Meniscal tears – repair vs. resection

A long walk here, a quick jog there, bending and twisting to pick an object off the floor – many of us take our mobility for granted, until it becomes an issue. We have 2 menisci in each knee. The meniscus is a specialized ‘C shaped’ piece of cartilage between the thigh bone (femur) and shin bone (tibia). It functions to act as a shock absorber between the 2 bones. It also helps stabilize the knee when we move. The meniscus is flexible, but that doesn’t mean it can’t be damaged. Meniscal tears often require surgery to alleviate symptoms such as pain with twisting/turning/squatting, catching sensation in the knee, swelling.

How is a meniscal tear diagnosed?

An orthopaedic surgeon will listen to your symptoms, conduct a physical examination paying specific attention to swelling, focal tenderness and pain during some special tests. An MRI may be ordered to confirm the diagnosis and to exclude other pathology,

Can a meniscal tear heal on its own?

There are different types of meniscus tears and some tears won’t heal without treatment. The meniscus gets its blood supply from the lining (capsule) of the knee joint. Therefore, tears that are close to the capsule have a better blood supply and a better chance of healing than those tears further away from the capsule. The decision to attempt a repair is based on patient symptoms, plus the location and pattern of the tear. ‘Degenerative’ tears are common in arthritic knees and are often treated with analgesia, weight loss, physio, gentle exercise etc.

What is a meniscal repair?

A meniscal repair can usually be performed arthroscopically. Your orthopaedic surgeon will use a camera and small instruments inserted through small cuts around the knee. The meniscus will be fixed back to the capsule, where it belongs! Small anchors or sutures inside the knee will be used to hold it in place. The advantage of a meniscal repair is that it allows the meniscus to continue its protective role, acting as a shock absorber and stabiliser of the knee. This reduces the risk of developing arthritis in future.

What is a meniscal resection?

A meniscal resection involves removing the torn part of the meniscus. The minimally-invasive arthroscopic procedure is also known as a meniscectomy. If you require a partial meniscectomy, your doctor will remove a piece of the torn meniscus so your knee can function normally. Only the damaged portion of meniscus will be removed, leaving as much normal tissue as possible.

Are meniscal repair and meniscal resection surgeries considered low-risk?

Meniscal repair and resection are both low-risk surgeries. Complications, while rare, may include swelling, pain, re tear, stiffness. injury to adjacent structures.

How long is recovery after meniscal repair and resection?

It depends! If you have a partial meniscectomy, you can expect to be walking immediately after surgery. You may require crutches for a week or two. The knee will be a little sore and swollen, but you are free to move and walk on your knee as much you like. You should notice the benefit of surgery within a few weeks.

If your meniscus is repaired, the recovery will be slower. This is to optimize the chances of it healing and to minimize the risk of re-tear. You will be wearing a knee brace that limits how much you can bend your knee. You will also be using crutches for 6 weeks after surgery. Beyond 6 weeks you will not require crutches or a brace, but you are advised to avoid squatting and activities that involve twisting and turning. Beyond 12 weeks you can slowly start returning to sporting activities. It may be up to 6 months before you notice the full benefit.

Meniscal tears: LMcG Orthopaedics

Here at LMcG Orthopaedics, Doctor Lorcan McGonagle provides a range of orthopaedic surgeries and treatments. Dr McGonagle’s specialties include knees, shoulder, elbow, wrist and hand, hip, foot and ankle.

If you have a question for Dr McGonagle and his Geraldton team, please get in touch with the clinic today on 08 9921 4847.