If pain and swelling continue despite non-surgical treatment, or if you have specific types of tears like root, radial, or bucket handle tears, surgery might be needed.

Arthroscopic Surgery

This is a common procedure where a small camera is inserted into the knee joint through a tiny incision. The doctor looks at the meniscus and then decides whether to repair, trim, or remove the damaged part. Other small tools are used to do the repair or trimming. This type of surgery is minimally invasive, meaning it causes less damage and has a quicker recovery time. It’s usually done in an outpatient center with general anesthesia.

After surgery, physical therapy will be recommended to help you recover. Most people are able to fully recover and return to their normal activities. This approach helps preserve the meniscus as much as possible and promotes faster healing.

Arthroscopic Partial Meniscectomy

Arthroscopic Partial Meniscectomy is a procedure used to clean up damaged tissue in the knee. This involves removing frayed edges and bits of torn cartilage to help reduce pain and improve knee function. It’s often used for meniscus tears in the “white zone,” which has a poor blood supply. The goal is to remove as little meniscus as possible, only the torn section and keep as much of the healthy meniscus as possible. Complete removal of the meniscus can lead to long-term knee pain and arthritis; thus we avoid this approach.

Recovery from this procedure is usually quick. Physical therapy starts the day after surgery to help with healing and improving knee movement. Most people can return to daily activities in about a week and sports within two to three months.

Meniscus Repair

For many people with acute meniscus tears, repair the torn tissue is the best option. This surgery aims to stitch the torn ends of the meniscus together to help it heal and keep its natural shape. This helps preserve healthy meniscus tissue and reduce long-term damage.

We believe that a repair surgery can be suitable for many patients, not just younger ones. If you are active and willing to do rehab, meniscus repair might be a good option for you. The healing rates of the meniscus are not as high as other tissue in our body due to its minimal blood flow, however, a 70-80% success rate is always higher than 0%, if you just cut it out.

Techniques for Meniscus Repair:

1. All-Inside Technique: This method uses tiny incisions to insert a camera and tools into the knee. Sutures are placed inside the joint to repair tears. This technique is good for many types of tears.
2. Inside-Out Technique: This involves placing sutures from inside the knee to outside through a small incision. It’s often used for larger tears, like bucket handle tears, and is known for its high success rate.
3. Outside-In Technique: Sutures are placed from outside the knee to inside through a small incision. This method is useful for repairing tears in the front of the meniscus where other techniques might not work.
4. Trans-Tibial Tunnel Technique: This technique is often used for root tears. Sutures are placed through tunnels created in the tibia, and the meniscus is held in place with an anchor. Patients will need to avoid weight-bearing for 6 weeks after surgery.

After surgery, physical therapy begins the day after to help regain movement and strength. Recovery times vary based on the type of tear and repair.

Meniscus Transplant

A meniscus transplant is a complex procedure for people who have had a nearly complete meniscus removal due to irreparable damage. This surgery replaces the damaged meniscus with a donor meniscus to restore knee function and reduce arthritis.

This surgery is usually recommended for younger patients who haven’t improved with other treatments and who have significant symptoms. It is not suitable for patients with extensive cartilage damage because the joint space may be too narrow.

If you have a meniscus transplant, preoperative imaging will be done to ensure a good fit for the graft. The surgery involves making an incision to insert the new meniscus and secure it with various techniques.

Rehabilitation after a Meniscus Transplant:

• First 6 Weeks: Use a knee immobilizer and crutches, with no weight-bearing.
• 6-8 Weeks: Gradually start weight-bearing.
• 8-12 Weeks: Begin light activities like lunges.

Recovery is strict to ensure the new meniscus integrates well. Not following the rehab plan can lead to problems with the transplant.

Two surgeon technique: Meniscus transplant is another procedure in which we believe a two experienced surgeon technique can lead to better outcomes. One surgeon preps the knee for the implantation, while the other surgeon prepares the donor meniscus and sizes it to the patient’s body. Then both surgeons work together to implant the graft and secure it. Often this procedure could be done with other complex procedures such as ligament reconstruction or osteotomies. It is important to do an excellent job while minimizing surgical time to decrease infection rates and minimize time under anesthesia.

Recovering from Meniscus Surgery

Recovery times depend on the type of surgery and the patient’s overall health.

• For Non-Surgical Treatments: You might find relief in 6-8 weeks if conservative treatments work.
• After Arthroscopic Debridement or Partial Meniscectomy: You will use crutches for a few days. Physical therapy starts the day after surgery, and most people return to daily activities in about a week. Sports may be possible within a 4-12 weeks depending on the sports, athlete and rehab access.
• After Meniscus Repair: Healing takes 3-4 months. Physical therapy starts the day after surgery, focusing on strength and range of motion. You can usually return to running at 4 months and expect full recovery by 6 months.

If you think you have a meniscus injury or have knee pain, contact us for a knee evaluation. We specialize in complex knee injuries and have advanced treatment techniques and make personalized treatment plans.