Meniscus Repair vs. Meniscus Removal: Which is Right for You?

The meniscus is a crucial piece of cartilage in the knee joint that helps cushion and stabilise the knee during movement. Whether you're an athlete or someone leading an active lifestyle, a meniscus injury can be painful and frustrating. When it comes to treating a torn meniscus, two main surgical options are considered: meniscus repair and meniscus removal (also called meniscectomy). Deciding between these options depends on several factors, including the severity of the tear, your activity level, and the long-term goals for your knee health. In this blog, we’ll explore the pros and cons of both procedures to help you make an informed decision.

What is a Meniscus Tear?

The meniscus is a piece of cartilage that acts as a shock absorber between the thighbone (femur) and the shinbone (tibia). Each knee has two menisci—the medial meniscus on the inner side and the lateral meniscus on the outer side. Meniscus tears are common knee injuries and can occur from sports, sudden twisting movements, or age-related degeneration.

The location and type of meniscus tear play a major role in determining the appropriate treatment, which is often either meniscus repair or removal.

Meniscus Repair: What You Need to Know

Meniscus repair is a surgical procedure aimed at stitching the torn edges of the meniscus back together. This approach is typically preferred for younger, active individuals or those with tears in the outer area of the meniscus, which has a good blood supply, allowing the tear to heal effectively.

Pros of Meniscus Repair:

1. Preserves Natural Tissue: The main advantage of meniscus repair is that it preserves the meniscus, which plays a crucial role in stabilising the knee and protecting the joint from arthritis.
2. Long-Term Benefits: Preserving the meniscus can help reduce the risk of developing osteoarthritis or other degenerative joint conditions later in life, especially for younger individuals.
3. Better for Active Lifestyles: Athletes or individuals with physically demanding lifestyles may benefit from repair because it allows them to maintain knee stability and function in the long term.

Cons of Meniscus Repair:

1. Longer Recovery Time: Meniscus repair involves a longer recovery period compared to removal, often requiring 4-6 months of rehabilitation. This includes limiting weight-bearing activities and physical therapy.
2. Not Suitable for All Tears: Meniscus repair is only an option for certain types of tears, particularly those located in the outer "red zone," where there is sufficient blood supply for healing. Tears in the inner "white zone" may not heal well with repair.
3. Risk of Re-Tear: Even after repair, there is a possibility of re-tearing the meniscus, which may require additional surgery.

Meniscus Removal (Meniscectomy): What You Need to Know

In a partial meniscectomy, the damaged or torn portion of the meniscus is surgically removed. This option is often chosen for tears that are located in areas with poor blood supply, where repair would not heal successfully. It’s also considered for older individuals or those with degenerative meniscus tears.

Pros of Meniscus Removal:

1. Shorter Recovery Time: The recovery period after a meniscectomy is typically much shorter—often 4-6 weeks. This allows patients to return to their normal activities more quickly than with repair.
2. Effective for Certain Tears: For tears in the inner, avascular area of the meniscus (the "white zone"), removal may be the best option, as these tears are unlikely to heal even with repair.
3. Immediate Pain Relief: Many patients experience significant pain relief after a meniscectomy, as the torn piece of the meniscus causing discomfort is removed.

Cons of Meniscus Removal:

1. Increased Risk of Arthritis: Removing part of the meniscus reduces the knee's natural cushioning, which can lead to increased wear and tear on the joint. Over time, this raises the risk of developing osteoarthritis.
2. Loss of Knee Stability: The meniscus plays an important role in knee stability, and removing it—either partially or completely—can lead to future instability or discomfort, particularly during high-impact activities.
3. Not Ideal for Younger Patients: For younger, active individuals, removing part of the meniscus may result in long-term complications, such as joint degeneration or the need for future surgeries.

Which Option is Right for You? Deciding between meniscus repair and meniscus removal depends on several key factors, including:

• Location of the Tear: Tears in the outer part of the meniscus with good blood supply are better candidates for repair, while those in the inner part may require removal.
• Severity of the Tear: Large or complex tears may not be suitable for repair and may require partial removal.
• Age and Activity Level: Younger, active individuals often benefit from repair to maintain knee stability, while older individuals with degenerative tears may opt for removal.
• Recovery Timeline: If a shorter recovery time is essential, meniscectomy may be the preferred choice. However, for long-term knee health, repair is often the better option.

Conclusion: Choosing the Right Treatment for Your Meniscus Injury

The decision between meniscus repair and meniscus removal should be made in consultation with your orthopaedic surgeon, who will evaluate the type and severity of your tear, as well as your activity level and long-term goals. While repair offers the benefit of preserving the meniscus and reducing the risk of arthritis, it also requires a longer recovery period. On the other hand, meniscus removal provides faster recovery but may increase the risk of joint degeneration over time.

At MSK Doctors, we specialise in advanced techniques for meniscus repair and removal, ensuring you receive the best possible care based on your individual needs. Contact us today to discuss your treatment options and develop a personalised plan for recovery.

FAQ Section:

1. What is the difference between meniscus repair and meniscus removal? Meniscus repair involves stitching the torn edges of the meniscus back together, while meniscus removal (meniscectomy) involves removing the damaged portion of the meniscus. Repair is generally preferred for tears in the outer part of the meniscus, while removal may be recommended for tears in areas with poor blood supply.

2. How long does it take to recover from meniscus surgery? Recovery time depends on the type of surgery. Meniscus repair typically requires 4-6 months of rehabilitation, while recovery from meniscus removal is usually quicker, taking 4-6 weeks.

3. Which option is better for long-term knee health? Meniscus repair is often better for long-term knee health because it preserves the meniscus, reducing the risk of arthritis and joint degeneration. However, repair is not suitable for all types of tears.

4. Can meniscus tears heal on their own? Small, stable meniscus tears in the outer "red zone" of the meniscus may heal on their own with rest and physical therapy. However, larger or more complex tears often require surgical intervention.

5. Is meniscus removal (meniscectomy) risky? While meniscectomy is a common and relatively safe procedure, removing part of the meniscus can lead to increased wear and tear on the knee joint over time, raising the risk of osteoarthritis and knee instability.

6. When should I consider meniscus surgery? If you are experiencing persistent knee pain, swelling, or instability that is not improving with conservative treatments, you may need to consider surgery. Your surgeon will evaluate your condition and recommend the best treatment based on your specific injury.