Meniscal Tear Treatment Options
The meniscus is a vital knee structure that performs essential biomechanical functions including distribution of weight across the knee, shock absorption, stability, joint lubrication, and proprioception (the ability to sense movement).) Treatment of meniscus tears is focused on preserving this vital knee structure.
Dr. Harrison must consider numerous factors to determine the best treatment for you. In addition to the characteristics of the tear, its type, location, size, and severity, your age, symptoms, and activity level must also be considered.
About the location of the tear
There are three zones in the meniscus. The outer one third of the meniscus has a good blood supply which is key to healing. This is called the red zone. A small or partial tear in the red zone has the potential to heal without surgery and with surgical repair. When the tear occurs in the inner two thirds of the meniscus with a poor blood supply, called the white zone, it cannot heal and may require surgery.
Conservative treatment is effective for many meniscus tears. It involves RICE: rest, ice, compression, and elevation, plus anti-inflammatory over the counter NSAIDS to reduce pain and inflammation. This may be sufficient treatment.
When symptoms persist, a cortisone injection can be added to and facilitate healing by reducing pain and inflammation, which is especially helpful for older patients with degenerative tears.
When symptoms endure after the aforementioned treatments, arthroscopic surgery is indicated. The surgical goal is to treat pain, increase function, and when possible, preserve the meniscus.
What is arthroscopic surgery?
Arthroscopic surgery is minimally invasive surgery that involves the use of an arthroscope, a small thin, lighted tube with a camera on its end that is inserted, through a tiny incision, into the knee joint. Images from the arthroscope are projected onto a TV monitor and Dr. Harrison can see directly inside the joint to evaluate the tear. Then he can make several other tiny incisions, and inserts very small tools for repair, debridement, or meniscus replacement.
Minimally invasive arthroscopic surgery is typically an outpatient procedure performed under general and/or local anesthetic. Benefits include less damage to surrounding tissues, less bleeding and quicker recovery. After arthroscopic surgery the patient will proceed to physical therapy to help healing and restore strength and function.
What are the surgical options?
Surgical options include debridement, repair, partial meniscectomy, and meniscus replacement.
- Debridement is a procedure to remove fragments of torn cartilage to improve pain and function. It is valuable to preserve a healthy, but smaller meniscus, when the tear is in the white zone and may be considered to treat degenerative tears when conservative measures are insufficient alone. Physical therapy will help healing and restoration of function. Most people can return to the daily life activities in a week and return to sports within several months.
- Arthroscopic meniscal repair is favored when the tear is in the red zone and the meniscus can be preserved. It involves sewing together the torn edges of the meniscus. Recovery from a repair of isolated meniscus tears usually requires bracing for 4-6 weeks and the use of crutches for about 6 weeks after surgery to limit or prevent weight bearing while the repair heals. Physical therapy after repair is essential to aid healing and restore function. Sometimes a meniscus repair occurs concurrent with an ACL reconstruction. In that case there will be different postoperative instructions and recovery times.
- A partial meniscectomy is removal of the torn part of the meniscus that cannot be repaired. Dr. Harrison will try to preserve as much of the native meniscus and function as possible. It is used to treat the pain. It can take four weeks to recover. Physical therapy is important to regain full range of motion.
- Total meniscectomy and a meniscus transplant. The meniscus cannot be removed without replacement because studies show that an absent meniscus leads to early onset knee osteoarthritis. This procedure involves the complete removal of the damaged meniscus and replacing it with a donor meniscus (a meniscus allograft transplant). Studies report that a transplant lasts about ten years at this time.
Contact Dr. Jeffrey D. Harrison to schedule a consultation and learn about your condition and all your treatment options.
Dr. Harrison is a board-certified fellowship trained orthopedic and sports medicine surgeon who specializes in arthroscopic knee and shoulder surgery. He is the Head Team Physician for the United States Alpine Ski Team and the Head Team Physician for Weber State University for over 20 plus years. Dr. Harrison completed his undergraduate degree at Baylor University and received his medical degree from the University of Arizona College of Medicine. He completed his orthopedic residency at the University of Utah followed by a fellowship in sports medicine at the Cincinnati Sports Medicine and Orthopedic Center. He finished his formal training with an additional AO Trauma Fellowship in Bern, Switzerland.
At a Glance
Dr. Jeffrey Harrison
- Board-Certified, Fellowship-Trained Orthopedic Surgeon
- Head Team Physician US Women's Alpine Team and Weber State University
- Performs over 800 surgeries per year
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