Meniscal surgery is an arthroscopic (keyhole) procedure to treat a tear in one of the two menisci — the crescent-shaped shock absorbers in the knee. The torn meniscus may be partially trimmed (partial meniscectomy) or repaired with stitches, depending on the tear pattern and location.
Two small incisions are made at the front of the knee. A camera (arthroscope) is inserted to view the joint. The torn meniscus is assessed. If the tear is in an area with poor blood supply, the damaged portion is trimmed away (partial meniscectomy). If the tear is in a repairable location, it is stitched back together (meniscal repair). The operation typically takes 20–45 minutes.
Surgery is considered when a meniscal tear causes persistent pain, swelling, catching, or locking of the knee that has not responded to physiotherapy and time. In younger patients with acute tears, meniscal repair is preferred to preserve the meniscus and protect the joint long-term.
Many meniscal tears, particularly degenerative tears in older patients, can be managed with physiotherapy, pain medication, and activity modification. Evidence shows that in patients over 40 with degenerative tears, physiotherapy is often as effective as surgery.
Standard pre-assessment. This is usually a day-case procedure.
For partial meniscectomy: rapid relief of mechanical symptoms (catching, locking). For meniscal repair: preservation of the meniscus and potential long-term protection of the joint. Most patients return to normal activities within a few weeks (meniscectomy) to a few months (repair).
Expected for one to two weeks after surgery.
Temporary limitation of movement improving with exercises.
Some patients continue to experience knee pain, particularly if arthritis is present.
Meniscal repairs do not always heal. Failure may require further surgery to trim the meniscus.
Joint infection in approximately 0.5% of cases.
DVT is uncommon after knee arthroscopy but possible.
Rare.
Removal of meniscal tissue increases the long-term risk of osteoarthritis.
Usually performed under general or spinal anaesthesia. Can sometimes be done under local anaesthesia with sedation.
For partial meniscectomy: walking without crutches within days. Return to sport at four to six weeks. For meniscal repair: crutches for four to six weeks, with restricted bending. Return to sport at three to six months. Physiotherapy is important for both.
Wound check at two weeks. Surgeon review at six weeks. Physiotherapy as needed.
Repairs only heal reliably when the tear is in an area of the meniscus with good blood supply (the outer third). Tears in the inner, avascular zone cannot heal and are trimmed instead.
Removing meniscal tissue increases the long-term risk of wear on the joint cartilage. This is why surgeons try to preserve as much meniscus as possible.
After partial meniscectomy: usually four to six weeks. After meniscal repair: three to six months, to allow the repair to heal.