Meniscus tear: how is it repaired?

Treatment for a meniscus tear depends on the location and the pattern. If surgery is necessary, the aim is to preserve the meniscus by repairing or removing the torn section.

Here, one of our highly experienced orthopaedic surgeons Mr Rohit Jain discusses the possible treatment options for a meniscus tear and what you can expect from meniscus surgery.

What are the non-surgical treatment options for a meniscus tear?

Non-operative treatment is typically used for small meniscus tears that don’t cause significant mechanical symptoms like clicking, locking or giving way. However, locking of the knee is a key symptom we look for. A large tear is more likely to cause locking as the knee moves through its range of motion. If locking is the predominant symptom, surgery is usually the preferred treatment.

Pain management often involves the RICE protocol: Rest, Ice, Compression and Elevation. This initial treatment is usually combined with anti-inflammatory medication like Ibuprofen to reduce pain and swelling.

What does surgical repair entail?

The meniscus is divided into two zones: the red zone, which has a good blood supply and is more likely to heal, and the white zone, which has a poor blood supply and often requires surgery.

In surgery, we either resect or repair the meniscus. If the tear is in the red zone, we aim to repair it. If it’s in the white zone, we usually trim the torn part away.

Most meniscal surgeries are keyhole and performed as day cases. Patients arrive on the day of surgery and are given general anaesthetic. A few small cuts are made in the front of the knee to insert a camera into the joint. This allows us to visualise all structures and confirm the diagnosis. Depending on the tear’s location and size, we either repair or resect it.

What happens during recovery?

Recovery from meniscal surgery varies depending on the type of procedure. Keyhole surgery is generally quicker and involves a shorter recovery period. Patients can often return to normal activities within a few days. However, some patients may experience stiffness or swelling, which can take a few weeks to resolve.

After surgery, small cuts are stitched and a bandage is applied for three days. Patients are encouraged to move immediately after the anaesthetic wears off and then undergo physiotherapy. Recovery after partial meniscal resection takes three to four weeks, while repair requires around three to four months. This is a slower process that demands controlled rehabilitation.

Keyhole surgery complications are generally low. The procedure, which takes 20-30 minutes depending on tear complexity, allows for rapid mobilisation. Potential complications include pain, bleeding, infection, nerve and vessel damage, clots in legs or lungs and joint stiffness.

Is a meniscus tear possible again?

Some residual symptoms may occur post-surgery. While we aim to preserve as much soft tissue as possible, this doesn’t prevent future tears. The meniscal tissue remains and is susceptible to re-tearing. Returning to a demanding work environment, such as heavy lifting or twisting, could trigger another tear.

If you'd like Mr Jain’s expert opinion on your knee pain, don't hesitate to make an appointment with him via his Top Doctor’s profile here.