meniscus tear is a common injury to the cartilage that
stabilizes and cushions the knee joint. The type of the tear can determine
whether your tear can be repaired. Radial tears sometimes can be repaired, depending on
where they are located. Horizontal, flap, long-standing, and degenerative
tears—those caused by years of wear and tear—generally cannot be
Your doctor will likely
suggest the treatment that he or she thinks will work best for you based on
the zone where the tear is, the pattern of the tear, and how big it is. Your age, your
health, and your activity level may also affect your treatment options. In some cases, the surgeon makes the final decision during surgery, when he or she can see the how strong the meniscus is, where the tear is, and how big the tear is.
Surgical repair may be done by open surgery, in which a
small incision is made and the knee is opened up so that the surgeon can see
inside the knee and the meniscus can be repaired. Increasingly, surgeons use
arthroscopic surgery to repair the meniscus. The
surgeon inserts a thin tube (arthroscope) containing a camera and a light
through small incisions near the knee and is able to see inside the knee
without making a large incision. Surgical instruments can be inserted through
other small incisions. The surgeon repairs the meniscus using sutures (stitches) or anchors.
Other knee injuries—most commonly
to the anterior cruciate ligament (ACL)—may occur at the same time as a torn
meniscus. In these cases, the treatment plan is altered. Typically, your
orthopedist will repair your torn meniscus, if needed, at the same time ACL
surgery is done. In this case, the ACL rehabilitation plan is followed. To learn more, see the topic
Anterior Cruciate Ligament (ACL) Injuries.
Your surgeon may recommend that you do
not move your knee more than absolutely necessary (immobilization) for 2 weeks
after surgery. This may be followed by 2 weeks of limited motion before you are
able to resume daily activities. Physical therapy should begin right after
surgery. But heavy stresses, such as running and squats, should be postponed
for some months. You must follow your doctor's rehabilitation (rehab) plan for optimum
healing. Afterwards, you may still continue to have pain and require more
physical therapy or, sometimes, additional surgery.
timetable for returning to walking, driving, and more
vigorous activities will depend on your success in rehab.
exercises you can do at home (with your doctor's approval), see:
How your doctor treats a meniscus tear depends upon the size and location of the tear, your age, your health and
activity level, and when the injury occurred. Treatment options include
nonsurgical treatment with rest, ice, compression, elevation, and physical
therapy; surgical repair; surgical removal of the torn section (partial
meniscectomy); and surgical removal of the entire meniscus (total
meniscectomy). In general, surgical repair is favored over partial or total
meniscectomy. If the meniscus can be repaired successfully, saving the injured
meniscus by doing a meniscal repair—rather than partial or total
removal—reduces the occurrence of knee-joint degeneration.
tears located at the outer edge of the meniscus often heal on their own. Larger
tears located toward the center of the meniscus may not heal well, because blood
supply to that area is poor. In a young person, surgery to repair the tear may
be the first choice, because it may restore function.
Surgical repair may result in less
pain and a return to normal knee function. Also, you may be able to prevent
long-term complications (such as
osteoarthritis) with successful surgical repair of
your tear. The success rate of repair in the red zone is 85%.1
Successful repair of meniscus tears depends to a
large degree on where the tear is located. Tears at the outer edge of the
meniscus (the red zone) tend to heal well. Blood supply to tears that extend
into the center of the meniscus (white zone) is questionable, and surgical
repair of a tear in this zone may not heal well.
Risks of the surgery itself are uncommon but may
If surgical meniscus repair is
indicated, the procedure should be done as soon as possible after the
injury. But if the tear is in the red zone and you choose to put off a surgery
to see if the meniscus tear heals on its own, a later repair may still heal
the meniscus properly.
You may be able to prevent long-term
complications such as osteoarthritis with successful surgical repair of your
tear. Although no long-term studies have proved this, successful meniscus
repair may save meniscal cartilage and reduce the stress put on the knee joint,
thereby lowering the risk of osteoarthritis.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
Beynnon BD, et al. (2010). Meniscal injuries. In JC DeLee et al., eds., DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice, 3rd ed., vol. 2, pp. 1596–1623. Philadelphia: Saunders Elsevier.
September 10, 2012
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
& Patrick J. McMahon, MD - Orthopedic Surgery
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