Meniscal Repair
Background
The menisci are two C-shaped pieces of cartilage that act as shock absorbers between the thighbone and shinbone. They help distribute weight across the knee and contribute to stability. When a torn meniscus has the potential to heal, meniscal repair uses sutures to preserve the tissue rather than remove it.
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Not every tear is repairable. The location and pattern of the tear, tissue quality, blood supply, and condition of the rest of the knee all influence treatment.Â
The Surgical Procedure
Meniscal repair is usually performed arthroscopically using a camera and small instruments inserted through incisions around the knee. The tear is examined to determine whether the meniscus can be preserved and which repair technique will provide a secure fixation.
Meniscal Repair
For a repairable tear, sutures are placed across the damaged portion of the meniscus to hold it together while it heals. Depending on the tear, additional small incisions may be needed to safely place the sutures. If part of the meniscus cannot be repaired, a limited amount of damaged tissue may need to be removed.
Meniscal Root Repair
The meniscal root anchors the meniscus to the shinbone. When this attachment tears, the meniscus may no longer distribute pressure across the knee effectively. During a root repair, sutures are placed in the torn root and secured back to its attachment site on the bone, commonly through a small bone tunnel. Root repairs generally require about six weeks of protected weight bearing to allow the attachment to heal.
Meniscal Transplantation
For selected patients who have previously lost most of a meniscus and continue to have pain, a meniscal allograft transplant may be an option. This procedure places a size-matched donor meniscus into the knee. It is considered separately from repair and is generally best suited to patients without advanced arthritis. Knee alignment, stability, and cartilage health also affect whether transplantation is appropriate.
Recovery Timeline
Your recovery plan depends on the type of tear and repair, whether other procedures were performed, and how the meniscus is healing.
Early Recovery (Weeks 1 - 6)
The priority is to protect the repair while controlling swelling and restoring safe knee motion.
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A brace and crutches may be used to protect the knee.
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Weight bearing and bending restrictions depend on the repair.
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Root repairs typically require stricter protection, often including no weight bearing for approximately six weeks.
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Physical therapy focuses on motion within the allowed limits and maintaining quadriceps strength.
Intermediate Recovery (Weeks 6 - 12)
Weight bearing and motion progress as permitted. Physical therapy focuses on restoring a normal walking pattern, improving strength, and building balance and control.
Late Recovery (Months 3 - 6)
Strengthening becomes more demanding. Running and impact activity are introduced only when the knee meets the appropriate milestones. Deep squatting, twisting, and heavy loading may remain restricted, particularly after a root or complex tear repair.
Return to Sport (Months 6 - 9 and Beyond)
Return to sport is based on healing, strength, knee control, and the demands of the activity. Root and other complex repairs may require a longer progression. If a meniscal transplant is performed, it follows its own rehabilitation plan.
What to Expect
A Longer Recovery Than Meniscus Trimming
Repairing the meniscus gives the tissue an opportunity to heal, but it requires more protection than removing a torn fragment. Feeling better in the first few weeks does not mean the repair is ready for twisting, squatting, or sports. Please pay attention to your weight-bearing and range of motion restrictions throughout your recovery.
Swelling and Stiffness
Some swelling and stiffness are expected after surgery. Rest, ice, and physical therapy help restore motion. Increasing swelling after an activity may be a sign that the knee needs more time before progressing.