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 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.

A 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 repaired.

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.

• If you have a small tear at the outer edge of the meniscus, 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, you may want to think about surgery. These kinds of tears tend to heal well after surgery.
• If you have a tear that spreads into the inner two-thirds of the meniscus, your decision is harder. Surgery to repair these kinds of tears may not work.
• If you have a tear in 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.

Our surgeon uses 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).

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.

What To Expect After Meniscus Repair

Your surgeon may recommend that you limit the motion before you resume to daily activities. Physical therapy may or may not be necessary after the 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.

Why Meniscus Repair Is Done

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 and surgical repair. If the meniscus can be repaired successfully, saving the injured meniscus by doing a meniscal repair reduces the occurrence of knee-joint degeneration.

Small 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.

What To Think About

If surgical meniscus repair is indicated, the procedure should be done as soon as possible after the injury. But if the tear is minor 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. Successful meniscus repair may save meniscal cartilage and reduce the stress put on the knee joint, thereby lowering the risk of osteoarthritis.