The meniscus is a soft, tough structure inside the knee that acts as a cushion between the thigh bone (femur) and shin bone (tibia). It helps absorb shock, spread the load across the knee and support normal knee movement.

A torn meniscus does not always need surgery. When surgery is required, the two main options are meniscus repair and partial meniscectomy, where only the damaged part of the meniscus is removed.

The choice depends on the type of tear, where it is located, how old the tear is, the condition of the meniscus and the patient's symptoms.

The aim is to save the meniscus when it has a good chance of healing after repair. However, trying to repair a tear that is unlikely to heal may lead to a long recovery without a reliable result. In these situations, removing the damaged and unstable part may be a better option.

When is meniscus repair considered?

No.

Some meniscus tears have a good chance of healing after repair, while others do not.

Repair is more likely to work when:

• The tear is in an area with a good blood supply

• The torn edges are healthy enough to hold stitches

• The tear is not too old

• The torn part can be brought back into its normal position

• The type of tear is suitable for repair

Some tears are less suitable for repair, including long-standing tears, many tears in the inner part of the meniscus where blood supply is poor, certain radial tears and tears where the meniscus has become badly damaged or worn.

The final decision is sometimes made during the operation after directly examining the meniscus.

When is meniscus repair done?

Meniscus repair means putting stitches into the torn meniscus to hold it together while it heals.

Repair is considered when the meniscus has a reasonable chance of healing and preserving it is likely to provide a useful long-term benefit.

The advantage of repair is that the patient's own meniscus is kept rather than removing the torn portion.

However, repair is not suitable for every tear. A repair that is unlikely to heal can mean a longer recovery without providing a lasting benefit.

What is partial meniscectomy?

Partial meniscectomy means removing only the damaged and unstable part of the meniscus.

The healthy part of the meniscus is left in place.

This may be recommended when the tear cannot be repaired reliably, for example when the torn tissue is badly damaged, the tear is long-standing, or the area has very little blood supply.

The aim is to remove the part that is causing problems while keeping as much healthy meniscus as possible.

Why isn't every torn meniscus repaired?

A meniscus needs a good blood supply and healthy tissue to heal after it is repaired.

Some tears are in areas where there is very little blood supply. Other tears may be old, badly damaged or have a shape that makes reliable healing unlikely.

Trying to stitch such a tear may mean several months of restricted activity without a good chance of success.

In these situations, carefully removing the damaged part may give a more predictable recovery.

Does an MRI tell me whether I need surgery?

Not by itself.

An MRI can show where the meniscus is torn and what the tear looks like, but the scan is only one part of the decision.

Your symptoms, examination, age, activity level, how long the problem has been present and the overall condition of your knee are also important.

Sometimes the final decision between repair and partial meniscectomy can only be made after looking directly at the meniscus during arthroscopy.

What happens during arthroscopic meniscus surgery?

The operation is performed through small openings around the knee.

A small camera is placed inside the knee so that the surgeon can see the meniscus and other structures clearly.

The torn meniscus is then examined carefully.

If the tear is suitable for repair, it is stitched back together using special sutures.

If the tear is unlikely to heal or cannot be repaired reliably, the damaged and unstable portion is removed while keeping the healthy part of the meniscus.

Which is better: meniscus repair or partial meniscectomy?

Neither operation is better for every patient.

Meniscus repair is preferred when the tear has a good chance of healing. It keeps the patient's own meniscus but requires a longer and more protected recovery.

Partial meniscectomy is used when the damaged part cannot be expected to heal reliably. Recovery is usually faster because there is no repaired tissue that needs to heal.

The aim is not simply to repair every tear or remove every torn portion. The aim is to choose the treatment that gives the knee the best chance of a good and lasting result.

How long does recovery take?

Recovery depends mainly on which procedure is performed.

After partial meniscectomy, many patients can walk soon after surgery and return to normal daily activities relatively quickly.

After meniscus repair, recovery takes longer because the repaired meniscus needs time to heal. Walking, bending the knee and higher-impact activities may need to be increased gradually.

Your exact rehabilitation programme will depend on the type of tear and the procedure performed.

When can I return to sports?

Many patients can return to sports after meniscus surgery.

After partial meniscectomy, return to sports is generally quicker.

After meniscus repair, return takes longer because the repair needs time to heal.

Before returning to running, jumping or sports involving sudden changes of direction, the knee should have regained good movement, strength and control.

What are the risks of meniscus surgery?

Arthroscopic meniscus surgery is commonly performed, and serious complications are uncommon.

Possible problems include infection, bleeding, blood clots, stiffness, continued pain or swelling, or symptoms returning.

After a meniscus repair, the tear may sometimes fail to heal and further treatment may be needed.

After partial meniscectomy, removing a large amount of meniscus can increase stress on the knee. This is why the surgeon removes only the damaged part that needs to be removed and preserves healthy meniscal tissue whenever reasonably possible.

Frequently Asked Questions

Does every meniscus tear need surgery?

No. Many meniscus tears can be treated without surgery. Surgery may be considered when symptoms continue despite appropriate treatment or when the tear causes significant problems such as persistent catching or locking.

Can every meniscus tear be repaired?

No. Some tears have a good chance of healing after repair, while others do not. Long-standing tears, tears in areas with very little blood supply, certain radial tears and badly damaged tears may be better treated by removing the damaged portion.

Is meniscus repair always better than removing the torn part?

No. Repair is useful when the tear has a good chance of healing. If a tear is unlikely to heal, partial meniscectomy may provide a more predictable recovery.

How long does it take to recover?

Recovery is usually faster after partial meniscectomy. Meniscus repair takes longer because the repaired meniscus needs time to heal.

Can I return to sports after meniscus surgery?

Yes. Many patients return to sports after appropriate treatment and rehabilitation. The timing depends on the type of surgery and recovery of knee movement, strength and function.