Surgery can help return your knee to normal. Compare your options. Compare Option 1 Have surgery for a torn meniscus Don't have surgery. Compare Option 2 Have surgery for a torn meniscus Don't have surgery. Have surgery for a torn meniscus Have surgery for a torn meniscus You have surgery to fix or remove the meniscus. In most cases, you will go home on the same day as the surgery. Either type of surgery is followed by rehabilitation that includes rest, walking, and doing exercises until you have full range of motion without pain.
After surgery to fix your meniscus, you must limit movement for up to 2 weeks. It may take weeks or months before you can go back to your daily activities after surgery. That means that of people who have this surgery, 85 have relief from pain and can use their knee normally, while 15 do not.
Out of people who had surgery to remove part of the meniscus, 78 to 88 had relief from pain and knee problems. You may still have pain and joint stiffness after surgery. Surgery has risks, such as: Infection.
Damage to nerves or blood vessels around the knee. Blood clots in the leg. Damage to the joint. Risks from anesthesia. Your age and your health can also affect your risk. Don't have surgery Don't have surgery You try rest, ice, compression, and elevation. You try over-the-counter medicine such as ibuprofen or naproxen to help with pain and swelling.
You may do exercises to build up your thigh muscles quadriceps and hamstrings and increase your flexibility. You may be able to relieve pain and return your knee to normal. You avoid surgery that you may not need if the tear heals on its own. You avoid the risks of surgery. You can still have surgery later if your symptoms don't get better. Your tear may not heal on its own, so you may still need surgery. You may still have pain, or your pain may get worse.
You may not have full use of your knee. Personal stories about meniscus tear surgery These stories are based on information gathered from health professionals and consumers. What matters most to you? Reasons to have surgery Reasons not to have surgery. I want to do whatever I can to fix my knee. My pain isn't too bad. I think surgery may help me avoid long-term joint problems. I don't want to have surgery for any reason. I accept the risks of surgery.
I feel that surgery is too risky for me. My other important reasons: My other important reasons:. Where are you leaning now? Having surgery NOT having surgery. What else do you need to make your decision? Check the facts. True You're right. Your treatment for a torn meniscus will depend on where the tear is located, the pattern of the tear, and how big it is. Your age, health, and activity level can also affect your treatment options. False Sorry, that's not right.
I'm not sure It may help to go back and read "Get the Facts. Most of the time, horizontal tears and tears caused by years of wear and tear can't be fixed. Surgery may be able to prevent long-term joint problems, such as osteoarthritis. Decide what's next. Yes No. I'm ready to take action.
I want to discuss the options with others. I want to learn more about my options. Your Summary. Your decision Next steps. Your knowledge of the facts Key concepts that you understood. Key concepts that may need review.
Getting ready to act Patient choices. What matters to you. Print Summary. Credits and References Credits. Controversial role of arthroscopic meniscectomy of the knee: A review. World Journal of Orthopedics. The journal of knee surgery. Sports health. Management of traumatic meniscal tear and degenerative meniscal lesions. Save the meniscus. Orthop Traumatol Surg Res. Treatment of degenerative meniscal lesions : From eminence to evidence-based medicine. Arthroscopic meniscectomy versus non-surgical or sham treatment in patients with MRI confirmed degenerative meniscus lesions: a protocol for an individual participant data meta-analysis.
BMJ open. Increased risk for knee replacement surgery after arthroscopic surgery for degenerative meniscal tears: a multi-center longitudinal observational study using data from the osteoarthritis initiative.
Osteoarthritis Cartilage. Epub Jul Arthroscopic lavage and debridement for osteoarthritis of the knee: an evidence-based analysis. Ontario health technology assessment series. Meniscal extrusion or subchondral damage characterize incident accelerated osteoarthritis: Data from the Osteoarthritis Initiative. Clin Anat. Analysis of meniscal degeneration and meniscal gene expression. BMC Musculoskelet Disord. J Orthop Res. Can even experienced orthopaedic surgeons predict who will benefit from surgery when patients present with degenerative meniscal tears?
A survey of orthopaedic surgeons who made predictions. Br J Sports Med. Indian journal of orthopaedics. Arthroscopic partial meniscectomy for medial meniscal tear in late middle-aged adults.
Mechanical function near defects in an aligned nanofiber composite is preserved by inclusion of disorganized layers: Insight into meniscus structure and function.
Acta Biomaterialia. When should I involve a Prolotherapist in my care? Call Us: Email Us. Email Us Subscribe. Should I have another meniscus surgery?
Should I have meniscus surgery? Waiting until the arthroscopic procedure to figure out what type of surgery I am getting. My MRI was not helpful. What is concerning the most to these patients is that their knee problems came upon them much more quickly, in some cases almost immediately after surgery. They go something like this: I have severe osteoarthritis in both knees.
I just turned 50, I do not want to even consider knee replacement without trying everything first Again, some people do benefit from meniscus surgery in the short-term and near future. If you would like to focus on treatment plans please visit our articles Does Stem cell therapy work for meniscus tears? Prolotherapy for meniscus tears Platelet Rich Plasma Therapy for meniscus repair If you have been given the meniscus injury surgical recommendation, you have been told that you will get one of these three procedures.
An Arthroscopic meniscus repair. In this procedure, there is a small tear that the suture can sew up. In some instances, surgeons are taking bone marrow from the iliac crest and are using stem cell therapy to accelerate this repair.
An Arthroscopic partial meniscectomy. In this procedure, there is a piece of a meniscus that is more badly torn or macerated all chewed up and considered non-repairable. There is basically nothing to stitch up. This piece of the meniscus is recommended for removal because of its condition.
An Arthroscopic total meniscectomy. The whole meniscus is considered damaged beyond repair and the entire meniscus will be recommended for removal. What happens when all or part of the meniscus is removed? Post surgical changes are demonstrated in the medial meniscus with smaller than expected size of body of the medical meniscus.
The meniscus is much smaller than anticipated. Altered signal intensity the signal; has detected abnormalities in the body and posterior horn of the medical meniscus extending to inferior articular surface demonstrates similar appearance to previous performed MRI.
The patient had a previous MRI that demonstrated similar degenative changes. This either represents residual changes from prior surgery and mensicus tear or recurrent tear persistent from previous exam. In six reviews of randomized controlled trials, arthroscopic partial meniscectomy did not show clinically important benefit over conservative treatment for knee function and pain.
In the most recent review, which was based on 10 randomized controlled trials, arthroscopic partial meniscectomy did not provide a clinically meaningful improvement in knee pain, function, or quality of life. However, small benefits of arthroscopic partial meniscectomy were reported for patients without osteoarthritis.
The authors indicated that surgical treatment should not be considered the first line intervention for patients with knee pain and meniscal tear.
Accelerated breakdown of the articular cartilage between the femur and tibia and the patella and femur bones How does this happen? But why did these people have the surgery in the first place? Especially if they were told meniscus surgery could accelerate and cause irreversible knee damage? Most of the time when someone comes into our clinic for the first time they will report on the characteristic symptoms of meniscus related knee problems: Knee catches at seemingly random times.
Knee locks causing significant pain. When you remove the meniscus you remove vital knee lubrication One of the most vital but lessor known roles of the meniscus is to provide lubrication to the knee, which it accomplishes through diffusing spreading out synovial fluid across the joint. Surgeons suggest the reasons people come in for meniscus surgery is over expectation of what the surgery can really do for their knee problem Doctors writing in The Journal of the American Academy of Orthopaedic Surgeons 5 offer a very good rationale for why people still have meniscus surgery.
Here are some talking points of the research: For older patients or those more active patients with developing arthritis, the use of partial meniscectomy to manage degenerative meniscus tears and mechanical symptoms may be beneficial; however, its routine use in the degenerative knee over physical therapy alone is not supported.
Physical therapy has been found to be just as good as the surgery in a paper published in the New England Journal of Medicine 6. In younger populations sports-minded , partial meniscectomy removal of meniscus tissue may provide an earlier return to play, and a lower revision surgery rate compared with meniscal repair.
However, partial meniscectomy may result in the earlier development of osteoarthritis. Evaluating this data, one could imply that: Younger patients get the meniscus partial removal surgery because they need to get back to work or back to the game quicker and surgery, despite its drawbacks, gets them there faster. As we will see in the research below this is not grounded in fact, for many people getting this surgery, the situation becomes worse.
The risks of cortisone use pre-surgery Most people that contact us already have a good understanding the frequent or long-term cortisone use has its challenges and risks.
Corticosteroid short-term success and long-term problems. This highlights the need for shared decision making which should include giving the patient information on realistic expectations. Gordon H. But if a doctor says anything, Dr. They strongly suggest that the procedure is next to useless. If there is any benefit, it is very small and there are downsides, expense, and potential complications.
I will go for it. What they did was to conduct a multicenter, randomized, double-blind, sham-controlled trial in patients 35 to 65 years of age who had knee symptoms consistent with a degenerative medial meniscus tear and no knee osteoarthritis. Results also showed that meniscectomy did not provide better functional improvement than the nonoperative group Earlier in research published in the American Journal of Sports Medicine showed what little value meniscectomy has.
This study was a randomized controlled trial with the highest level of evidence level 1. The study had patients with medial meniscus tears — 81 women and 21 men with an average age of Fifty patients underwent arthroscopic meniscectomy while 52 participated in nonoperative strengthening exercises. In This is typically limited to the red zone of the meniscus where ample blood supply allows for suturing and healing.
Very rarely a meniscus allograft transplantation cadaver donor in 0. Older patients were more likely to get a meniscectomy and less likely to get a repair.
What are we to make of this? In 4 out of 5 patients, meniscus tissue had to be removed. In 1 out of 5 patients the injury was fixable because of location and size. Meniscus transplant has lost much of its appeal.
The meniscus is hard to save. Does meniscus surgery lead to knee replacement? To save the knee, you must save the meniscus. A torn meniscus can prevent your knee from working right. A meniscus tear is usually caused by twisting or turning, often with the foot planted while the knee is bent.
These tears can occur when you lift something heavy or play sports. As you get older, your meniscus gets worn. This can make it tear more easily. If you are older, you may not know what you did to cause the tear. Or you may only remember feeling pain after you got up from a squatting position, for example.
Pain and slight swelling are often the only symptoms. There are three types of meniscus tears, each increasing in severity. The more serious the tear, the more severe the symptoms. With a minor tear , you may have slight pain and swelling. This usually goes away in 2 or 3 weeks. With a moderate tear , you may feel pain at the side or center of your knee.
Swelling slowly gets worse over 2 or 3 days. This may make your knee feel stiff and limit how well you can bend your knee. Usually you are still able to walk. You might feel a sharp pain when you twist your knee or squat. These symptoms go away but can come back if you twist or overuse your knee. In severe tears , pieces of the torn meniscus can move into the joint space. This can make your knee catch, pop, or lock.
You may not be able to straighten it. Your knee may feel "wobbly" or buckle without warning. It may swell and become stiff right after the injury or within 2 or 3 days. When possible, it's better to fix the meniscus than to remove it. If the meniscus can be fixed, you have a lower risk of future joint problems. Your doctor will likely suggest the treatment that he or she thinks will work best for you based on where the tear is, the pattern of the tear, and how big it is.
Your age, your health, and your activity level may also affect your treatment options. In some cases, the surgeon makes the final decision during surgery, when he or she can see how strong the meniscus is, where the tear is, and how big the tear is. Some kinds of tears can't be fixed. Radial tears sometimes can be fixed, but it depends on where they are. Most of the time, horizontal , long-standing, and degenerative tears—those caused by years of wear and tear—can't be fixed.
The older you are, the less likely it is that your tear can be repaired. For these kinds of tears, you may need to have part or all of the meniscus removed. When possible, meniscus surgery is done using arthroscopy instead of open surgery. During arthroscopy, your doctor puts a lighted tube with a tiny camera—called an arthroscope, or scope—and surgical tools through small incisions.
In a young person, surgery to fix the tear may be the first choice, because it may restore use of the knee. Surgery has risks, including infection, a blood clot in the leg, damage to nerves or blood vessels, and the risks of anesthesia. After surgery you may still have pain and joint stiffness. This means that of people who have this surgery, 85 have relief from pain and can use their knee normally, while 15 do not. Surgery to remove part of the meniscus meniscectomy is better at keeping your knee stable than surgery to remove all of the meniscus.
Partial removal also allows a quicker and more complete recovery than total removal. Removing the whole meniscus typically reduces some symptoms. But losing the meniscus reduces the cushioning and stability of the joint. Most people, especially if they are young or active, are not satisfied with a total meniscectomy. This is why surgeons try to remove as little of the meniscus as possible.
This means that 78 to 88 people out of people who have this surgery have reduced symptoms and are able to return to most or all of their activities. Small tears found at the outer edge of the meniscus often heal with rest. Instead of surgery, you may try rest, ice, compression, and elevation. You may wear a knee brace. You can try over-the-counter medicine such as ibuprofen or naproxen to help with pain and to reduce swelling.
If your symptoms go away, your doctor may suggest exercises to build up your quadriceps and hamstring muscles and increase your flexibility. It's important to follow your doctor's guidelines so that you don't hurt yourself again. These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I've had quite a bit of pain on one side of my knee for a couple of weeks, but my symptoms have decreased. My doctor thinks that my meniscus may be healing on its own. I'm still seeing my doctor, though, and I've started rehabilitation with a physical therapist.
He's got me going through range-of-motion and knee strengthening exercises at home. I don't think I'll need surgery. A few months ago, I started having pain in my right knee when I would move it certain ways. My doctor examined my knee and asked me about my symptoms. He diagnosed a tear in my meniscus. These choices will be signaled globally to our partners and will not affect browsing data. We and our partners process data to: Actively scan device characteristics for identification.
I Accept Show Purposes. Table of Contents View All. Table of Contents. The Truth About Meniscus Tears. Degenerative Meniscus Tears vs. Normal Meniscus Tears. Tear Location Matters. Stability of a Meniscus Tear. When Surgery Is Necessary. When Surgery Is a Last Resort. Was this page helpful? Thanks for your feedback!
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