What is meniscus repair?

In the simplest terms possible, meniscus repair is a minimally-invasive surgical procedure that basically stitches together the portions of the tear much like you would do to repair an article of clothing. Relatively speaking, meniscal repair, or preservation, is a newer treatment option than the original treatment method of a meniscectomy during which a surgeon removes all or part of the damaged meniscus.

The increase in popularity among both patient and surgeons for meniscal repair comes at the same time as the long-term consequences of removing the meniscus, specifically its potential role in the development of osteoarthritis, are becoming more apparent1. In addition, recent technological advances have made repairs of the meniscus potentially easier, faster and stronger than ever before.

Meniscus repair may:

  • Provide long-term pain relief and preserve the whole meniscus
  • Allow the knee to return to its previous level of function
  • Reduce the risk of developing osteoarthritis in the knee

A primary concern for most patients following any type of knee surgery is the development of osteoarthritis and the potential need for future surgeries.2 Meniscus repair is popular with patients because it helps reduce these risks.2

Not all meniscus tears are suitable for repair. Your surgeon will recommend the best treatment option for your situation based on the type of meniscus tear, its size, location, and consideration for your age and activity levels.

What is a Meniscectomy?

Unlike meniscus repair, a meniscectomy is a type of surgery where at least some portion of the damaged meniscus is removed. Whether to remove all or part of your meniscus is typically based on issues like the location, length, pattern, and stability of the tear, as well as the overall condition of the rest of your meniscus. Your surgeon may also take into consideration the condition of the rest of your knee, your age, and any age- or injury-related degeneration that has already occurred.

As you might expect, whenever any portion of your meniscus is removed, there is the possibility for a reduction in the cushioning and shock absorbing benefits the meniscus provides. Depending on the amount of meniscus that is removed, the initial impact of this loss may not pose much of an issue. However, over time, friction caused by the repeated motion of the knee can cause the remaining cartilage around the damage to wear away and lead to a condition known as osteoarthritis.

Because of the potentially negative impact a total meniscectomy can have on a patient's ability to be active, surgeons generally try to remove as little of the meniscus as possible. However, under some clinical conditions a surgeon may only be able to perform a meniscectomy.

Meniscus removal may:

  • Provide short-term pain relief but may accelerate the progression of knee arthritis
  • Potentially shorten recovery period
  • Increase knee joint pressure as a result of reduced cushion and support

Myth: "The only thing that matters is recovery time"

Fact: Sure, every patient hopes for a speedy and painless recovery - but that's not the only thing to be considered. You may be sacrificing long-term joint health for short-term convenience. It's always smart to weigh the consequences and compare your options.

Meniscus Repair

VS

Meniscus Removal
Tear is stitched together and natural meniscus shape maintained   Meniscus tissue is removed in part or whole
Preserves tissue and may return normal knee joint pressure3   Potential of accelerated advanced arthritis4 and higher risk for knee replacement in less than 9 years5,6
Along with rehabilitation, repair can facilitate the return to near normal activity levels   May lead to diminished long-term sports performance, mobility, and total knee health7

In a 2010 study, 81% of patients having a meniscus repair did not show any significant osteoarthritis at the time of follow up, while 60% of meniscectomy patients did show osteoarthritic changes. Functional scores showed no difference between the two procedures, however 94% of meniscal repair patients returned to their previous level of sport activity compared to only 44% of the meniscectomy group. There was a significant drop in sport activity in the meniscectomy group only.8

What is Recovery Like after Meniscus Repair?

Following meniscus repair surgery, patients typically wear a brace for 4-6 weeks, and may need the support of crutches. Heavy lifting may be restricted during this time. Regular rehabilitation exercises are commonly prescribed to restore knee mobility and strength. Generally, patients return to near normal active lifestyles after surgery and rehabilitation.9

Important safety notes

Individual results may vary. There are risks associated with any surgical procedure including meniscus repair. Meniscus repair is not recommended for everyone. Consult your physician to determine if this procedure is right for you.

The information listed on this site is for informational and educational purposes and is not meant as medical advice. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation.

Postoperative care is individualized and is determined by the physician based on the patient's symptoms, injury pattern, unique patient anatomy, patient medical history, and individual treatment requirements. Not all patients will have the same surgical procedure or timelines for rehabilitation.

References

  1. Cavanaugh JT, Killian SE. Rehabilitation following meniscal repair. Curr Rev Musculoskelet Med. 2012;5(1):46-58.
  2. Brophy RH, Gefen AM, Matava MJ, Write RW, Smith MV. Understanding of Meniscus Injury and expectations of Meniscus Surgery in Patients Presenting for Orthopaedic Care. Arthroscopy. 2015 Dec; 31(12):2295-2300.
  3. Beamer B, Masoudi A, Walley K, et al. Analysis of a New All-Inside Versus Inside-Out Technique for Repairing Radial Meniscal Tears. Arthroscopy. 2015;31(2):293-8.
  4. Papalia R, Del Buono A, Osti L, Denaro V, Maffulli N. Meniscectomy as a risk factor for knee osteoarthritis: a systematic review. British Medical Bulletin 2011;99:89-106.
  5. Chung KS, Ha JK, Yeom CH, et al. Comparison of Clinical and Radiologic Results Between Partial Meniscectomy and Refixation of Medial Meniscus Posterior Root Tears: A Minimum 5-Year Follow-up. Arthroscopy. 2015;31(10):1941-50.
  6. Beaufils P, Becker R, Kopf S, et. al. Surgical management of degenerative meniscus lesions: the 2016 ESSKA meniscus consensus. Knee Surg Sports Traumatol Arthrosc. 2017 Feb;25(2):335-346. Epub 2017 Feb 16.
  7. Chahla J, Cinque ME, Godin JA, et.al. Meniscectomy and Resultant Articular Cartilage Lesions of the Knee Among Prospective National Football League Players. AJSM. 2018;46(1):200-207.
  8. Stein, T., Mehling, A. P., Welsch, F., von Eisenhart-Rothe, R., & Jager, A. (2010). Long-Term Outcome After Arthroscopic Meniscal Repair Versus Arthroscopic Partial Meniscectomy for Traumatic Meniscal Tears. The American Journal of Sports Medicine, 38(8), 1542-1548.
  9. Noyes F, Barber-Westin S. Arthroscopic Repair of Meniscus Tears Extending Into the Avascular Zone With or Without Anterior Cruciate Ligament Reconstruction in Patients 40 Years of Age and Older. Arthroscopy. 2000;16(8):822-9.

All information provided on this website is for information purposes only. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

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