Meniscus Repair Surgery: A Complete Guide

Introduction to Meniscus Repair Surgery

Meniscus repair surgery is a common orthopedic procedure designed to fix a torn meniscus—a crucial cartilage in your knee that acts as a shock absorber. Whether you're an athlete or someone dealing with age-related wear and tear, a meniscus tear can cause significant pain and mobility issues. Surgery becomes necessary when conservative treatments like rest, ice, and physical therapy fail to provide relief.

This guide will walk you through everything you need to know—from symptoms and diagnosis to the surgery itself and recovery. Modern techniques, like arthroscopic surgery, have made meniscus repairs minimally invasive with faster recovery times. However, understanding the process can help ease anxiety and prepare you for a smoother journey back to full mobility.

Key Points:
  • Meniscus repair is often done arthroscopically (minimally invasive).
  • Surgery is recommended when non-surgical treatments don’t work.
  • Recovery time varies but usually takes 4-6 weeks for light activities.

What is a Meniscus and Why Does It Need Repair?

The meniscus is a C-shaped piece of cartilage in your knee that cushions the joint, distributes weight, and provides stability. Each knee has two menisci—the medial (inner) and lateral (outer). These structures are essential for smooth movement, but they’re also prone to tears due to sudden twists, deep squats, or degenerative changes over time.

When a meniscus is torn, it can cause pain, swelling, stiffness, and even locking of the knee. Not all tears require surgery—small ones may heal on their own—but larger or complex tears often need surgical intervention. Without repair, a damaged meniscus can lead to chronic pain, arthritis, and further joint deterioration.

Did You Know?
  • The meniscus has limited blood supply, so some tears heal poorly without surgery.
  • Athletes (e.g., soccer players, runners) are at higher risk for acute tears.
  • Degenerative tears are common in adults over 40 due to aging.

Symptoms Indicating the Need for Meniscus Repair

How do you know if your knee pain is a meniscus tear? Common symptoms include a sharp pain when twisting or rotating the knee, swelling, a "popping" sensation at the time of injury, and difficulty straightening the leg. Some people even feel their knee "giving way" or hear a clicking sound when walking.

If the tear is severe, you might experience locking—where the knee gets stuck in one position. This happens when a torn piece of meniscus flips into the joint, blocking movement. Chronic tears may cause persistent aching, especially after prolonged standing or climbing stairs. Ignoring these signs can worsen the damage, making early diagnosis crucial.

When to See a Doctor:
  • Persistent knee pain lasting more than a few days.
  • Inability to bear weight on the affected leg.
  • Swelling that doesn’t improve with rest and ice.

Diagnosis: How Doctors Identify a Torn Meniscus

Diagnosing a meniscus tear starts with a physical exam. Your doctor will check for tenderness, range of motion, and perform specific tests like the McMurray test (bending and rotating the knee to elicit pain). Imaging tests, such as an MRI, provide detailed visuals of soft tissues and confirm the tear’s location and severity.

X-rays, while not showing the meniscus itself, help rule out fractures or arthritis. In some cases, an arthroscopy—a tiny camera inserted into the knee—is used for both diagnosis and treatment. Early and accurate diagnosis ensures the right treatment plan, whether it’s physical therapy or surgery.

Diagnostic Tools:
  • MRI: Gold standard for soft-tissue injuries.
  • McMurray Test: Physical maneuver to detect tears.
  • Arthroscopy: Minimally invasive diagnostic surgery.

Types of Meniscus Repair Surgery (Arthroscopic vs. Open Surgery)

Most meniscus repairs today are performed arthroscopically—a minimally invasive technique where small incisions are made, and a camera-guided tool repairs the tear. This method reduces scarring, pain, and recovery time compared to traditional open surgery. The surgeon may stitch the torn edges together, remove damaged tissue (partial meniscectomy), or use anchors to reattach the meniscus.

Open surgery is rare but may be needed for complex tears or revisions. The choice depends on the tear’s type, location, and the patient’s age/activity level. For example, younger patients with acute tears are better candidates for repair, while older adults with degenerative tears might require removal.

Surgery Options:
  • Arthroscopic Repair: 90% of cases; faster recovery.
  • Partial Meniscectomy: Removal of torn fragment.
  • Open Surgery: Reserved for severe/complex tears.

Preparing for Meniscus Repair Surgery

Preparation starts with pre-operative tests (blood work, EKG) to ensure you’re fit for surgery. Your surgeon will advise stopping blood-thinning medications (e.g., aspirin) and fasting the night before. Arrange for someone to drive you home post-surgery, as you’ll be under anesthesia.

Pre-habilitation (pre-surgery physical therapy) can strengthen the knee and speed up recovery. Set up a recovery space at home with essentials (ice packs, pillows for elevation, crutches). Mental preparation is equally important—understanding the procedure reduces anxiety and sets realistic expectations.

Pre-Surgery Checklist:
  • Complete pre-op medical tests.
  • Stop NSAIDs/alcohol as advised.
  • Arrange post-surgery support (transport, help at home).

Step-by-Step Procedure of Meniscus Repair

On surgery day, you’ll receive anesthesia (local, spinal, or general). The surgeon makes 2-3 small incisions around the knee, inserts an arthroscope (camera), and examines the tear. Using specialized tools, they stitch the torn edges or trim unstable fragments. The incisions are closed with sutures or steri-strips, and a bandage is applied.

The entire procedure takes about 30-60 minutes. You’ll wake up in recovery with a brace or bandage and be monitored before discharge. Most patients go home the same day, with crutches to avoid weight-bearing initially.

During Surgery:
  • Small incisions (less than 1 cm each).
  • Tear is either stitched or trimmed.
  • No overnight stay typically required.

Recovery Process & Rehabilitation Tips

Recovery begins immediately with rest, ice, compression, and elevation (RICE). Crutches are used for 1-2 weeks to avoid pressure on the knee. Physical therapy starts within days to restore range of motion and strength. Full recovery takes 3-6 months, depending on the repair type.

Rehabilitation focuses on gradual progression—from gentle exercises (quad sets, heel slides) to resistance training and sports-specific drills. Adhering to your PT plan is critical to prevent re-injury. Most patients return to light activities in 4-6 weeks and sports by 3-4 months.

Recovery Timeline:
  • Week 1-2: Rest, ice, limited weight-bearing.
  • Week 3-6: PT begins; regain flexibility.
  • Month 3+: Strength training; return to sports.

Risks and Complications of Meniscus Surgery

While meniscus repair is generally safe, risks include infection, blood clots, nerve damage, or incomplete healing. Some patients experience stiffness or persistent pain, especially if the meniscus doesn’t heal properly. In rare cases, a second surgery is needed.

Choosing an experienced surgeon minimizes complications. Follow post-op instructions meticulously—avoiding premature weight-bearing or skipping PT reduces risks. Long-term, a successfully repaired meniscus protects against arthritis, while removal increases joint stress over time.

Possible Complications:
  • Infection (rare; treated with antibiotics).
  • Blood clots (prevented with movement/medication).
  • Re-tear (higher risk if returning to sports too soon).

Final Thoughts

Meniscus repair surgery can restore knee function and quality of life when done correctly. By understanding the process—from diagnosis to rehab—you’ll be better prepared for a successful outcome. Always consult a trusted orthopedic surgeon to explore your options.

Have questions? Share them in the comments below!