Understanding When Surgery is Right – Meniscus Tears

The human body is complex and miraculous in many ways. While there are many parts of the body that can effectively heal on their own, I’m afraid the meniscus is not one of them. A meniscus tear, even a small one, needs surgical assistance to heal properly.


What is a Meniscus Tear? You have two menisci, one in each knee. The meniscus is the cartilage that cushions your knee joint. There’s also articular cartilage in the knee, which actually covers each of the bones. Both of these keep the bones from rubbing together and causing pain.


A meniscus tear can be caused by abruptly twisting the knee joint. When you’re younger, this cartilage is more flexible and can easily move with the joint. But as you age, your meniscus becomes more brittle and has less give. After the age of fifty, you’re more likely to tear your meniscus during daily activities; whereas, younger people usually injure their meniscus by playing sports (especially basketball).


When is Surgery Right? As I said before, if you tear your meniscus, you will need surgery to correct the issue. Surgical intervention can help save some of this cushioning cartilage where possible.


Before knee arthroscopy was common, it was normal for orthopaedists to remove the entire meniscus, even for small tears. Some believed that a patient didn’t really need the meniscus, while others thought that it would grow back. Unfortunately, both of these beliefs are false. You do need it, and it doesn’t grow back.


If you’re in your twenties or thirties and have a clean tear, it may be possible to save and repair the meniscus. That will leave the most cushioning in your knee, and we want to keep as much as possible to avoid arthritis and knee replacements later on.


However, if you are older or have a chronic meniscus tear, the torn portion of the cartilage may have to be removed. The remaining meniscus is saved to maintain as much cushioning as possible. If the entire meniscus is removed, you’re likely looking at a total knee replacement in twenty years or less.


What to Expect. Before your surgery begins, you’re given a local anesthetic and put under sedation. Because the local anesthetic is so effective, patients can actually stay awake throughout the duration of the procedure if they’d like. I can even show you what I’m doing while I’m doing it to help you better understand your injury.


To perform the surgery, I use an arthroscope (a tiny camera) to look inside the knee joint. This is what you would see on the screen if you decided to watch your surgery. After surgery, your knee will feel great, but it’s best to keep activities to a minimum to prevent pain in the next few days. I recommend patients use the RICE method and only get up to grab a snack or use the restroom. Your knee will feel stiff in the days right after your surgery.


Recovery is fairly quick. You can usually be back to school or work in about three days. If your job is labor-intensive, you can return to light duty work after one week and full duty in two to three weeks.