The meniscus is a C-shaped cartilage structure in the knee that provides cushioning, load distribution, and joint stability. A torn meniscus can cause pain, swelling, and mechanical symptoms such as locking or catching. Whenever possible, meniscus repair is preferred over meniscectomy (removal of the torn portion), as preserving the meniscus helps maintain long-term knee function and reduces the risk of arthritis.

Factors Influencing Meniscus Healing

Meniscus repair has a failure rate of approximately 20-25%, with success depending on several key factors:

Location of the tear: Tears in the outer third (red-red zone) have the best healing potential due to the rich blood supply, while tears in the inner third (white-white zone) are less likely to heal.
Tear pattern: Longitudinal, vertical, and peripheral tears respond better to repair, whereas complex or degenerative tears may not be ideal candidates.
Patient factors: Younger patients and those with good tissue quality tend to have better outcomes.

The Shift Toward Meniscus Preservation

The trend in orthopedic surgery has been to aggressively repair the meniscus whenever possible, rather than performing partial meniscectomy. Preserving meniscal tissue reduces the risk of long-term joint degeneration and improves knee biomechanics. However, if a meniscus repair fails, the next surgical option is typically a partial meniscectomy to remove the damaged tissue while preserving as much of the meniscus as possible.

The Procedure

Meniscus repair is performed arthroscopically using small incisions. The torn meniscus is sutured together using techniques such as all-inside, inside-out, or outside-in suturing methods. In some cases, biologic augmentation is used to improve healing potential.

Biologic Augmentations to Enhance Healing

Platelet-Rich Plasma (PRP): Contains growth factors that may enhance tissue healing.
Bone Marrow Aspirate Concentrate (BMAC): A source of stem cells that may improve meniscus repair outcomes.
Fibrin clot techniques: Used to encourage vascular ingrowth in poorly perfused areas.

Recovery Process

Initial Phase (0-6 Weeks): Patients are often non-weight-bearing or limited-weight-bearing with a brace to protect the repair.
Intermediate Phase (6-12 Weeks): Gradual range of motion and strengthening exercises begin.
Advanced Phase (3-6 Months): Progressive return to activity, with full return to sports typically around 6-9 months.

Risks and Considerations

Failure rate of 20-25%, which may require revision surgery or partial meniscectomy.
Stiffness or loss of motion if post-operative rehabilitation is not followed correctly.
Ongoing research into biologic augmentation to improve healing rates.

Conclusion

Meniscus repair is an important procedure aimed at preserving knee function and preventing long-term degeneration. If you have a meniscus tear and are considering treatment options, contact our office for a comprehensive evaluation and personalized care plan.

Meniscus Repair

Procedures