When is surgery needed for meniscus tear

During some activities — especially contact sports — the force and degree of twisting your knee can tear some of the wedge-shaped cartilage that provides cushioning between your thigh bone and shinbone.

This cartilage is your meniscus. Each of your knees has two meniscus wedges. Meniscus tears are common among athletes, especially those who play sports that require a lot of squatting, twisting, and changing positions.

If not treated, part of the meniscus may come loose and slip into the joint. You may need surgery to restore full knee function. Untreated meniscus tears can increase in size and lead to complications, such as arthritis. Endurance is an important part of sports. For some athletes, playing through a little pain is a badge of honor. In the case of meniscus tears, some people think the injury will heal over time on its own.

This can lead to a longer recovery to allow for the meniscus to heal. Commonly, a period of physical therapy is prescribed following surgery. After arthroscopic partial meniscectomy taking out or cleaning up part of the torn meniscus , you are allowed to bear weight immediately following surgery.

This limitation is based upon pain levels. With meniscus repair surgery, a period of non weight-bearing for six weeks might be necessary.

The meniscus functions as a shock absorber to protect the cartilage within your knee. If your meniscus is severely damaged or part of it is removed, this can increase the load placed on the cartilage.

Over time, this can lead to wear on the cartilage and development of osteoarthritis. This can make your knee catch, pop, or lock. You may not be able to straighten it.

Your knee may feel "wobbly" or buckle without warning. It may swell and become stiff right after the injury or within 2 or 3 days. When possible, it's better to fix the meniscus than to remove it. If the meniscus can be fixed, you have a lower risk of future joint problems. Your doctor will likely suggest the treatment that he or she thinks will work best for you based on where the tear is, the pattern of the tear, and how big it is.

Your age, your health, and your activity level may also affect your treatment options. In some cases, the surgeon makes the final decision during surgery, when he or she can see how strong the meniscus is, where the tear is, and how big the tear is. Some kinds of tears can't be fixed. Radial tears sometimes can be fixed, but it depends on where they are. Most of the time, horizontal , long-standing, and degenerative tears—those caused by years of wear and tear—can't be fixed.

The older you are, the less likely it is that your tear can be repaired. For these kinds of tears, you may need to have part or all of the meniscus removed. When possible, meniscus surgery is done using arthroscopy instead of open surgery. During arthroscopy, your doctor puts a lighted tube with a tiny camera—called an arthroscope, or scope—and surgical tools through small incisions.

In a young person, surgery to fix the tear may be the first choice, because it may restore use of the knee. Surgery has risks, including infection, a blood clot in the leg, damage to nerves or blood vessels, and the risks of anesthesia.

After surgery you may still have pain and joint stiffness. This means that of people who have this surgery, 85 have relief from pain and can use their knee normally, while 15 do not.

Surgery to remove part of the meniscus meniscectomy is better at keeping your knee stable than surgery to remove all of the meniscus.

Partial removal also allows a quicker and more complete recovery than total removal. Removing the whole meniscus typically reduces some symptoms. But losing the meniscus reduces the cushioning and stability of the joint.

Most people, especially if they are young or active, are not satisfied with a total meniscectomy. This is why surgeons try to remove as little of the meniscus as possible. This means that 78 to 88 people out of people who have this surgery have reduced symptoms and are able to return to most or all of their activities.

Small tears found at the outer edge of the meniscus often heal with rest. Instead of surgery, you may try rest, ice, compression, and elevation.

You may wear a knee brace. You can try over-the-counter medicine such as ibuprofen or naproxen to help with pain and to reduce swelling. If your symptoms go away, your doctor may suggest exercises to build up your quadriceps and hamstring muscles and increase your flexibility.

It's important to follow your doctor's guidelines so that you don't hurt yourself again. These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions. I've had quite a bit of pain on one side of my knee for a couple of weeks, but my symptoms have decreased.

My doctor thinks that my meniscus may be healing on its own. I'm still seeing my doctor, though, and I've started rehabilitation with a physiotherapist. He's got me going through range-of-motion and knee strengthening exercises at home. I don't think I'll need surgery.

A few months ago, I started having pain in my right knee when I would move it certain ways. My doctor examined my knee and asked me about my symptoms. He diagnosed a tear in my meniscus. A follow-up MRI confirmed it. I've been doing rehabilitation, but it's been 2 months and I've still got pain, particularly if I twist my knee at all.

The orthopedic surgeon thinks that I may have a flap or piece of the torn meniscus moving in the knee, which is giving me a lot of problems with my knee locking. He's recommending surgical repair, and I am going to go ahead with the surgery. I injured my knee about a month ago in a tennis game. It didn't take my doctor long to diagnose a meniscus tear, and I'm going to have an arthroscopic test to see just how much I've damaged the knee. The surgeon says she can do repairs in the same procedure.

My mother has severe osteoarthritis, and I believe that my knee may develop early arthritis if I don't get this tear taken care of.

The arthroscopic surgery makes sense to me. I am a serious athlete and this isn't my first injury. But this is the first time I've had to think about surgery. I've had bad pain in my knee fairly constantly since I twisted it in the gym a few weeks ago.

It's particularly bad if I bend or flex my knee. The surgeon says that the MRI shows a large tear in the inner part of my meniscus, and that's the part that doesn't heal well. He's recommending a partial meniscectomy to remove the damaged tissue. He says that he'll only have to remove a small part of the meniscus and I'll still have stability in the knee, and no more pain!

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