is a meniscus injury treated?
When determining the treatment for a meniscal tear, the orthopaedic surgeon
will consider the following factors:
patient's activity level
location of the tear and the type of tear
the injury happened
Any other associated injuries
After considering these factors the doctor
will choose to treat the injury non-operatively or surgically.
Many small meniscal tears will heal without surgical treatment. Also,
some tears may have no symptoms and in other tears, symptoms may eventually
disappear. Partial tears, degenerative tears, and stable tears may
be observed for 2 - 3 months. If symptoms disappear, no surgery is
needed. The use of a knee brace and restriction of activities
may be recommended to prevent further injury.
Surgical treatment for a meniscal tear may be indicated if:
symptoms are disabling or last for
more than 2 - 3 months.
a displaced tear causes the joint
the anterior cruciate ligament is
also injured - In this case, the knee is highly unstable and excessive
motion exists within the joint. The meniscus is unlikely to heal without
the patient is a high-level athlete.
surgery is recommended, the procedure chosen is usually dependent
on the location and type of meniscal tear. All procedures are performed
through an arthroscope and usually don't require an overnight hospital
Trephination/ Abrasion Technique
Trephination/ Abrasion Technique
procedure is used for stable tears located on the periphery near
the meniscus and joint capsule junction, where there'sa good
blood supply. Multiple holes or shavings are made in the torn
part of the meniscus to promote bleeding, which enhances the healing process.
This surgical procedure is used for tears located in the inner 2/3
of the meniscus where there is no blood supply. The goal is to
stabilize the rim of the meniscus by removing as little of the inner meniscus
as possible. Only the torn part of the meniscus is removed. If the meniscus
remains mostly intact with only the inner portion removed, the patient
usually does well and does not develop early arthritis.
procedure involves the complete removal of the damaged meniscus.
This technique is only performed if absolutely necessary. Removal of the
entire meniscus frequently leads to the development of arthritis.
Repairs are performed on tears near the outer 1/3 of the meniscus where
a good blood supply exists, or on large tears that would require a
near-total resection. The torn portion of the meniscus is repaired by
using either sutures or absorbable
fixation devices. These devices include arrows, barbs, staples,
or tacks that join the torn edges of the meniscus so they can heal.
Experimental attempts to replace damaged meniscus are seen as important
recent advances in orthopaedic medicine. The new technology mentioned
here has been performed at a few surgical centers across the country on
a small number of patients.
Collagen meniscus implant -
This is a scaffold of collagen inserted into the patient's knee. Over
time, a new meniscus may grow within the joint. This procedure is
currently in FDA trials in the United States and has just been approved
as an accepted surgical procedure in Europe.
Meniscal transplant - This
procedure involves transplanting a meniscus from a donor into the
injured knee. Only a limited number of surgeons perform this procedure
on a routine basis. The long-term outcomes are still being evaluated.