What is meniscus surgery?

Meniscus surgery is the surgical treatment for a torn meniscus (damage in your knee). Either the orthopedic surgeon will repair or remove the damaged part of your meniscus.

A health care professional may recommend meniscus surgery for you if you have a severe (high-grade) torn meniscus or if you have attempted without success other nonsurgical treatment for the symptoms you are experiencing.

Many people with a torn meniscus need surgery because the damaged cartilage can make their knee unstable (buckle and give way), painful, swollen, or cause their knee to "lock up" or become "stuck."

What should I do to prepare for meniscus surgery?

You will probably want some or all of the following tests before your meniscus surgery:

• Physical exam.
• Blood tests.
• Chest X-ray.
• Knee X-ray.

Discuss all drugs and over-the-counter or herbal supplements you are taking with your healthcare provider and surgeon. You may be asked to stop taking certain prescription drugs and supplements before the time of surgery.

Your surgeon will inform you when to stop eating the day before the surgery. In most cases, you need to fast for 12 hours before the procedure is done.

Plan to make arrangements for getting to and from the operating room. You should not drive a car following your surgery, so make sure someone is arranged to take you home.

What happens during meniscus surgery?

An anesthesiologist will inject anesthesia to numb your body and prevent pain on the day of your surgery. The anesthesiologist may give either general anesthesia that puts you into a deep sleep or regional anesthesia that numbs you from the waist down. If you are to get regional anesthesia, your anesthesiologist will administer a sedative to relax you.

Most meniscus surgery is performed through a minimally invasive arthroscopy of the knee. Your surgeon will make several minor cuts (incisions) over your knee. They will insert tiny instruments and a camera into your knee joint to treat the meniscus tear. There are three types of meniscus surgery:

• Meniscus repair.
• Partial meniscectomy.
• Meniscus replacement.

Meniscus repair:

A meniscus repair is precisely what it says it is: your surgeon will repair the tear and any other damage in your meniscus. They will suture the tear together so your meniscus heals back into one piece. Your body absorbs the sutures as the tear heals.

Partial meniscectomy:

This approach is technically known as a "partial meniscectomy," as it will remove the damaged portion of your meniscus. Your surgeon will remove the damaged cartilage surrounding your meniscus, leaving the healthy tissue unharmed.

A meniscectomy might be a better option for more significant tears. Meniscus tears of higher grade may be too great for healing to be possible thoroughly enough to allow reattachment, even with a repair.

Meniscus replacement:

This surgery, also known as meniscus transplantation, is much less common. Only at times is it appropriate for a patient under 50 with knee arthritis or a severely damaged meniscus. Your surgeon's allograft, which is the donor meniscus from a human person, will replace your meniscus.

How long does meniscus surgery take?

This surgery usually takes an hour. It may take longer than or shorter than this, depending on which kind of surgery you need, how bad your tear is, and whether you have other injuries, like knee ligament tears, that also may require treatment.

How do I recover from meniscus surgery?

Meniscus surgery is commonly performed on an outpatient basis. That means you can go home the same day. Your surgical team will care for you in a recovery room as the anesthesia resolves. When you are safe to be discharged, you will need someone to take you home.

What are the advantages of meniscus surgery?

Meniscus surgery can help:

• Get you moving toward sports or other physical activities again.
• Increase your mobility.
• Make your knee more stable.
• Relieve or remove altogether the ache and other symptoms of a torn meniscus.

What are the complications of meniscus surgery?

Meniscus surgery is safe and effective but carries a risk of some complications, including the following:

• Blood clots
• Bleeding inside your knee
• Infections
• Nerve damage or blood vessel damage
• Stiffness in your knee joint even once you are out of the hospital.

Having meniscus surgery may increase your risk of developing knee arthritis in that knee later in life, especially if you have a partial meniscectomy. Although you can safely use your knee without your whole meniscus, having a section removed during a partial meniscectomy will increase the stress and friction inside that knee for the rest of your life.

Discuss your risk of complications with your surgeon. For most individuals, the benefit obtained from treating the torn meniscus and its associated symptoms tends to outweigh the risks significantly.

How long does it take to recover and recuperate after meniscus surgery?

The patient is typically expected in a few weeks to a few months after the surgery. Meniscus repairs will generally take longer to heal than a meniscectomy. The most extended recovery is for the meniscus replacement. Your surgeon can advise you precisely what you can anticipate and even offer more individualized therapy for your specific case and needs.

Recovery times generally are about six weeks for meniscectomies, considering your meniscus repairs take that amount of time plus time awaiting your meniscus to heal within your knee. This can take up to three months, depending on how quickly your body heals naturally. It can take months for the replacement of a meniscus to heal completely. You'll probably avoid engaging in high-level, intense physical activities such as sports for up to a year.

After your surgery, you will need:

• Crutches
• A knee brace to stabilize the knee joint
• Pain medication
• You must follow the RICE principle: rest, ice, compression, and elevation.

Physical therapy (PT): Your physical therapist will also give you exercises to be carried out at home to regain mobility, range of motion, and strength. You will need PT for several months following a meniscus repair surgery. Because recovery from a meniscectomy is much more rapid, you may only need PT for a few weeks.

How many days after meniscus surgery can I walk again?

 You will usually be able to get some weight-bearing status on your knee immediately following the removal of the torn part of the meniscus. However, it would help if you waited a few weeks before walking or engaging in light activities. You might need to wait a month before allowing yourself to return to more strenuous activities.

Returning to walking and other athletic activities is a little longer compared with arthroscopic meniscectomy. You will likely need crutches for at least some weeks after surgery to avoid placing stress on the knee when standing and walking. After a few weeks of using the crutches, you can walk without them. However, it might be a few more weeks before the patient can go through light activities without further support. Intensive physical activities could be a few months before your surgeon clears you.

How bad is it to repair a torn meniscus?

You'll have some pain after surgery and for at least several weeks as your body heals. That's all part of the process.

Your surgeon may prescribe prescription pain medication and recommend taking over-the-counter NSAIDs if it is appropriate for you to take them, in addition to acetaminophen, to help control your pain. You will have guidance on how much of each type of medication you can take at a specific time or even per day.

If you feel you are receiving too much pain medication, or if you have side effects concerns about your pain medication, speak to your surgeon.

Will my knee ever be the same after meniscus surgery?

Most people can return to all their usual activities, including playing sports, following meniscus surgery. Your surgeon and physical therapist will instruct you on when to discontinue using crutches or a brace for walking. Don't resume more demanding exercises until cleared by your surgeon.

Some people with an injury as simple as a meniscus tear need to rebuild trust in their body even if they are long past any physical rehabilitation. You probably have thoughts running through your head from worst-case scenarios to "This is never going to be the same again," especially with injuries related to work or sports injuries. This is normal. Talk to your surgeon or physical therapist about what you're feeling. They'll help you regain your confidence while getting back into your routine.

Inform your surgeon or primary care provider if you develop knee pain on that knee at a later time.

When to Call the Doctor?

Your surgeon will tell you when you must return to see them after discharge. However, you should contact them immediately if you have the following:

• Fever over 101 degrees F (38 degrees C).
• Heavy bleeding or drainage, either blood or fluid, from the surgical site.
• Breakage of pus or foul-smelling drainage coming from your surgical site.
• Pain in your knee that does not improve with rest or elevation.
• Trouble breathing.

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