If the meniscus is so badly damaged that it cannot be repaired, it may need to be removed or trimmed out. This is called a partial meniscectomy and is often effective in relieving the pain of a meniscus tear. When the meniscus is largely gone, however, persistent knee pain and or osteoarthritis can develop.
Without a meniscus, you might gradually develop knee pain and arthritis of your joint. Replacing your meniscus may provide significant pain relief. It may also help prevent arthritis in your joint. This can develop when your cartilage becomes frayed and rough.
If not treated, part of the meniscus may come loose and slip into the joint. You may need surgery to restore full knee function. Untreated meniscus tears can increase in size and lead to complications, such as arthritis.
Following a failed meniscal repair your doctor will recommend conservative therapy with pain medication and activity modification if the symptoms are minimal. If a residual tear is diagnosed, the meniscus may be trimmed before considering a second surgical repair 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.
Symptoms may go away but can come back from overuse or when you do activities that involve twisting. The pain may come and go over a period of years if the tear isn't treated. Larger tears usually cause more pain and immediate swelling and stiffness. Pieces of the torn meniscus can float into the joint space.
In general, it's better to fix the meniscus than to remove it. Some types of tears can't be fixed. For example, radial tears sometimes can be fixed, but it depends on where they are. But most horizontal, long-standing, and degenerative tears—those caused by years of wear and tear—can't be fixed.
The injury won't heal on its own, which means it may continue getting worse without proper care. For example, a partial tear may continue to worsen until it's a complete tear. Continuing to walk on the affected leg can aggravate your symptoms, making pain and stiffness worse in as little as a few days.
So unfortunately, having a meniscal tear which requires surgery may raise your risk of getting arthritis later in life. 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].
The vascular portion is called the “red zone” due to the presence of capillaries in the meniscal tissue. The avascular portion is called the “white zone” due to its absence of blood supply. Red zone tears have the potential to heal and white zone tears will likely never heal.
Ordinarily, your doctor or physical therapist will ask you to reduce your sports activities while your meniscus tear heals. Healing could take between four and eight weeks. However, the time depends on the severity and position of the tear.
It's sometimes possible to repair a torn meniscus, especially in children and younger adults. If the tear can't be repaired, the meniscus might be surgically trimmed, possibly through tiny incisions using an arthroscope. After surgery, you will need to do exercises to increase and maintain knee strength and stability.
Your doctor may recommend the RICE regimen—rest, ice, compression, and elevation—to treat a meniscus tear. Resting your knee can help relieve your symptoms. Your doctor may suggest using a cane for a few weeks to keep weight off your knee and to stay away from physical activity that may have contributed to the injury.
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.
In general, about 20% to 25% of meniscus transplants will have a tear of the transplant tissue in the first 5 years. This incidence will increase over time with most patients getting 12 to 15 years of good function after a meniscus transplant.
Complications. A torn meniscus can lead to a feeling of your knee giving way, inability to move your knee as you usually do or persistent knee pain. You might be more likely to develop osteoarthritis in the injured knee.
A meniscal transplant replaces the damaged meniscus with donor tissue matched for size. Meniscal transplants are not right for everyone. If you already have arthritis in your knee, a meniscal transplant may not help you. For a select group of people, however, meniscal transplants can offer significant pain relief.
It may take as long as 6 months before your knee is strong enough for hard physical work or certain sports. You will need to build your strength and the motion of your joint with rehabilitation (rehab) exercises. In time, your knee will likely be stronger and more stable than it was before the surgery.
A tear is usually labeled as severe if the meniscus has a big tear. Loose pieces may cause the knee joint to lock or catch. This level of injury may also keep you from bending or straightening your leg and can make walking difficult. Severe tears usually require surgery to repair.
The patient should avoid pivoting and squatting and should work on keeping the quadriceps muscles strong. If the swelling and pain have not resolved in 6 weeks, they usually won't without surgical intervention.
Sleeping positions
This is especially true if you're a stomach or side sleeper, and you can't lay in your regular position due to the location of the incisions on your knee. Generally, learning how to sleep after meniscus surgery means sleeping on your back with your leg slightly elevated.
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.
Those in severe pain and for whom basic treatments don't work may be candidates for meniscus surgery. The best way to ensure that this is the right course to take is by receiving an MRI. A physician may also look at the tear with an arthroscope, a thin tool with a camera and a light at the end.
A meniscus surgery can fail for a number of reasons, including infection, a re-tear of the meniscus, a failed original repair or from a patient not following proper rehabilitation guidelines after the initial surgery.