Meniscectomy is the surgical removal of all or part of a torn meniscus. A meniscus tear is a common knee joint injury. Surgeons who perform meniscectomies (orthopaedic surgeons) will make surgical decisions based on the meniscus’s ability to heal as well as your age, health, and activity level.
Your doctor will likely suggest the treatment that he or she thinks will work best for you based on 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.
- If you have a small tear at the outer edge of the meniscus (in what doctors call thered zone), you may want to try home treatment. These tears often heal with rest.
- If you have a moderate to large tear at the outer edge of the meniscus (red zone), you may want to think about surgery. These kinds of tears tend to heal well after surgery.
- If you have a tear that spreads from the red zone into the inner two-thirds of the meniscus (called the white zone), your decision is harder. Surgery to repair these kinds of tears may not work.
- If you have a tear in the white zone of the meniscus, repair surgery usually isn’t done, because the meniscus may not heal. But partial meniscectomy may be done if torn pieces of meniscus are causing pain and swelling.
There are different types of meniscus tears. The pattern of the tear may determine whether a tear can be repaired. Horizontal and flap tears typically require surgical removal of at least part of the meniscus.
How Meniscectomy done for a Meniscus Tear
The choice of type of surgery is based on the size and location of the tear, your age and activity level, the surgeon’s experience, and your preferences. Orthopedic surgeons most often perform meniscus surgery with arthroscopy, a procedure used to both examine and repair the inside of a joint. A thin tube (arthroscope) containing a camera and light is inserted through small incisions near the joint. Surgical instruments are inserted through other small incisions. Arthroscopic surgery may limit knee damage from surgery and may promote fuller recovery. But some tears may require open knee surgery.
In a total meniscectomy, the entire meniscus is removed. In a partial meniscectomy, the surgeon removes as little of the meniscus as possible. Unstable meniscal fragments are removed, and the remaining meniscus edges are smoothed so that there are no frayed ends.
You may have general or regional anaesthesia for a meniscectomy. Arthroscopic partial meniscectomy is commonly done in an outpatient surgical center.
What To Expect After Meniscectomy for a Meniscus Tear
Rehabilitation (rehab) varies depending on the injury, the type of surgery, your orthopaedic surgeon’s preference, and your age, health status, and activities. Time periods vary, but meniscus surgery is usually followed by a period of rest, walking, and selected exercises. Most people who have arthroscopic meniscectomy can bear weight a day or two after surgery and can return to full activity within 2 to 4 weeks. After the full range of motion without pain is possible, you can return to your previous activity level.
The timetable for returning to walking, driving, and more vigorous activities will depend on the type and extent of the surgery and your success in rehab.
Why Meniscectomy Is Done
A decision to remove all or part of your meniscus will take into consideration the location, length, tear pattern, and stability of the tear as well as the condition of the whole meniscus. Your surgeon will also consider the condition of the entire knee, your age, and any age- or injury-related degeneration.
If a meniscus tear is causing pain or swelling, it probably means that torn pieces of the meniscus need to be removed and the edges surgically shaved to make the remaining meniscus smooth. Your orthopaedic surgeon will try to preserve as much meniscal tissue as possible to prevent long-term degeneration of your knee and allow you to return to full activities.