Can a meniscus heal?
Small tears in the meniscus that are not dislodged may heal, or may eventually
be symptom-free. Larger tears that displace, and tears associated with
instability, are less likely to heal. Tears in the outer 1/3 of the meniscus
are more likely to heal than tears toward the inside of the meniscus because
the blood supply is better in the outer region.
When does a meniscal tear need surgery?
A meniscal tear needs surgery when: 1) the tear causes symptoms such as
pain, swelling, catching, or locking, 2) a displaced portion of the meniscus
is causing the knee to lock, or 3) the tear is associated with knee instability.
Is an MRI needed to diagnose a meniscal tear?
An MRI is not always required to diagnose a meniscal tear. A meniscal
tear can be accurately diagnosed with a doctor's physical examination.
However, an MRI can be useful to determine the extent of the injury, the
displacement of a tear, and help determine if there are any other associated
injuries.
How does the doctor decide between repairing the tear vs. removing
the torn piece of meniscus?
The final decision is made during an arthroscopy when the surgeon gets
a close look and probes the tear. Tears in the outer third of the meniscus
are often repaired. This region has a better blood supply for healing.
Also, the outer portion of the meniscus is thicker and resection of these
tears will leave little meniscus remaining. Tears in the inner two-thirds
of the meniscus often require that the torn portion be removed because
the poor blood supply to this region limits healing. Also, the inner portion
of the meniscus is the thinnest section so removing a torn piece here
requires a minimal loss of tissue.
Why doesn't the surgeon just take out the entire damaged meniscus?
The meniscus has an important function inside the knee as a shock absorber
that helps distribute the load of the body. If the entire meniscus is
removed, the rest of the joint gets overloaded and the knee is susceptible
to arthritis. This is why the surgeon will save as much of the meniscus
as possible.
How is a meniscal tear fixed?
There are many techniques and instruments available to repair a torn meniscus.
Meniscal tears may be repaired using sutures or devices (such as arrows,
tacks, and screws) that the body absorbs after the meniscus has healed.
When can I play sports again after meniscal surgery?
This will depend on the type and location of tear, the size of the tear,
and whether the meniscus was surgically repaired or partially removed.
In general, rehabilitation is faster after a partial removal than after
a repair. Patients can often return to sports three months after meniscal
surgery.
References
