Torn meniscus surgery is one of the most common orthopedic surgeries, often performed alongside other knee repair surgeries, such as an ACL or MCL reconstruction. There are a wide variety of factors that influence treatment options. Here’s what you can expect before your surgery, and during your recovery.
When is surgery necessary for a torn meniscus?
A meniscus is a smooth, wedge-shaped cartilage located in the knee joint where the femur and the tibia meet. While commonly thought of as a single entity, there are actually two menisci: the medial meniscus and the lateral meniscus.
- Absorbs shock
- Provides stabilization
- Helps with load bearing
- Prevents your bones from rubbing together
A meniscus tear can occur in anyone at any time. It’s common for a torn meniscus to occur during other knee trauma, like tearing an ACL or MCL. Sports that require squatting, pivoting, or twisting can cause a meniscus to tear. As we age our meniscus weakens, however, and simple everyday actions like standing up can tear a meniscus.
Common meniscus tear symptoms
It can be hard to know if you have a meniscus tear. Some people may hear or feel a pop in the knee, and others may have no symptoms.
Symptoms from a meniscus tear can include:
- Reduced range of motion
- Catching or locking
- Instability in the knee
- Grinding in the knee
- Reduced capacity or inability to bear weight
If you think you’re suffering from a meniscus tear, the following video can help you figure out the extent of your injury.
How doctors diagnose meniscus tears
Using an MRI and functional knee tests, your doctor will diagnose your meniscus tear. The location and type of meniscus tear will influence your treatment.
There are five types of meniscus tears that can be located anywhere in the meniscus:
- Transverse radial
There are some good images for types of tears here.
Other treatment factors include your age and your activity level, and any other complicating factors.
Once diagnosed, your treatment will either be surgical or non-surgical. Meniscus tear surgery might not be an option if:
- Your doctor thinks the tear could heal on its own
- Your age or physical health prohibit surgery
If you are not a candidate for meniscus tear surgery, your doctor will likely manage your symptoms by prescribing physical therapy. They may also recommend support devices such as a knee brace. Always consult your doctor about your treatment options.
Will I need meniscus tear surgery?
Surgery can help increase mobility in your knee and reduce or remove symptoms of a meniscus tear. You and your doctor will decide on surgical goals that are most appropriate for you. These will either be repairing the meniscus or removing part of the meniscus (also known as a partial-menisectomy). In some cases, it may be necessary for them to completely remove the meniscus (known as a full menisectomy).
Because the meniscus plays such a critical role in the knee joint, the goal is to keep as much of the meniscus intact as possible.
What should I expect during surgery?
Prior to meniscus tear surgery, your surgeon will tell you if they intend to remove part of your meniscus or repair it. Do note that not all meniscus tears show up on an MRI. If your surgeon discovers any additional tears during the procedure, they may adjust treatment or make additional repairs or removals during the surgery.
Thoroughly follow all instructions from your doctor prior to surgery. Instructions vary but can include:
- Discontinuing the use of most medications or supplements two weeks prior to surgery
- Physical therapy to increase mobility prior to surgery
- No food or beverages 24 hours prior to surgery
- Requiring an adult to take you to and from surgery, or stay with you for a few days after surgery
In addition to anesthesia during surgery, you may receive a nerve-blocker to numb your whole leg prior to meniscus tear surgery. An anesthesiologist will inject the nerve-blocker in your leg just before surgery. It can take several days to regain feeling in your leg after receiving this nerve-blocker.
The procedure itself
This surgery is typically performed arthroscopically. The surgeon makes two to three small incisions in and around the knee, and then inserts tools and a tiny camera into the incisions. If your tear is small, not jagged, and close to the blood supply, your surgeon might opt to repair it with stitches. If the tear requires removal, the surgeon will cut away the affected area, leaving as much healthy tissue as possible.
Meniscus tear surgery is typically an out-patient procedure and takes anywhere from 45 minutes to several hours. After surgery, a post-op nurse will monitor you as you wake from the anesthesia. Pain immediately after surgery is not uncommon, but do tell your nurse if you experience any significant pain after waking up.
Typically, you will have a two-week post-operative appointment with your surgeon. During this appointment, they’ll discuss the images they took during surgery and any additional treatment that was necessary.
If you’re interested in learning more about the scientific approach to treating meniscal repairs, check out the World Journal of Orthopedics article: Treatment of meniscal repairs: An evidence based approach.
What should I expect during recovery from torn meniscus surgery?
Recovery from torn meniscus surgery varies from patient to patient. Always follow all post-operative recovery instructions from your surgeon to reduce the likelihood of future injuries and chronic conditions.
You will likely receive a prescription for pain medication following torn meniscus surgery. Because these medications can have side effects such as constipation and nausea, you may also receive additional prescriptions. Supplemental activities like eating a healthy, balanced diet and drinking plenty of water during your recovery can also reduce these symptoms.
Depending on your unique circumstances, your doctor may also prescribe breathing exercises. These exercises help your body recover from anesthesia and reduce your risk of pneumonia. Always follow through on all activities prescribed by your doctor.
Your limitations or restrictions during recovery will depend on the extent of your injuries. However, they can include:
- Using support devices like crutches, braces, or canes
- Wearing compression sleeves on your legs
- Avoiding weight-bearing activities or certain knee movements
- Avoiding driving or flying
- Stopping the consumption of alcohol or cigarettes
- Limiting showering or bathing in the days following surgery
- Avoiding certain medications, like ibuprofen
Physical therapy during recovery
While you are provided with a general recovery time from your doctor, it can take several years to return to all the activities you performed prior to meniscus tear surgery. This is especially true for athletes returning to a sport. Be sure to follow all instructions from your doctor and complete all physical therapy programs.
When recovering from a meniscus tear surgery, physical therapy will become a regular part of your routine for some time. Be sure to discuss your options with your doctor and do your research, as having a good physical therapist can greatly increase your chances of a full recovery.
Recovery from partial meniscus removal
If your surgeon removed part of your meniscus (a partial menisectomy), typical recovery time is three to four weeks, though this varies from patient to patient.
You will use crutches, ice therapy, and elevate your leg for up to a week post-op. You may perform light exercises to increase range of motion or attend physical therapy as soon as the day after surgery.
Following your immediate recovery time, you may continue to attend physical therapy for up to a year to regain complete confidence and physical ability back in your knee.
Recovery from meniscus repair
Recovery is more involved if your surgeon repaired your meniscus using stitches. Typical recovery time from a meniscus repair surgery is three to four months.
For the first four to six weeks, your knee will be locked in a special brace that restricts range of motion. Initially this brace is kept in a straight position and you will use crutches, as you are not allowed to bear any weight on your leg.
Once your surgeon is confident your meniscus is healing properly, you will begin to perform light physical therapy and range of motion exercises. You will continue in physical therapy for up to a year after surgery to regain confidence and ability back in your knee.
What are the risks and complications from torn meniscus surgery?
Any surgery can be risky, and there are many factors that can increase your risks. Be honest when completing forms for your doctor and discuss any possible risks or complications before the surgery.
The most common risks and complications from a torn meniscus surgery are:
- External scarring
- Internal scar tissue
- Blood clots
- Side effects from anesthesia
- Post-operative pulmonary edema
Other long-term risks include:
Keeping the incisions clean and following all post-op care instructions from your surgeon will help you reduce your risk of infection.
Always wash your hands before caring for your incision sites, and ask your caretakers to do the same.
Unless you’re having open knee surgery, your torn meniscus surgery scars should be relatively small. You’ll likely have two to three small scars around your knee.
Internal scar tissue
Everyone heals differently, and it’s not uncommon for some people to develop internal scar tissue in the knee because of surgery. This scar tissue can result in:
- Arthritic conditions, like chondromalacia
To reduce your risks of blood clots following surgery, your doctor will restrict your use of certain medications that thin your blood and will require you to wear compression leggings.
Blood clots that form in the lower leg can be extremely dangerous, and even deadly. Follow your doctor’s instructions exactly to reduce your risk.
Side effects from anesthesia
Side effects from anesthesia range from vomiting and nausea to total body aches.
There are different types of anesthesia and it affects everyone differently. If you’ve had complications from anesthesia in the past, be sure to discuss this with your doctor prior to surgery.
Post-operative pulmonary edema
Post-operative pulmonary edema is a condition where fluid builds up in your lungs following surgery, making it difficult to breathe.
It’s most common in patients with pre-existing heart conditions. Talk to your doctor if you’re especially concerned about this risk.
It’s not uncommon for individuals who have had anesthesia to develop pneumonia.
Breathing exercises prescribed by your doctor will help reduce or eliminate the risk of getting pneumonia after surgery.
If part or all of your meniscus was removed during torn meniscus surgery, developing degenerative arthritis in the future is a possibility.
The meniscus prevents the bones of your tibia and femur from rubbing together. Without its protective cushion, bone-on-bone rubbing can eventually cause arthritic conditions.
Just because you’ve had torn meniscus surgery doesn’t mean you won’t ever need knee surgery in the future.
If you develop scar tissue in the knee it may need to be removed to prevent future injury. If you have part or all of your meniscus removed, you may need a knee replacement in the future due to other degenerative conditions.
Meniscus tear surgery, while effective, doesn’t always eliminate pain.
Because each person heals differently, you may need to manage chronic knee pain after your surgery, particularly if you’ve had part or all of your meniscus removed.
Recovery from meniscus tear surgery can be lengthy. Not being able to perform the activities you could before surgery, missing out on events with family and friends, or having permanent limitations on the activities you are able to perform can cause depression.
If you experience long-lasting chronic pain, it can also lead to more serious symptoms of depression.
If you do experience depression, it’s important to reach out for help. Chronic pain support groups provide aid from others who are experiencing the same emotions and challenges. Likewise, therapy can help you process the changes that are occurring.
If you are having a meniscus repair, you will not be allowed to bear weight on your leg for four to six weeks.
You may also not be able to schedule your surgery immediately after injury. Muscle loss is a possibility from your lack of activity, and it can take time to rebuild the lost muscle.
Get help for chronic pain
While torn meniscus surgery can completely remove all of your symptoms, it’s possible you may experience chronic knee pain after surgery. If you experience continued pain that extends outside the normal recovery period provided by your physician, a pain specialist may be able to help you relieve your pain. Click the button below to find a pain doctor in your area who can help.