Meniscus Surgery

How meniscus surgery works

The operation is almost always done arthroscopically. Small incisions are made at the front of the knee, a camera is placed inside the joint, and fine instruments are introduced through a second portal. The surgeon inspects the whole joint, including both menisci, the cartilage surfaces and the cruciate ligaments, then decides what the tear requires. That decision is often made in the operating room, because a tear can look different on MRI than under direct vision.

Two main things can be done with a torn meniscus. It can be repaired, using sutures passed across the tear to hold the edges together so they may knit, or the torn portion can be trimmed away, which is called a partial meniscectomy. Repair preserves tissue and is favored where the tear pattern and location allow it, but it depends on blood supply and asks more of the recovery. Trimming removes the unstable fragment catching in the joint but takes away tissue that cannot be replaced. Where a meniscus has largely been removed already and a young patient has ongoing symptoms, transplantation using donor tissue may be discussed.

Reasons people are referred for surgery

• A knee that locks, catches, or will not fully straighten
• Persistent joint line pain that has not settled with therapy and activity change
• A tear in a younger patient with a pattern that looks repairable
• A meniscus tear alongside an ACL injury being reconstructed
• A large displaced fragment seen on imaging or suspected on examination

How candidacy is evaluated

Not every tear seen on MRI benefits from an operation, so the assessment weighs several things: your age and activity, how the knee behaves, whether symptoms are mechanical or more diffuse, the pattern and position of the tear, and how much arthritis is present in the same compartment. A degenerative tear in an arthritic knee is a different situation from a traumatic tear in an otherwise healthy joint. Standing x-rays help assess the cartilage, and examination establishes whether the tear explains the symptoms. Where repair is being considered, the location of the tear relative to the vascular outer rim is central.

Options in general terms

Before surgery, non-surgical measures are usually explored:

• Physical therapy. Restoring motion and building strength that unloads the knee.
• Activity change and injections. Reducing provocative loading, with injection categories that may suit an irritable joint.

If surgery is chosen, the procedures that may be discussed include:

• Meniscus repair. Suturing the tear to preserve tissue, with a protected recovery that limits deep bending and loading while it heals.
• Partial meniscectomy. Trimming the unstable torn portion back to a stable rim.
• Combined procedures. Meniscus work done alongside ligament reconstruction or cartilage treatment.
• Meniscus transplantation. Replacing a meniscus largely lost, considered only in selected patients.

What to expect when you consult Dr. Wolfson

Dr. Wolfson is board certified in the United States and Canada and is experienced in arthroscopic and minimally invasive techniques. A consultation covers whether an operation is likely to help your knee, which procedure is anticipated and why the plan may change once the joint is inspected, and what rehabilitation will be needed. He places considerable weight on post-operative physical therapy, and that commitment is part of the conversation before surgery is scheduled.

This page provides general information about meniscus surgery and is not medical advice. It is not a substitute for examination, imaging and diagnosis by a qualified physician. Every case is different and requires individual evaluation. If you have severe pain, an obvious deformity, loss of function, fever, or an injury from a significant accident, seek medical care promptly.

Contact Dr. Wolfson if you would like to setup an appointment. If you are a new patient, please book all in-person appointments with Dr. Wolfson via telephone.

If you live outside of the San Francisco Bay Area, you can request a complimentary phone consultation with Dr. Wolfson to assess your case. Please call or e-mail us to set up your complimentary consultation.

Call: (415) 221-4400

E-mail: [email protected]