Medial meniscus repair is an arthroscopic operation to stitch together a torn medial meniscus in the knee, preserving this important shock-absorbing structure rather than removing it.
The operation is performed arthroscopically through small incisions. The tear is identified and the edges are prepared. Sutures are passed through the meniscus to bring the torn edges together, using devices inserted through the arthroscope. A small incision on the inner side of the knee may be needed for inside-out repair techniques. The operation takes 45–90 minutes.
Repair is preferred over removal whenever possible because the meniscus is vital for knee function and joint protection. Repair is most successful for tears in the outer one-third of the meniscus (red zone) where blood supply supports healing. It is commonly performed alongside ACL reconstruction.
Physiotherapy and observation may be appropriate for small, stable tears causing minimal symptoms. Partial meniscectomy (trimming) is quicker to recover from but removes protective tissue.
MRI to assess tear pattern. Standard pre-assessment.
Preservation of the meniscus protects against future arthritis. Healing rates are approximately 80–90% for repairs in the vascular zone and when combined with ACL reconstruction.
Recovery is slower than after partial meniscectomy due to healing requirements.
Temporary loss of full flexion.
Knee swelling for several weeks.
The repair may not heal, requiring later partial meniscectomy. Risk approximately 10-20%.
The repaired meniscus may tear again with return to sport.
Saphenous nerve branch may be damaged with inside-out repair, causing numbness on the inner knee.
Joint infection.
DVT during restricted weight-bearing.
General or spinal anaesthesia with a nerve block.
Crutches and limited flexion for four to six weeks. Progressive range of motion under physiotherapy guidance. No deep squatting or pivoting for three months. Running at three to four months. Return to sport at six months. Full recovery six to nine months.
Reviews at two weeks, six weeks, three months, and six months. MRI may be used to assess healing.
The meniscus distributes load across the knee. Removing even part of it increases the risk of arthritis. Preservation through repair is preferred whenever the tear pattern allows it.
The repair needs time to heal. Early overloading can cause the stitches to pull out. Meniscectomy removes tissue, so there is nothing that needs to heal.