It is preferable to preserve as much of the meniscus as possible. If the meniscus can be repaired successfully, saving the injured meniscus by doing a meniscal repair reduces the occurrence of knee joint degeneration compared with partial or total removal (meniscectomy). Meniscus repair is more successful in younger people (experts think people younger than about 40 years old do best), in knees that have good stability from the ligaments, if the tear is in the red zone, and if the repair is done within the first few weeks after the injury (acute).1
Meniscal repair may prevent degenerative changes in the knee joint. Many doctors believe that a successful meniscus repair lowers the risk of early-onset arthritis, because it reduces the stress put on the knee joint.
Orthopedists most often perform meniscus surgery with arthroscopy, a procedure used both to examine and then to treat the inside of a joint by inserting a thin tube (arthroscope) containing a camera and a light through small incisions near the joint. Surgical instruments are inserted through other small incisions near the joint. Some tears require open knee surgery.
- Meniscus Tear: Should I Have Surgery?
Rehabilitation (rehab) varies depending on the injury, the type of surgery, your orthopedic surgeon's preference, and your age, health status, and activities. Time periods vary, but in general meniscus surgery is usually followed by a period of rest, walking, and selected exercises. After you have full range of motion without pain and your knee strength is back to normal, you can return to your previous activity level.
For some exercises you can do at home (with your doctor's approval), see:
Meniscus Tear: Rehabilitation Exercises.
Other knee injuries, most commonly to the anterior cruciate ligament (ACL) and/or the medial collateral ligament, may occur at the same time as a meniscus tear. In these cases, the treatment plan is different. Typically, your orthopedist will treat your torn meniscus, if needed, at the same time that ACL surgery is done. In this case, the ACL rehab plan is followed.
Meniscal transplant is an experimental treatment for meniscal tears. It might be a good option for a meniscus that is already weakened or scarred due to previous injury or treatment. In this surgical procedure, a piece of meniscus cartilage from a donor (allograft) is transplanted into the knee.
To be eligible for meniscal transplantation, a person:
- Should be younger than age 50.
- Must be finished growing.
- Must not be obese.
- Has knee pain and swelling that has not responded to other treatment.
- Must have no arthritis (or minimal arthritis) in the knee joint.
- Must have a well-aligned knee, meaning the legs are not bent outward at the knees (bowlegged) or bent inward at the knees (knock-kneed).