Treatment of Meniscus Repair
Cartilage lacks a supply of blood or lymph vessels, which normally nourish other parts of the body. Without a direct supply of nourishment, cartilage is not able to heal itself if it gets injured.
In regards to the meniscus, the outer edge has ample blood supply. This means a tear in that area could repair itself. The inner portion of the meniscus, however, lacks blood supply, meaning it is unlikely the meniscus will heal on its own. Because of this, it is a good idea to see an orthopedic specialist right away, even if your knee injury doesn’t feel all that bad.
Your orthopedic surgeon treats will assess your tear including its size, and location, to determine the best treatment options for you. Your age, activity level, and other related injuries will also factor into your treatment plan.
Nonsurgical Meniscus Treatment
Initially, your doctor will most likely treat the torn meniscus by focusing on decreasing pain and swelling in the knee. If your tear is small and on the outer edge of the meniscus, where there is ample blood supply, your doctor may recommend waiting to see if the meniscus will heal on its own before recommending surgery.
Your orthopedic doctor may suggest the RICE protocol, which stands for:
- Relative Rest. Taking a break from the activity that caused the injury. This may also include the use of crutches until you can walk without a limp.
- Ice. Using cold packs for 20-minute intervals, several times a day.
- Compression. Wearing a compression band to help prevent swelling and blood loss.
- Elevation. Reclining when you rest, ensuring that your leg is higher than your heart. This helps reduce swelling.
Anti-inflammatory medications can also be recommended to help decrease these symptoms starting with over-the-counter medicines like ibuprofen. Some patients may also receive physical therapy treatments for meniscus problems. As long as your symptoms do not persist and your knee is stable, nonsurgical treatment may be all you need.
Surgical Meniscus Repair
If pain continues despite non-surgical treatment, meniscus surgery may be recommended. Left untreated, a damaged meniscus can lead to other knee problems. Loose meniscus cartilage may move around inside your joint, causing symptoms such as locking of the knee, the inability to straighten the knee out, popping or clicking when moving the knee, and knee instability. In situations like these, your surgeon will want to remove the torn part that is getting caught in the knee joint as soon as reasonably possible.
But even a less severely torn meniscus may not heal on its own. In cases such as these, surgery may be the best option.
Today, most meniscus repairs are done arthroscopically, with a camera and small instruments that are inserted through tiny incisions, called portals, on each side of the knee below the patella. For some tear locations, additional portals may also be created.
Surgical treatment of a torn meniscus can include:
- Partial meniscectomy, where the damaged portion of the meniscus is removed.
- Meniscus repair, where the surgeon uses sutures to sew the torn edges of the meniscus together.
If the meniscus cannot be repaired or has been previously removed, a meniscus transplant may be performed to help slow the onset of knee arthritis. Meniscal transplantation uses borrowed tissue to take the place of the original meniscus. Experiments have been tried using various replacement materials. One material that is showing promise is an allograft. An allograft is tissue that is from a donor, usually preserved human meniscus tissue. Because it is so new, this type of surgery is currently only available for select patients in a limited number of locations.
Meniscus repair surgery is usually done on an outpatient basis. Patients usually go home the same day as surgery. The portals are covered with surgical strips, and the knee may be wrapped in an elastic bandage.
To learn more about meniscus surgery, download our educational document A Patient’s Guide to Meniscal Surgery.
Rehabilitation for Torn Knee Cartilage
Nonsurgical rehabilitation for a meniscus injury is an option for some patients. It typically lasts six to eight weeks.
There is typically a process for physical therapy that builds up your range of motion and strength to get you back to your regular activities. Each physical therapy plan is customized for the patient. The general process that is followed includes:
- Exercises that will improve your range of motion, like flexing and extending your knee as much as you can without pain.
- Stretching your leg muscles.
- Basic exercises that will help strengthen your quadriceps and hips.
- As you progress, your physical therapist may add more advanced exercises, like toe raises with weights, squats, and harder stretches to be sure you are regaining the most strength and range of motion possible.
Your physical therapist may give you some exercises to do at home while working on other exercises together during a session to be sure you’re progressing and using good form.
If your orthopedic specialist prescribes a brace, the physical therapist will work with you to explain how to use the brace.
You can return to your sporting activities when:
- Your quadriceps and hamstring muscles are back to nearly their full strength and control
- You are not having swelling of the knee that comes and goes
- You aren't having problems with the knee giving way
Rehabilitation After Meniscus Repair Surgery
Rehabilitation proceeds cautiously after surgery on the meniscus, and treatments will vary depending on whether you had part of the meniscus taken out or your orthopedic surgeon repaired or replaced the meniscus.
Patients are strongly advised to follow the recommendations about how much weight you can place on your leg and how long you can stand or walk following surgery.
After a partial meniscectomy, your surgeon may instruct you to place a comfortable amount of weight on your operated leg using a walking aid. After a meniscal repair, however, patients may be instructed to keep their knee straight in a locked knee brace and to put only minimal or no weight on their foot when standing or walking for up to six weeks.
At first, expect to see the physical therapist two to three times a week. If your surgery and rehabilitation go as planned, you may only need to do a home program and see your therapist every few weeks over a six-to-eight-week period.
You can learn more about meniscal knee injuries by downloading our educational document A Patient’s Guide to Meniscal Injuries.