Meniscus Tear Surgery and Non-Surgical Treatments

knee arthroscopy
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A meniscus tear is an injury to the shock absorber of the knee joint. Two types of cartilage are in the knee. The meniscus is a type of cartilage that sits between the thigh bone and shin bone. The meniscus functions to cushion the knee joint and provide stability to the knee joint. A meniscus tear is a common injury to the meniscus.

Not every torn meniscus is the same, and not every meniscus tear requires the same type of treatment. Often I hear from people diagnosed with this injury that their presumption is a surgery is necessary for treatment. While surgery may be an option and is sometimes necessary for treatment, there may also be other options. 

Non-Surgical Options

An acute meniscus tear can be treated with ice application, rest, anti-inflammatory medications, and physical therapy. These simple measures will help decrease swelling and pain in the joint.

Depending on the size and type of the meniscus tear, and the physical demands of the patient, these may be the only treatment necessary. A cortisone injection can be a helpful treatment to reduce inflammation within the joint, but it will not help heal the meniscus tear. If these treatments fail to provide relief, a surgical procedure may be recommended.

Non-surgical treatments are most effective for meniscus tears that occur as a result of degenerative changes to the meniscus. This means that as we age, the meniscus tissue becomes more brittle and prone to damage. Degenerative meniscus tears typically start showing up as people reach their 40s and 50s and become more common with age. Many times, these symptoms of degenerative meniscus tears will gradually resolve with non-surgical treatments. In fact, numerous studies have found that long-term results are not improved with surgery for people with a degenerative meniscus tear. 

When Surgery Is Necessary

If your meniscus tear symptoms are not significant, surgery can often be delayed or avoided altogether. Many people live normal, active lifestyles despite having a meniscus tear. It is only when the meniscus tear becomes symptomatic, and interferes with activities, that surgery to treat the meniscus tear should be considered.

Surgery has the best results when the primary symptoms of the meniscus tear are mechanical. This means that the meniscus tear is causing a catching or locking sensation of the knee. When the meniscus tear is causing pain only, the results of surgery may not be as reliable. 

Arthroscopic Meniscectomy

A meniscectomy is a procedure to remove the torn portion of the meniscus. This procedure is far more commonly performed than a meniscus repair. The meniscectomy is done to remove the damaged portion of the meniscus while leaving as much healthy meniscus as possible. The meniscectomy usually has a quick recovery and allows for the rapid resumption of activities.

Meniscus Repair

A meniscus repair is a surgical procedure done to repair the damaged meniscus. The meniscus repair can restore the normal anatomy of the knee and has a better long-term prognosis when successful. However, the meniscus repair is a more significant surgery, the recovery is longer, and, because of limited blood supply to the meniscus, it is not always possible.

Meniscus Transplant

Meniscus transplantation consists of placing the meniscus from a donor patient into an individual who has had their meniscus removed. The ideal patient for a meniscus transplant is someone who had their meniscus removed and subsequently begins to develop knee pain. Meniscus transplant is not performed for an acute meniscus tear, rather it is performed when removal of the entire meniscus has caused persistent pain in the knee.

Long-Term Prognosis

When you tear the meniscus of your knee, the shock absorbing ability of the joint is threatened. Because of this, there is an increased risk of developing damage to the cartilage surface of the knee joint. Loss of the meniscus places more of a burden on the cartilage surfaces of the joint and they are more likely to develop wear-and-tear arthritis.

You can make changes to decrease your risk of developing arthritis after having sustained a meniscus tear. For example, weight loss, low-impact exercise, and prevention of further trauma to the joint will all improve the long-term prognosis.

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Article Sources
  • Maher SA, Rodeo SA, Warren RF. "The Meniscus" J Am Acad Orthop Surg. 2017 Jan;25(1):e18-e19.