Do I Need My Meniscus Repaired?

Whether you need a meniscus repair depends on several factors, including the type, location, and severity of the tear, as well as your age, activity level, and overall health. Here are some considerations to help determine if a meniscus repair is necessary:

Factors Influencing the Need for Meniscus Repair

1. Type of Tear

   • Longitudinal (Vertical) Tears: These tears are often repairable, especially if they are located in the outer third of the meniscus.
   • Radial Tears: These tears are less likely to be repairable, but it depends on their location and extent.
   • Horizontal Tears: These tears may sometimes be repaired, especially in younger patients or in combination with other repairs.
   • Complex Tears: These involve multiple patterns and are often more challenging to repair.

2. Location of the Tear

   • Red Zone (Outer Third): This area has a good blood supply, making tears here more likely to heal with repair.
   • Red-White Zone (Middle Third): Tears in this area have a moderate blood supply and may or may not be repairable.
   • White Zone (Inner Third): This area has poor blood supply, making tears here less likely to heal with repair.

3. Severity of the Tear

   • Small, Stable Tears: These may not require repair and can often be managed with conservative treatments like physical therapy.
   • Large, Unstable Tears: These are more likely to need surgical repair to restore knee function and prevent further damage.

4. Age and Activity Level

   • Younger, Active Individuals: More likely to benefit from repair, especially if they wish to return to high-level sports or activities.
   • Older, Less Active Individuals: May be better candidates for partial meniscectomy (removal of the damaged portion) or non-surgical management.

5. Associated Injuries

   • ACL Tears: If you have an ACL tear along with a meniscus tear, repairing the meniscus during ACL reconstruction can improve outcomes.
   • Other Ligament Injuries: The presence of other injuries may influence the decision to repair the meniscus.

Non-Surgical Management

• Rest, Ice, Compression, Elevation (RICE): To manage pain and swelling initially.
• Physical Therapy: To strengthen the muscles around the knee and improve function.
• Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation.

Surgical Options

• Meniscus Repair: Suturing the torn pieces together. This is typically recommended if the tear is in the red zone or in younger, active patients.
• Partial Meniscectomy: Removing the damaged part of the meniscus. This is often chosen if the tear is in the white zone or if repair is not feasible.
• Total Meniscectomy: Removal of the entire meniscus, which is rarely done due to the risk of developing arthritis.

Consultation with a Specialist

• Orthopedic Surgeon: A consultation with an orthopedic surgeon, particularly one who specializes in knee injuries, is essential to evaluate your specific case.
• MRI and Physical Exam: Imaging studies like MRI and a thorough physical examination will help determine the best course of action.

Decision Making

• Personal Goals: Consider your personal goals, such as returning to sports, daily activities, or minimizing future arthritis risk.

Ultimately, the decision to undergo meniscus repair should be based on a comprehensive evaluation by a healthcare professional who can tailor the treatment to your specific needs and circumstances.

Author

Dr. Catherine Logan, MD, MBA Catherine Logan, MD, MBA, MSPT, is a sports medicine orthopaedic surgeon specializing in complex knee and shoulder surgery at Colorado Sports Medicine and Orthopaedics (COSMO) in Denver, Colorado. As a former physical therapist & trainer, Dr. Logan provides a distinct expertise in sports injury, prevention, and surgical management.