Meniscus Tear (cont.)
IN THIS ARTICLE
There are many things to consider when deciding how to treat your torn meniscus, including the extent and location of the tear, your pain level, your age and activity level, your doctor's preference, and when the injury occurred. Your treatment choices are:
Whenever possible, meniscus surgery is done using arthroscopy, rather than through a large cut in the knee.
The location (zone) of the tear is one of the most important factors in determining treatment. See a picture of the meniscus zones.
Also, the pattern of the tear may determine whether a tear can be repaired. Longitudinal tears are often repairable. Radial tears may be repairable depending on where they are located. Horizontal and flap (oblique) tears are generally not repairable. See a picture of different types of tears.
Another factor when considering treatment is that repairs to the lateral meniscus (on the outer side of knee) typically heal better than repairs to the medial meniscus (on the inner side of the knee). See a picture of the lateral and medial menisci.
It is preferable to preserve as much of the meniscus as possible. If the meniscus can be repaired successfully, saving the injured meniscus by doing a meniscal repair reduces the occurrence of knee joint degeneration compared with partial or total removal (meniscectomy). Meniscus repair is more successful in younger people (experts think people younger than about 40 years old do best), in knees that have good stability from the ligaments, if the tear is in the red zone, and if the repair is done within the first few weeks after the injury (acute).1
Meniscal repair may prevent degenerative changes in the knee joint. But it has not been proved conclusively that repairing a tear prevents more long-term problems (such as osteoarthritis) than not repairing a tear. Many doctors believe that a successful meniscus repair lowers the risk of early-onset arthritis because it reduces the stress put on the knee joint.
Orthopedists most often perform meniscus surgery with arthroscopy, a procedure used both to examine and then to repair the inside of a joint by inserting a thin tube (arthroscope) containing a camera and a light through small incisions near the joint. Surgical instruments are inserted through other small incisions near the joint. Some tears require open knee surgery.
Rehabilitation varies depending on the injury, the type of surgery, your orthopedic surgeon's preference, and your age, health status, and activities. Time periods vary, but in general meniscus surgery is usually followed by a period of rest, walking, and selected exercises. After you have full range of motion without pain and your knee strength is back to normal, you can return to your previous activity level.
For some exercises you can do at home (with your doctor's approval), see:
Other knee injuries, most commonly to the anterior cruciate ligament (ACL) and/or the medial collateral ligament, may occur at the same time as a meniscus tear. In these cases, the treatment plan is different. Typically, your orthopedist will repair your torn meniscus, if needed, at the same time that ACL surgery is done. In this case, the ACL rehabilitation plan is followed. For more information, see the topic Anterior Cruciate Ligament (ACL) Injuries.
Meniscal transplant is an experimental treatment for meniscal tears. It might be a good option for a meniscus that is already weakened or scarred due to previous injury or treatment. In this surgical procedure, a piece of meniscus cartilage from a donor (allograft) is transplanted into the knee.
To be eligible for meniscal transplantation, a person:
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