Menisci are cartilage pads that act as shock absorbers between the shin and thigh bones. These cartilages are pivotal in knee stability and distributing weight during mobility. Meniscus injuries can occur either on the medial (inner) or the lateral (outer) part of the knee and they manifest either as a tear or in extreme cases, a complete rupture.

Meniscus injury is a common knee injury which affects people of any age. When a meniscus injury occurs, conservative treatment is explored as preservation of meniscus tissues is prioritised. If deemed necessary, you may be advised to undergo a meniscus repair surgery. Where a “repair” is not suitable, a meniscectomy may be performed also known as an arthroscopic meniscectomy or keyhole surgery. Surgery may either be a complete meniscectomy where the meniscus and its rims are removed or a partial meniscectomy where only impacted or damaged areas of the meniscus are removed.

It is fairly uncommon for patients to undergo a complete meniscectomy. Partial removal is favoured as it provides an opportunity for quicker recovery rates. Additionally, arthroscopic meniscectomy reduces the risk of long-term knee problems such as arthritis and prolonged pain.

Factors affecting the decision for suitability of surgery include:

• Patients with a desire to return to sports or athletic endeavour; patients that are athletes tend to seek treatment with the quickest recovery rate.
• Type of injury sustained; there are only certain tear positions and locations which can be repaired. These include tears in the outer edge or longitudinal tears. Degenerative, flap, and horizontal tears are usually irreparable.
• The conservative approach provides no relief of symptoms. If 2nd-degree injuries show no improvement and pain progresses in the kneecap, your orthopaedist would consider a meniscus surgery.

Depending on the surgery you require, the procedure may vary. First, two or three small incisions are made at the knee and an arthroscope is inserted, allowing your surgeon to visually assess the condition of your knee through the camera. This phase of the procedure is also known as arthroscopic diagnosis.

Where a tear is sustained, your surgeon will suture the torn areas together and allow healing to naturally occur. On top of addressing meniscus repair, other injuries that may have occurred such as ACL injuries will be addressed. The surgical site is then irrigated to prevent infections before it is closed either by suture or staples.  

• Minimally invasive
• Quicker discharge
• Minimal scarring
• Improved mobility
• Prevents development of knee arthritis
• Reduces and relieves pain

Meniscus repair can be used to treat the following conditions:

• Outer and longitudinal tears of the meniscus: the only type of tears that meniscus repairs work on, other tears such as degenerative, flap, or horizontal are irreparable.  
• Multi-ligament knee injuries: also known as MLKI, it involves a combination of PCL injuries, MCL injuries, ACL injuries, and LCL injuries.
• Structural knee damage from obesity: obesity puts excess strain and pressure on the meniscus making it more prone to structural damage.

Meniscus repair surgeries have a high success rate of 85-90%. Additionally, successful recovery is also significantly observed among those who concurrently undertake ACL reconstruction surgeries. It is also common practice to conduct second MRIs to observe the recovery of meniscus tears.

The recovery rate varies according to the type of tear sustained and the surgery employed. In general, it could take anywhere between 1-2 months for younger patients to recover. For patients with arthritis or severe tear conditions, recovery may take between 6-12 months.

Diet, habits/lifestyle, and dedication towards rehabilitation will play a role in the rate of recovery. With positive post-surgical care and collaborative work with your orthopaedist, you can expect a satisfactory outcome.

Results will vary from person to person, depending on the severity of the issue and your overall health. Your orthopaedist can give you a better idea of what to expect based on your individual needs and circumstances.

Typically, only one surgery is required for recovery of knee mobility and to relieve symptoms. There are situations in which revision repair is necessary. This is usually the case where meniscus repairs are not conducted during ACL reconstruction surgeries. If patients retear their meniscus, a second surgery would also be necessary.

Treatment for meniscus injuries does not stop at surgery. To attain complete recovery, one will need to attend physiotherapy sessions and appropriately manage medications such as painkillers. The frequency of physiotherapy sessions will vary according to your personal goals such as the need to return to athletic endeavours.