Meniscus tear is a very common type of injury to cartilage that cushions and stabilizes the knee joint. The kind of tear suffered can determine if it can be repaired or not. Radial tears, depending upon where it is situated, can be repaired. However, horizontal, long-standing, degenerative, and flap tears that happened due to long term wear and tears cannot be repaired usually.
The zone or location of tear, its pattern and its size determines the kind of treatment a patient requires. In most cases, depending on age, health and activity level of the patient, the treatment determination is done by the doctor or surgeon during the surgery, when the person can see the intensity, size, and pattern of the tear. Treatment options comprise non-surgical treatment combined with rest, compression, elevation, ice, and physical therapy; surgery repair of torn meniscus; surgery of the torn portion, termed partial meniscectomy in addition to surgical elimination of entire meniscus, termed as total meniscectomy. Generally, surgical repairing of torn meniscus is preferred instead of total or partial meniscectomy as surgical repair reduces occurrence of degeneration of the knee-joint. The factors determining treatment type include:
- If the patient has a small meniscus tear on the outer edge, termed as red zone, then a home treatment is advised during which the tears heal with ample rest.
- A medium to large tear in the red zone needs surgery.
- A tear that tends to spread from red zone to inner two-thirds of cartilage, called white zone, it might not get healed even with surgery. In such cases, partial meniscectomy are done to prevent torn fragments of the meniscus from causing swelling and pain.
Surgical repair is done through open surgery method involving a small incision made in the knee to open it to allow the surgeon to see the condition of the meniscus and if it can be repaired. Large incisions are not done, instead the surgeon inserts an arthroscope- a small tube having a light and a camera, using which he can see the condition of the meniscus. Surgical instruments are inserted through other such small incisions and the meniscus is repaired using stitches or anchors.
In situations where other knee injuries commonly occurring at the ACL or anterior cruciate ligament might simultaneously occur with a torn meniscus, treatment plan is changed. Then an orthopedist repairs the patient’s torn meniscus (as required) along with the ACL surgery.
Meniscus Surgery – Recovery Time
Surgeons usually recommend patients not to move their knee except when absolutely needed for about 2 weeks post-surgery. This is followed by 14 days of restricted motion before resuming daily activities. Physical therapy must be started right after surgery although heavy stresses like running and squats must not be done at least for a couple of months post-surgery. Patients are strictly advised to follow their doctor’s rehabilitation plan to ensure optimum healing. Subsequently, pain may continue to linger and might require additional therapy or in some cases, additional surgery. The timetable to resume daily activities depends upon the patient’s success in the rehab.
|Time required for resuming normal activities|
|Activity||Uncomplicated meniscectomy||Meniscus Surgery|
|Standing, walking and other activities where stress on the knee is involved.||If pain can be tolerated, you can go ahead with it||Soon enough, but wear a brace|
|Walk without crutches||In a week’s time||Between three and six weeks|
|Driving||· In a week or two, if the patient is able to regain motion with no or minimal pain.||Four to six weeks|
|Regain complete range of motion||Within one or two weeks||Do not bend your body too much till five to six weeks from the surgery for complete recovery|
|Resuming high level activities like intense physical work or sports||4 – 6 weeks, if the patient feels that he or she has regained strength and unhindered motion.||Three to six months depending on what the doctor advises|
Prospects of Surgical Repair
Surgical repair causes lesser pain and the blessings of restored knee function. Besides, successful surgical repair of the meniscus tear can prevent complications like osteoarthritis. Success rate of surgical repair of red zone is about 85%.
Risks from surgical repair are uncommon but might lead to:
Infection due to improper surgery:
- Damage to blood vessels or nerves around the knee region.
- Blood clotting in the leg.
- Risks pertaining to anesthesia.
If the doctor advises surgical repair of the torn meniscus, then the procedure must be done immediately after the injury without delay. However if the tear is located in the red zone, do not put off the surgery to wait to see if the meniscus tear gets repaired on it own. Chances are, if the tear is located in red zone; then a surgical repair, even a later one can still repair the meniscus completely. As stated earlier, long term-complications like osteoarthritis can be prevented by successful surgical repair but there is no scientific evidence or studies done to prove this. However, successful surgical repair of meniscus tear might have the power to save meniscal cartilage as well as lessen the amount of stress put on knee-joint, thereby reducing the chances of osteoarthritis.
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