A torn meniscus results from damage or degeneration to the menisci in your knees. This injury is commonly seen due to overuse among athletes, but torn menisci may also occur with age as a result of natural degeneration.
Menisci are crescent-shaped
At first, a torn meniscus may be asymptomatic. Further use of the injured menisci can lead to chronic swelling, pain, and clicking noises. Symptoms may worsen especially after activity.
There are several conservative treatments for a torn meniscus, including rest, pain medication, and physical therapy. Depending on how large the tear is, as well as other contributing health factors, your doctor may recommend surgery.
We’ll break down the different surgical options available for torn menisci, including what to expect during recovery, possible complications, and overall prognosis for each type of surgery.
Meniscus surgery remains
Surgery for a torn meniscus isn’t always the first treatment option on the table. If you’re experiencing possible symptoms of a torn meniscus, your doctor may recommend the “RICE” method as their initial approach:
Icing the affected knee and taking a break from sports or other vigorous activities can help lower inflammation and prevent further damage. In addition to RICE, non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen, may help reduce pain and swelling. Wearing a knee brace can also be helpful.
Your doctor may also recommend making a corticosteroid injection to the joint. Cortisone shots
Meniscus injuries in older people are often the result of degeneration over time, Yale Medicine explains. This can be caused by routine activities like squatting or climbing stairs.
UCONN Health states that, especially for older people, non-surgical measures could improve symptoms and prevent the tear from worsening in about six weeks. Rather than heal, the meniscus tear is scarred down and absorbed to a degree that it no longer causes pain. However, extensive tears in older adults may require surgery.
Conservative measures don’t work in all cases of torn menisci, especially for younger patients. Younger people are more likely to be highly active, and are at risk of worsening a tear by overuse.
In determining your candidacy for meniscus surgery, your doctor will consider the following factors:
- your age (surgery may be especially critical in preventing knee degeneration in children and young adults)
- the size of the tear
- the length of the tear (tears over 1cm usually cannot heal themselves)
- whether the tear causes symptoms that interfere with your daily life
- whether you have other co-occurring conditions in the knee
The meniscus and ACL
A torn meniscus can accompany other knee injuries, such as tears in the anterior cruciate ligament (ACL). The ACL is next to the menisci, running through the center of each knee joint. It allows for bending and twisting.
Surgery on the meniscus is done by an orthopedic surgeon. Depending on the extent of your meniscus tear, your surgeon may recommend removing or repairing part of the meniscus via a knee arthroscopy.
During a knee arthroscopy, your surgeon makes a small incision in the knee joint so they can place a small camera (arthroscope) inside to guide them as they perform surgery on the affected meniscus. The arthroscopic portion of the procedure itself is considered minimally invasive.
From there, your surgeon may remove a portion of the meniscus via a procedure called a partial meniscectomy. This involves trimming away the damaged portion only.
If your doctor recommends a meniscus repair, they will insert sutures or “meniscus repair anchors” to hold the remaining parts of your meniscus together. Over a period of several weeks or months, the meniscus will then heal as one piece.
Another possible, though rare, procedure is a meniscus reconstruction. This surgery is
While individual recovery times may vary, a partial meniscectomy usually has a shorter recovery period than a meniscus repair. According to the American Academy of Orthopaedic Surgeons (AAOS), the estimated recovery time is three to six weeks for a partial meniscectomy, and three to six months for a meniscus repair.
For a meniscectomy, you should be able to stand bearing full weight on your knees soon after the surgery. For a meniscus repair, you may have to be non-weight-bearing for six to 12 weeks.
After either surgery, you may first notice a significant reduction in knee pain. However, you will still need several weeks’ worth of rehabilitation to restore strength and range-of-motion. This involves a combination of physical therapy as well as at-home strengthening exercises recommended by your doctor. You should also take any pain relieving medications as prescribed.
It’s important to be aware of possible complications that may arise from a meniscus surgery. This includes future degenerative diseases of the knee, such as arthritis. It’s estimated that removing more than 20 percent of a damaged meniscus could increase such risks.
However, having surgery to repair tears—rather than removing them—could also decrease your likelihood of arthritis by improving the meniscus’ health. This is why
Infection is rare, but always a risk with any surgical procedure. Symptoms of a knee infection may include pain and excess swelling in the joint, and fever or chills. Contact your doctor immediately if you believe you may be experiencing this complication.
Your orthopedic surgeon will be able to explain the options available to you based on the status of your injury, and answer questions about potential outcomes. They’ll help you make the best decision based on your age, overall health, and lifestyle.
Meniscus tears and osteoarthritis
Some patients may have other health issues affecting their knees which may complicate treatment. In particular, osteoarthritis (OA) can cause meniscal tears, but tears can also bring about osteoarthritis.
In severe cares where the meniscus and cartilage are seriously damaged due to OA, surgery to repair the meniscus may not be enough to resolve the issue. Your doctor may recommend a knee replacement.
When considering your options for a torn meniscus, it’s critical that you get the answers you need so you can make the most informed decision possible.
The following are some important questions you can ask your doctor:
- How large is my meniscus tear- could it heal without surgery?
- What will happen if I try and wait for a the tear to heal on its own?
- Do you recommend that I take over the counter pain relievers? Should I take these alongside the RICE method?
- Am I at risk of developing knee arthritis? How will surgery increase or decrease such risks?
- Are there any other issues currently affecting my knees (such as a torn ACL)?
- Which type of surgery is most appropriate for my torn meniscus—repair or removal? What are the risks and benefits of each surgery for my case?
- Should I have meniscus surgery at my age? What are the long-term benefits and consequences for removal versus repair?
- How long do you expect my recovery process to take after surgery? How long will I need to take off work? Will I need someone to help me around the house with everyday tasks?
- When will I be able to resume my normal activities?
- Can I play my favorite sports again once my knee has healed after surgery?
- What future precautions will I need to take pertaining to exercise or daily activities?
While a torn meniscus is a relatively common injury, especially in athletes and older people, it’s important to seek prompt treatment to help prevent further damage and degeneration. Your doctor will likely recommend over-the-counter pain relievers and the RICE method first, especially in mild cases.
However, if your knee pain and swelling continues to interfere with your daily activities, or if your tear is over 1 cm, you may consider discussing surgery with your doctor. This will involve either a partial meniscectomy, or repair surgery.
Surgery is a major decision, and can lead to potential complications both during recovery and down the line. Before pursuing surgery for a torn meniscus, be sure to thoroughly discuss all of the benefits and risks with your doctor.