Meniscal Repair

Meniscal repair is a surgical procedure aimed at repairing a torn meniscus, which is a crescent-shaped cartilage located in the knee joint. The meniscus acts as a cushion and stabilizer for the knee, helping distribute weight and absorb shock. When torn due to injury or degeneration, it can lead to pain, swelling, instability, and limited knee function. Meniscal repair involves suturing the torn edges of the meniscus together to promote healing, rather than removing the damaged portion. This procedure is often preferred over meniscectomy (removal of the torn part) as it preserves the natural cartilage, reducing the risk of long-term knee damage and arthritis.

Meniscal tears often occur due to sudden twisting motions, trauma, or overuse, especially in sports that involve pivoting or heavy impact, such as soccer, basketball, or skiing. Age-related degeneration can also contribute to meniscal tears, particularly in individuals over 40. The tear can be classified based on location (e.g., medial or lateral meniscus), type (e.g., vertical, horizontal, or complex), and severity. When the tear affects the knee's stability and function, it can cause pain, swelling, and difficulty with movement, especially when bearing weight or rotating the knee. If conservative treatments like physical therapy, ice, and rest fail, meniscal repair may be necessary.

Meniscal tears can often be treated through non-surgical methods such as rest, ice, compression, and elevation (RICE), physical therapy, or injections. However, when the tear is significant, surgery may be required to restore the knee's function and prevent further damage. Meniscal repair involves reattaching the torn edges of the meniscus using sutures, which can stimulate healing and restore the meniscus's cushioning ability. Unlike meniscectomy, which involves removing the torn part, meniscal repair aims to preserve as much of the natural cartilage as possible. This procedure can prevent long-term knee complications, such as arthritis, by maintaining the knee's stability and shock-absorbing capabilities.

Before undergoing meniscal repair surgery, patients undergo a thorough evaluation that typically includes physical exams and imaging tests such as X-rays or MRIs to assess the tear's location, size, and severity. This helps the surgeon determine the most appropriate treatment approach. If surgery is necessary, the patient may be advised to stop taking certain medications, like blood thinners, in preparation for the procedure. Preoperative physical therapy may be recommended to strengthen the muscles around the knee and reduce swelling. Patients are also educated about the procedure, anesthesia options, and expected recovery time, which varies based on the complexity of the tear and the surgery.

Meniscal repair is typically performed using an arthroscopic technique, which is minimally invasive. The surgeon makes small incisions around the knee and inserts a camera (arthroscope) to visualize the tear. Specialized surgical tools are used to trim or clean the torn edges of the meniscus and then stitch the torn pieces together. The sutures are placed to hold the meniscal edges in alignment and promote healing. In some cases, additional tools may be used to secure the repair or augment the meniscus if there is insufficient tissue. The procedure usually takes 1-2 hours, depending on the severity of the tear and the complexity of the repair.

After surgery, patients are closely monitored in the recovery room for any complications, such as infection or blood clots. Pain management is provided through medications, and the knee is typically iced and elevated to reduce swelling. In most cases, patients are given crutches or a brace to keep weight off the knee for a period of time, allowing the meniscus to heal properly. Physical therapy starts early in the recovery process, with a focus on restoring the knee's range of motion and reducing swelling. The surgeon may provide guidelines regarding weight-bearing restrictions and activity levels, which are crucial for ensuring the success of the repair.

Rehabilitation is critical to the success of meniscal repair surgery. Physical therapy typically begins within a few days of surgery, focusing on restoring range of motion, improving strength, and enhancing knee stability. Initially, exercises are gentle and focused on preventing stiffness and swelling. As healing progresses, patients begin more active rehabilitation, including strengthening exercises for the quadriceps and hamstrings. Return to full activity, including sports, may take anywhere from 4 to 6 months, depending on the tear's severity and the patient's commitment to rehabilitation. Long-term recovery involves maintaining a strong and flexible knee through regular exercise to avoid future injuries and complications, such as arthritis. Regular follow-up visits with the surgeon are essential to monitor healing and ensure the meniscus is functioning properly.