What Does Meniscus Repair Involve?

When a meniscus tear occurs, physicians may recommend a non-surgical approach of conservative treatment based on the RICE (rest, ice, compress, elevate) protocol, non-steroidal anti-inflammatory drugs, physical therapy, and cortisone injections. If symptoms fail to subside after this initial approach, patients may consider meniscus repair surgery if their diagnosis allows it.

Not every meniscus tear can be repaired, and sometimes a partial or total removal of an injured meniscus may be required; however, physicians typically choose to perform repairs whenever possible since it leads to fewer complications and prevents arthritis from setting in. 

Meniscus repair performed through the minimally invasive arthroscopic method may be recommended in the following cases:

  • Healthy patients who want to remain active
  • The quality of meniscal tissue is good (not including the injury)
  • The tear runs vertically across the meniscus
  • The tear is situated in the vascularized outer "red zone" of the meniscus that favors healing
  • The patient understands the necessity of undergoing a lengthy rehab

Arthroscopic meniscal repairs are performed with patients being administered a general, spinal, or local anesthetic, so they don't experience any pain. After the knee is secured in a proper position, the operating physician makes several small incisions around the knee, through which a narrow tube with a camera and light (arthroscope) is introduced to visualize the knee internally. A sterile saline solution can be injected into the joint to increase instrument maneuverability.

After determining the tissue quality, stability, size, pattern, and location of the meniscus tear, specialized small tools are passed through the incisions to perform the required repair. If blood flow to the operated area is insufficient, several methods may be employed to promote faster healing, including:

  • Placing a blood clot within the tear
  • Creating access channels for increased vascularization in the meniscal peripheral rim
  • Allowing the joint lining to bleed

After the meniscus is repaired and secured with sutures or absorbable stitches, the saline solution is drained, the incisions are closed, and the intervention is done. The length of meniscus repair surgery is usually 1 – 1 ½ hours; however, if patients require additional repairs such as an ACL reconstruction, the length of the operation may increase. 

Meniscus repairs have a 90% success rate, and since they're performed on an outpatient basis, individuals can return home the same day as their intervention. Since the knee will be immobilized to ensure proper healing, it's recommended to have a designated driver on the way back and have someone help out in the first days with menial tasks.