus is that it increases your risk of developing post-traumatic knee arthritis in the longer-term future, usually about 10-20 years after the procedure. However, short-term recovery is often faster after a meniscectomy than after a meniscus repair.
We will, of course, take as much time as necessary to discuss the surgical options available to you, the risks and benefits, and what to expect. Keep in mind, though, that if the damage to the meniscus is extensive, repair will not be an option available to you.
Post-Surgical Recovery After Meniscus Surgery
The recovery process for both procedures is similar although, as mentioned above, recovery tends to be somewhat faster for meniscus removal and somewhat slower for meniscus repair.
Most people are able to return to ordinary daily activities while wearing a brace 1-2 days following a meniscectomy or 3-4 days after a meniscus repair. Taking your prescribed pain medications and resting and elevating the knee as much as possible in the first few days can help ease discomfort and help the healing process along.
In the weeks to follow, carefully following our guidelines for physical therapy and rehab of the knee is crucial to ensuring optimal long-term results. Please do not move onto the “next phase” of your rehab plan or start more rigorous physical activities before we give you the go-ahead. Even if you feel like you’re ready to do more, this can actually set back your recovery.
Following a meniscectomy, most people can expect a complete return to full activity (including sports) in about 4-6 weeks, provided that rehab guidelines were carefully followed. For a repair, you’d likely be looking at 8-12 weeks, although this varies depending on a variety of factors.
If you’re dealing with any kind of pain, discomfort, instability, or poor mobility in your knee, don’t wait any longer to seek the care you need. Our orthopedic specialist, Dr. Scott Fujii, is here to ensure you get the highest quality care for your injury.
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