Meniscus Repair of the Knee

What and where is the meniscus?

The meniscus is found in the knee joint. Each knee has two, c-shaped pieces of fibrocartilage that sit between the femur (upper leg bone) and the tibia (shin bone) and act as shock absorbers. The job of the meniscus is to provide extra stabilization to the knee and to provide a cushion between the bones to disperse the weight of the body and reduce friction during movement.

What is a meniscus tear?

A meniscus tear is most commonly seen in young, active adults and athletes. A meniscus tear occurs when the strong fibrocartilage separates or tears away from the soft tissue attachment in the knee joint. Meniscus tears can occur in different locations and in different tear-patterns. Each meniscus tear can be unique, as are the treatment options for each type of tear. For instance, the outside third of each meniscus has a blood supply which helps with self-healing. The inner portion of the meniscus is thinner and tears more easily but does not have the benefit of a blood supply to help the tear heal. Each scenario influences the decision of which type of meniscus repair is best for patients in Manhattan, New York City and the surrounding New York boroughs. Dr. Benedict Nwachukwu, orthopedic knee surgeon, specializes in helping patients with meniscal injuries and he can offer the best treatment options for meniscus repair.

What is a meniscus repair?

The goal of any meniscus treatment, whether it be non-surgical or surgical, is to preserve as much of the meniscus as possible. A surgical meniscus repair is done arthroscopically, using a small camera called an arthroscope and small, specialized instruments to perform the repair within the knee joint. Knee arthroscopy is one of the most commonly performed surgical procedures in the United States. The most successful cases of meniscus repair are performed on younger patients in the area of the knee where there is ample blood supply to facilitate healing. Ideal candidates for a meniscus repair have a healthy weight, a stable, non-arthritic joint, proper knee alignment, and a favorable tear pattern.

Saving the meniscus is preferable and very important to Dr. Nwachukwu. However, certain cases, especially if the tear of the meniscus is in the “white zone” (the area that does not have a blood supply) the removal of the torn portion may be necessary for proper healing.

How is a meniscus repair performed?

Meniscus tears that are ideal for repair are located in the red zone, meaning they have a better blood supply and can often heal with a repair technique. These meniscus tears occur in the outer third portion of the tissue. During a meniscus repair, Dr. Nwachukwu uses strong sutures, placed across the meniscus tear to bring the damaged tissue back together. The sutures are then tightened to secure the meniscus so it can heal and preserve the function of the meniscus. The repair can also be biologically enhanced by poking holes into the bone so that marrow creates a “bandage” which creates new tissue at the repair site.  Biologic augmentation may also be considered, such as BMAC (Bone Marrow Aspirate Concentrate) or PRP (platelet rich plasma).

What if the meniscus cannot be repaired?

Most meniscal tears, especially those in older individuals, occur in the white zone, or the inner two-thirds of the tissue. This area of the meniscus is not amenable to repair and a meniscectomy is the best surgical solution for repair. A meniscectomy removes only the torn portion in a minimally invasive manner. Dr. Nwachukwu carefully removes only the damaged area, leaving as much of the healthy meniscus as possible.

How long is the recovery after a meniscus repair?

A meniscus repair takes time to heal. Patients can expect to be placed in a knee brace to immobilize the joint for about 4 weeks. Weight bearing may be restricted, depending on the size and type of tear and the repair. Physical therapy will begin shortly after surgery and will progress along with strengthening exercises until the knee has regained its full strength and range of motion. Full recovery can take approximately 4 to 5 months.

For more resources on meniscus repair, or to see if you are a candidate for this specialized surgery, please contact the office of Benedict Nwachukwu, MD, orthopedic knee surgeon serving Manhattan, New York City and the surrounding New York boroughs.