A meniscus tear is an injury to the cartilage that stabilizes and cushions the knee joint. The type of tear often determines whether it can be repaired or not and the location of the tear will determine the type of procedure that will be used. Radial tears may be successfully repaired, depending on where they are located. Horizontal, flap, long-standing, and degenerative tears generally cannot be repaired.
Your physician will recommend the treatment that he or she thinks will work best for you based on the zone where your tear is, the pattern of the tear, and how big it is. Your age, your health, and 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 the how strong the meniscus is, where the tear is, and how big the tear is.
Small tears at the outer edge of the meniscus often heal with rest and home treatment. Moderate to large tear at the outer edge of the meniscus more commonly require surgery to repair and typically heal well after surgery. A tear that spreads from the outer edge into the inner two-thirds of the meniscus can be more challenging to repair and the success of surgery is less likely. Tears to the inner meniscus are not typically done because the meniscus may not heal after surgery. In these cases a partial meniscectomy in which torn pieces of the meniscus are removed may be done to help reduce pain and swelling.
Surgery to repair the meniscus may be done by open surgery, in which a small incision is made and the knee is opened up so that the surgeon can see inside the knee and the meniscus can be repaired. Increasingly, surgeons use arthroscopic surgery to repair the meniscus. The surgeon inserts a thin tube (arthroscope) containing a camera and a light through small incisions near the knee and is able to see inside the knee without making a large incision. Surgical instruments can be inserted through other small incisions. The surgeon repairs the meniscus using sutures (stitches) or anchors.
Always tell your physician or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription. During the two weeks before your surgery you may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), and other drugs. Ask your physician which drugs you should still take on the day of your surgery.
If you have diabetes, heart disease, or other medical conditions, your surgeon may ask you to see your doctor who treats you for these conditions. Tell your physician if you have been drinking more than one or two drinks of alcohol per day. If you smoke, try to stop. Ask your doctor for help. Smoking can slow down wound and bone healing. Always let your doctor know about any cold, flu, fever, herpes breakout, or other illness you have before your surgery.
On the day of your surgery you will usually be asked not to drink or eat anything for six to 12 hours before the procedure. Be sure to take any medicines your doctor told you to take with a small sip of water. Your physician or physician’s office will tell you when to arrive at the hospital.
Your physician may recommend that you do not move your knee more than absolutely necessary (immobilization) for two weeks after surgery. This may be followed by two weeks of limited motion before you are able to resume daily activities. Physical therapy should begin right after surgery.