How your orthopedic surgeon treats your tear will depend on the type of tear you have, its size, and location. The outside one-third of the meniscus has a rich blood supply. A tear in this "red" zone may heal on its own, or can often be repaired with surgery. A longitudinal tear is an example of this kind of tear.
The inner two-thirds of the meniscus, however, lacks a blood supply. Without nutrients from blood, tears in this "white" zone cannot heal. These complex tears are often in thin, worn cartilage. Because the pieces cannot grow back together, tears in this zone are usually surgically trimmed away.
Along with the type of tear you have, your age, activity level, and any related injuries will factor into your treatment plan.
How is a torn meniscus treated without surgery?
If your tear is small and on the outer edge of the meniscus, it may not require surgical repair. As long as your symptoms do not persist and your knee is stable, nonsurgical treatment may be all you need. The RICE protocol is effective for most sports-related injuries. RICE stands for Rest, Ice, Compression, and Elevation:
- Rest. Take a break from the activity that caused the injury. Your doctor may recommend that you use crutches to avoid putting weight on your leg.
- Ice. Use cold packs for 20 minutes at a time, several times a day. Do not apply ice directly to the skin.
- Compression. To prevent additional swelling and blood loss, wear an elastic compression bandage.
- Elevation. To reduce swelling, recline when you rest, and put your leg up higher than your heart.
Non-steroidal anti-inflammatory medicines. Drugs like aspirin and ibuprofen reduce pain and swelling.
How is a torn meniscus treated with surgery?
If your symptoms persist with nonsurgical treatment, your doctor may suggest arthroscopic surgery.
Knee arthroscopy is one of the most commonly performed surgical procedures. A small camera is inserted through a small incision (portal). This provides a clear view of the inside of the knee. Your orthopedic surgeon inserts small surgical instruments through other portals to repair the tear.
- Partial meniscectomy. In this procedure, the damaged meniscus tissue is trimmed away.
- Meniscus repair. Some meniscus tears can be repaired by suturing (stitching) the torn pieces together. Whether a tear can be successfully treated with repair depends upon the type of tear, as well as the overall condition of the injured meniscus. Because the meniscus must heal back together, recovery time for a repair is much longer than from a meniscectomy.
Once the initial healing is complete, you will be taught rehabilitation exercises. You will need to do regular exercises to restore your knee mobility and strength. You will start with exercises to improve your range of motion. Strengthening exercises will gradually be added to your rehabilitation plan.
For the most part, rehabilitation can be carried out at home, although your doctor may recommend physical therapy. Rehabilitation time for a meniscus repair is about 3 months. A meniscectomy requires less time for healing — approximately 3 to 4 weeks.