Arthroscopic meniscectomy is one of the most common orthopedic procedures performed worldwide to address painful meniscus tears in the knee. This minimally invasive surgery involves using a small camera (arthroscope) and specialized instruments to either trim or repair damaged meniscus tissue. Unlike open surgery, arthroscopy requires only tiny incisions, resulting in less pain, faster recovery, and minimal scarring.
The procedure is typically recommended when conservative treatments like rest, physical therapy, or medications fail to relieve symptoms. Meniscectomy aims to alleviate pain, improve knee function, and prevent further joint damage. While it's highly effective for certain types of tears, surgeons always consider preserving as much healthy meniscus as possible since this cartilage plays a crucial role in knee stability and shock absorption.
The meniscus is a C-shaped piece of tough, rubbery cartilage that acts as a shock absorber between your thigh bone (femur) and shin bone (tibia). Each knee has two menisci - the medial meniscus on the inner side and the lateral meniscus on the outer side. These crescent-shaped structures play several vital roles: distributing body weight across the knee joint, providing stability, reducing friction during movement, and protecting the articular cartilage from wear and tear.
Meniscal tears occur frequently in both athletes and older adults. Common types include: radial tears (across the meniscus), flap tears (irregular edges), bucket-handle tears (displaced inner portion), and degenerative tears (age-related wear). The location and pattern of the tear significantly influence whether repair or removal is possible. Understanding your specific tear type helps set realistic expectations for treatment outcomes.
Not all meniscus tears require surgery. Arthroscopic meniscectomy is typically recommended when: you experience persistent knee pain that limits daily activities, have mechanical symptoms like locking or catching of the knee, fail to improve with 6-12 weeks of conservative treatment, or have a tear pattern that won't heal on its own (such as complex or displaced tears).
Common symptoms that may indicate the need for surgery include: sharp pain when twisting or squatting, swelling that recurs after activity, stiffness making it hard to fully bend or straighten the knee, and a sensation of the knee "giving way." Your orthopedic surgeon will use MRI scans and physical exams (like McMurray's test) to determine if your specific tear would benefit from surgical intervention. Age, activity level, and overall knee health also factor into this decision.
Arthroscopic meniscectomy is typically an outpatient procedure performed under general or spinal anesthesia, lasting about 30-60 minutes. Here's what to expect: The surgeon makes 2-3 small incisions (about 1/4 inch each) around the knee. Through one incision, they insert the arthroscope - a pencil-sized camera that projects magnified images onto a monitor. Saline solution expands the joint space for better visualization.
Using specialized instruments inserted through the other portals, the surgeon carefully examines the entire knee joint, identifies the torn meniscus, and determines whether to trim the damaged portion (partial meniscectomy) or attempt repair. For trimming, small surgical shavers or scissors remove only the unstable fragments while preserving healthy tissue. The incisions are closed with stitches or steri-strips, and the knee is bandaged. Most patients go home the same day with crutches and a simple brace for comfort.
Recovery from arthroscopic meniscectomy varies by individual but generally follows this timeline: First 48 hours: Focus on pain management (ice and prescribed medications) and keeping the leg elevated to reduce swelling. You'll be weight-bearing as tolerated, often with crutches for 1-7 days. First 2 weeks: Light activities resume as pain allows. Physical therapy begins to restore range of motion and gentle strengthening.
Weeks 3-6: Most patients discontinue crutches and advance exercises to improve strength and proprioception. 6 weeks onward: Gradual return to sports and high-impact activities under guidance. While many feel significantly better within 2-4 weeks, full recovery may take 3-6 months for athletes. Adhering to your rehab program is crucial - studies show patients who complete prescribed physical therapy regain function faster with lower complication rates.
While arthroscopic meniscectomy is considered very safe (complication rates <5%), all surgeries carry some risk. Potential issues include: infection (signs are fever, increasing pain or redness), blood clots (more likely if immobile), persistent swelling or stiffness, nerve or blood vessel damage (rare), and incomplete pain relief if arthritis was also present. Some patients develop new tears later or experience accelerated joint degeneration years after meniscus removal.
You can minimize risks by: choosing an experienced surgeon, carefully following pre/post-op instructions, attending all physical therapy sessions, avoiding premature return to sports, and maintaining a healthy weight to reduce knee stress. Report any unusual symptoms immediately - early intervention prevents most complications from becoming serious. Smoking cessation before surgery also significantly improves healing.
Many meniscus tears - especially small, stable ones in the outer "red zone" (good blood supply) - may heal with conservative care. Common alternatives include: RICE protocol (Rest, Ice, Compression, Elevation), physical therapy to strengthen supporting muscles, cortisone injections to reduce inflammation, PRP (platelet-rich plasma) injections to stimulate healing, and activity modification to avoid aggravating movements.
Surgery is usually preferred when: the tear causes mechanical symptoms (locking), is large/unstable, is in the inner "white zone" (poor healing capacity), or when non-surgical options fail after 3 months. Younger patients with repairable tears may opt for meniscus repair instead of removal. Your doctor will recommend the best approach based on your tear type, age, activity goals, and overall joint health.
Arthroscopic meniscectomy boasts high success rates: 85-90% of patients report significant pain relief and functional improvement. Studies show 80% return to pre-injury activity levels within 3-6 months. However, outcomes depend on several factors: younger patients with acute traumatic tears generally do better than older adults with degenerative tears and existing arthritis.
Long-term, removing meniscus tissue increases future osteoarthritis risk since the joint loses some shock absorption. Preserving even partial meniscus helps - that's why surgeons remove only damaged tissue. Patients who maintain ideal body weight, follow a knee-friendly exercise regimen, and avoid high-impact activities when advised typically enjoy good joint function for decades. Regular follow-ups help monitor knee health over time.
How long does the surgery take?
The procedure itself typically takes 30-60 minutes, though you'll spend several hours at the surgical center for prep and recovery.
When can I drive after surgery?
Most patients resume driving 1-2 weeks post-op, once they can comfortably bear weight and control the vehicle. Always follow your surgeon's specific advice.
Will I need a knee brace afterward?
A simple brace may be provided for comfort, but prolonged bracing isn't usually necessary unless you had a complex tear or repair.
How soon can I return to work?
Desk jobs: often within a week. Physical jobs: 4-6 weeks. Your surgeon will tailor recommendations based on your recovery progress.
Can the meniscus grow back after removal?
No, the removed cartilage doesn't regenerate. However, the remaining meniscus adapts to compensate in most cases.