Surgery for a Meniscus Tear

Medically Reviewed by Zilpah Sheikh, MD on July 14, 2024
Written by Tammy Worth
8 min read

You have two c-shaped disks of cartilage (soft tissue) that connect your thigh bone to your shinbone. These are called menisci. They’re like shock absorbers for your bones. They also help to keep your knee stable.

A meniscus tear is a pretty common knee injury. Athletes who play contact sports such as football and hockey are prone to meniscus tears. This tear is most likely to happen when you turn your upper leg, but your foot stays planted on the ground. But you can also get this injury when you kneel, squat, or lift something heavy. The risk of injury increases as you get older, when bones and tissues around the knee begin to wear down.

If you tear your meniscus, your leg might swell and feel stiff, and you may have to limp when you walk. You might feel pain when twisting your knee, be unable to straighten your leg fully, or feel the joint catch when you move it.

Treatment for a meniscus tear will depend on its size, what kind it is, and where it’s located within the cartilage. Your doctor will perform a physical exam to see if the meniscus is torn, how badly, and where. If your doctor thinks the meniscus might be torn, they will likely suggest an MRI scan. This test is very effective at helping your doctor see your injury. Your doctor may also suggest an arthroscopy to see the inside of the knee better. During this test, your doctor will make a small incision in your knee and put in a scope with a light attached to get images.

Meniscus tears are put into three categories. Depending upon which category you are in and your physical goals, your doctor will recommend one of the following treatments.

If your doctor’s exam shows your meniscus tear is mild (Grade 1 or 2), you may not need surgery.

Conservative treatment

Most likely, your doctor will recommend that you rest, use pain relievers, and apply ice to your knee to keep the swelling down. While resting your knee, it's best to avoid movements that make the pain worse. Elevating your knee while icing it can help reduce swelling and pain. Ice it for 15 minutes at a time every 4-6 hours immediately after the injury. After a couple of days, ice it as needed.

Physical therapy

Your doctor may also suggest physical therapy. This will help to strengthen the muscles around your knee and keep it stable. You can usually begin physical therapy when the inflammation in your knee is reduced, and you can walk without pain.

Physical therapy will usually consist of stretching and strengthening your leg muscles, especially those that support the knee. When you can exercise, your therapist will start you with low-impact exercises. After your leg is stronger and your mobility improves, you will likely be able to do more intense exercise.

Your physical therapy can last from four weeks to more than 8 weeks, depending on the severity of your tear. Your doctor will evaluate your progress to see how long you'll need rehabilitation.

Medications

Your doctor may recommend using nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen or naproxen. These can help reduce pain and swelling. Acetaminophen can also help with pain relief.

Your doctor may recommend an injection in the knee with corticosteroids. This anti-inflammatory medication helps reduce swelling and stiffness. Corticosteroids usually begin working in 2-3 days and are usually only given once. This medicine can increase blood sugar levels, so it may not be an option if you have diabetes.

If your doctor thinks you have a Grade 1 or 2 tear, but your symptoms seem to be worse, they may recommend surgery.

If these treatments don’t work for a low-grade tear, or your doctor finds that you have a Grade 3 tear, you will probably need surgery. The goal of surgery is to remove or repair the meniscus. By doing this, you should have more stability in the knee and reduce the risk of arthritis later in life. Your doctor will make sure that you are healthy enough for surgery, and you will usually receive general anesthesia before the procedure.

Your doctor might choose to do any one of the following:

Arthroscopic repair. This is a short procedure that usually takes an hour or less. Your doctor will make small cuts in your knee and insert fluid to wash away debris and control bleeding to get a better view of the joint. They’ll insert an arthroscope to see the tear. Then, they’ll place small devices that look like darts along the tear to stitch it up, which your body eventually absorbs. Because there is little blood supply to this area, only about 10% of tears can be repaired.

Arthroscopic partial meniscectomy. Your doctor will begin with the same process as a repair. But they will remove the torn meniscus and leave the healthy part in the joint so your knee can function normally.

Arthroscopic total meniscectomy. If there is too much damage to the cartilage to keep any part, your doctor will remove the whole meniscus. This can often lead to arthritis in the knee over time. If you are a young, healthy person, your doctor may recommend meniscus transplant surgery. Your doctor will get a replacement cadaver meniscus from a tissue bank and place it in your knee.

Knee replacement. This is not as common, but if your meniscus is torn and you have advanced arthritis in the knee, your doctor may recommend a total knee replacement.

Meniscus repair is low-risk. Complications are rare. They may include injury to the skin or nerves, infections, and knee stiffness.

You will likely be able to go home the same day of surgery after you have recovered from the anesthesia. Your doctor may prescribe antibiotics to reduce the chance of getting an infection. They may also recommend compression stockings to help prevent blood clots.

How long does it take to recover after a meniscus tear surgery?

If you have a partial or total meniscectomy, you may be able to put weight on your knee, walking, within a day or so. You should be able to return to sports you take part in within 4-6 weeks. If your meniscus was repaired, it can take 6-9 months to return to sporting activities. 

Meniscus tear and repair surgeries tend to be effective. Depending on the type of surgery and where it is located, success rates are as high as 80% up to 5 years after the operation.

Aftercare steps

For at least the first week or so after surgery, your doctor will recommend the RICE method for your knee -- rest, ice, compression, and elevation -- as much as possible. They will probably have you keep your original bandage on and avoid putting your leg fully underwater -- like in a bath or a pool -- until you return for a follow-up visit with your doctor. 

With meniscus repair surgery, you will probably have to use crutches to keep weight off your leg for several weeks. You may be in a brace for 6-8 weeks. If part of your meniscus was removed or replaced, you may have to use crutches for a week, depending on your doctor's recommendations. 

If your meniscus was replaced, you can often drive when you stop taking pain medication. After a partial repair on your left leg, you can usually drive within a couple of weeks. It will take 2-3 weeks after a repair on your right leg.  

Physical therapy 

Your doctor may recommend physical therapy as part of your recovery. It will help increase your range of motion and help your knee get stronger. They may also share some exercises you can do at home.

The initial weeks of physical therapy will be spent working to help you fully straighten your leg (which you often can't do after a meniscus tear) and bend your knee to 90 degrees. You'll work on stretching your hamstring and strengthening your quadriceps and calves. Your physical therapist will help you return to your normal walking gait. Eventually, you will begin exercises that may include a stationary bike, squats, and the leg press machine. You will gradually work up to more time in motion and increased weight on gym machines.

Handling pain after a meniscus tear surgery

You can have a lot of pain immediately, and for up to a week, after surgery. Your doctor may give you hydrocodone or oxycodone for pain relief. These are narcotic medications and should only be taken as prescribed by your doctor. If you prefer not to take narcotics or if you want to take them less frequently, you may try taking 600 milligrams of ibuprofen every 8 hours and 1,000 milligrams of Tylenol every 6 hours. Talk to your doctor before taking any nonprescription medications to make sure they are safe and you won't have any interactions with prescriptions.

It is rare to have major issues after arthroscopic meniscus tear surgery. But, as with any surgery, it is possible to have a blood clot or infection afterward. Other potential risks include:

  • Injury to the nerves, tissues, and blood vessels near the surgery site
  • Arthritis in the joint when you age
  • Joint stiffness
  • Problems with the heart or lungs caused by anesthesia
  • Pulmonary embolism

You should call your doctor if you have any of the following after surgery:

  • A 101-degree or higher fever
  • A lot of blood or other fluid draining from the incisions
  • Drainage coming from the wound with a bad smell
  • Pain or swelling that doesn't stop when you prop up your leg
  • Breathing problems
  • Nausea or vomiting that won't stop
  • Redness around the site of surgery that gets worse over time
  • Pain, tenderness, or heat in your calf

You may not always need surgery after a torn meniscus. But if you do, it may prevent arthritis and improve stability in the knee down the road. The surgery is done on an outpatient basis and is typically very safe. Depending on whether or not you have a meniscus removal or repair, you can be back on your feet within a few days or several weeks. You can usually return to sports activities within 6 months.

How long does meniscus surgery last? Surgery for a meniscus tear usually lasts about 30 minutes to an hour, depending on the type of repair needed.

How much does the meniscus surgery cost? Meniscus tear surgery usually costs between $5,000 and $10,000, but you may pay much less out of pocket, depending on your insurance coverage.