• Introduction
  • Meniscus Surgery

    Types of Surgery

    Described below are three types of surgery for torn meniscus, although the third (complete meniscectomy) is avoided if possible.  One (partial meniscectomy) accounts for the vast majority of surgeries. Today, almost all meniscus surgery is done arthroscopically. In arthroscopic surgery, small incisions are made and a flexible tube with a miniature camera and light source attached is inserted. The procedure is guided by images from the camera. Tiny instruments are placed at the tip of the tube to perform the surgical procedure.

    Partial Meniscectomy (removal of torn meniscus tissue)

    Knee Injury - torn meniscus with arthroscopic repairIf you are facing potential surgery for a knee meniscus tear, it’s very likely that you are considering a procedure called partial meniscectomy. Since the meniscus serves an important function in the knee, it is best to save as much of the meniscus as possible. A partial meniscectomy involves the removal of the torn piece of the meniscus only – the undamaged portion of the meniscus remains in place. This procedure is typically performed arthroscopically.  A small shaver is used to remove the torn part of the meniscus.  This is different than a surgery for meniscus repair.  Meniscus repair involves suturing together the torn portions of the meniscus and allowing the meniscus to heal. Note: on the meniscus tear images, you will see the terms medial and lateral. “Medial” refers to the portion of the knee toward the midline of the body, the inside portion of the knee between the legs. “Lateral” refers to the outside portion of the knee, away from the midline of the body.
    (see patient feedback after meniscus surgery from highly satisfied patients, partly satisfied patients, dissatisfied patients)

    Meniscus Repair (repairing torn meniscus tissue when it can heal)

    Meniscus repair is far less common than partial meniscectomy because a repair can only be done if the tear is in the area of the meniscus that has a blood supply (the outer edge or “red zone”). Other factors can also limit the success of this procedure. For example, complex tears or tears in cartilage that is very worn or thin are less likely to respond well. In a repair procedure, the surgeon will use either sutures or small bio-absorbable tacks to bring the pieces of meniscus back together
    (see surgeon opinions on expected use of  meniscus repair)

    Which is the More Common Meniscus Surgery?

    diagram of meniscus repairBecause of the important limitations of repair and other factors such as the longer time to recover, partial meniscectomy is quite common while meniscus repair is not. The vast majority of meniscal tear surgical procedures involve partial meniscectomy. Of the more than 850,000 annual meniscus surgeries in the US, historically only about 7% of these have been repaired annually2.

    Complete meniscectomy is the complete removal of the meniscus. In the past, this used to be a common procedure; but today it is avoided, if possible. The absence of the meniscus often leads to bone-on-bone friction, resulting in arthritis.  Some physicians believe there is an open issue about whether partial meniscectomy causes or accelerates arthritis
    (see surgeon opinions on whether partial meniscectomy causes or accelerates arthritis)