In arthroscopy, part of the meniscus is removed. As a result, the knee has considerably less support and absorbancy. In time, osteoarthritis in the knee worsens, and the only option for successful treatment is a total knee replacement.
In the case of meniscus tears, some people think the injury will heal over time on its own. But the truth is that there are different types of meniscus tears — and some tears won't heal without treatment. If your tear is on the outer one-third of the meniscus, it may heal on its own or be repaired surgically.
The most common procedure for a torn meniscus is knee arthroscopy. It usually takes less than an hour. First, you receive anesthesia. The surgical team cleans the skin on your knee and covers the rest of your leg with a surgical drape.
For most people who have a symptomatic meniscus tear, arthroscopic surgery is selected to remove or repair the torn tissue. However, if you have arthritis, you may benefit from injection and physical therapy without surgery. Arthroscopy has revolutionized how knee surgery is performed.
Tears on the outer one-third of your meniscus can heal independently because this area has a rich blood supply, and blood cells can regenerate the meniscus tissue. However, if the tear is located on the inner two-thirds, the tear will not repair itself and will need to be surgically removed.
Surgery to repair tears in the meniscus relieves symptoms 85% of the time. That means that of 100 people who have this surgery, 85 have relief from pain and can use their knee normally, while 15 do not. Surgery to repair tears may reduce the risk of long-term joint problems.
Continuing to walk on the affected leg can aggravate your symptoms, making pain and stiffness worse in as little as a few days. Plus, suffering a torn meniscus may also increase your risk of complications, like developing osteoarthritis in that knee.
If you sit at work, you may be able to go back in 1 to 2 weeks. But if you are on your feet at work, it may take 4 to 6 weeks. If you are very physically active in your job, it may take 3 to 6 months.
If you have a partial or total meniscectomy, you can expect your recovery to take about a month. If your meniscus was repaired, it may take as long as 3 months.
What type of meniscus tear is the worst? Bucket-handle meniscus tears are the most serious type of meniscus injury. They often occur alongside a ligament injury. Bucket-handle tears require prompt surgery in order to have the best possible chance of recovery.
It has also been shown that a knee that has undergone meniscus surgery has weaker thigh muscles and poorer quality of cartilage 4 years after the surgery [3]. This is also thought to increase the risk of arthritis.
A cortisone shot can help decrease the inflammation and pain caused by a torn meniscus. A cortisone shot usually does not help in healing of the meniscus and, hence, does not improve any mechanical symptoms. If a meniscus is repairable, then a cortisone shot is not preferred as it may impair healing of the meniscus.
Since the meniscus helps protect the knee from wear and tear, surgeons try to repair the meniscus whenever possible. However, most meniscus tears are not considered repairable. The meniscus has a limited blood supply, and tears in areas of little or no blood flow have a high risk of not healing.
Arthroscopic meniscus repair is moderately painful. Because more soft tissue surgery is performed, it is more painful than a standard arthroscopy, but less painful than a ligament reconstruction or another procedure that requires drilling holes through the bone.
Operative management. Currently, there are three main methods for the surgical management of meniscus tears: meniscectomy, meniscal repair, and meniscal reconstruction.
Thankfully, meniscal tears are usually not serious injuries, although they can seriously hurt! Sudden meniscal tears can occur when twisting on your knee or squatting deeply. The episodes of pain and swelling afterward should go away with time.
You can't walk right after surgery. How long recovery takes depends on the type of meniscus surgery and the severity of the injury, but expect two weeks down time, at minimum. The meniscus is a crescent-shaped pad of cartilage located in the knee that helps stabilize and cushion the joint.
Over 4-6 weeks, the pain and swelling may decrease and activities of daily living may become tolerable. However, athletic activities may reproduce pain and swelling. Sometimes even activities of daily living such as going up and down stairs or getting in and out of cars may produce pain in a knee with a torn meniscus.
Avoid positions and activities that place excessive pressure on knee until pain and swelling resolve. Problematic positions include squatting, pivoting, repetitive bending (eg, climbing stairs, rising from seated position, operating clutch and pedals), jogging, and swimming using the frog or whip kick.
Most meniscal tears improve with time and physiotherapy. Physiotherapy will include load modification e.g. reducing your running and walking and reduction or avoidance of the movements and activities that make your pain or swelling worse. This advice will also be accompanied with a comprehensive exercise programme.
Sleep on your back with the leg slightly elevated
This is especially important during the first few days after meniscus surgery. Keeping the leg elevated (but not bent!) encourages healthy circulation, which helps keep pain and swelling in check.
In most patients, meniscus tear repair is preferred over meniscus removal. That's because studies have shown when the meniscus is repaired and preserved, patients tend to experience better overall healing and better long-term joint function.
Meniscus tears, indicated by MRI, are classified in three grades. Grades 1 and 2 are not considered serious. They may not even be apparent with an arthroscopic examination. Grade 3 is a true meniscus tear and an arthroscope is close to 100 percent accurate in diagnosing this tear.