Meniscus Surgery for a Meniscus Tear: Treatment, Postoperative Care, and Orthopedic Specialists

Meniscus surgery is a surgical procedure to treat a damaged meniscus. The meniscus is a crescent-shaped disc of cartilage in the knee joint that acts as a shock absorber between the thighbone and the shinbone. A tear or wear and tear of the meniscus can lead to locking, pain, and swelling in the knee.

Depending on the type and extent of the damage, meniscus surgery involves either removing the injured part of the meniscus (partial meniscectomy), suturing it (meniscus repair), or, in rare cases, replacing it with an implant or donor tissue.

The menisci consist of durable fibrocartilage tissue and are shaped like “crescent-shaped washers.” 

Medical professionals distinguish between:

• the medial (inner meniscus) and 
• lateral (outer meniscus) meniscus

They act as shock absorbers between the femoral condyle and the tibial plateau and ensure even pressure distribution across the articular cartilage surfaces.

The meniscus tissue, which is initially elastic and tear-resistant, undergoes natural aging in humans.

Common causes of premature degeneration include:

• unnatural overuse due to repeated injuries
• instability following cruciate ligament tears
• excess weight, or
• axial misalignments such as bowlegs or knock-knees
• Meniscus injuries are more common in occupations that involve activities that strain the knees.

The goal of the surgery is to relieve pain, restore mobility to the knee joint, and prevent complications—particularly osteoarthritis.

Reasons for meniscus surgery may include:

• tears caused by accidents, such as during sports
• wear-and-tear (degenerative) changes, often in older adults
• repeated knee injuries or prolonged stress on the knee
• misalignments (e.g., bowlegs or knock-knees)
• Irritation in the knee accompanied by swelling and inflammation
• Joint locking or impingement
• Pain that does not respond to conservative treatment

Treatment is usually performed using minimally invasive techniques as part of arthroscopy (joint endoscopy). During the procedure, doctors insert instruments and a camera into the knee through small incisions. Depending on the findings, the following procedures are available:

Partial meniscus resection

• Removal of only the damaged portion of the meniscus
• Goal: To preserve as much healthy tissue as possible
• The procedure is usually performed on an outpatient basis
• Short rehabilitation period

This method is used for severely damaged or irreparably torn portions of the meniscus. The loss of shock-absorbing function is deliberately accepted in order to prevent mechanical damage to the joint.

Meniscus suturing (meniscus refixation)

• Preservation of the natural meniscus through suturing techniques
• Particularly effective for fresh tears in well-vascularized areas
• More complex treatment with a longer healing period
• Better long-term prognosis if successful

Modern materials such as absorbable sutures or small anchors improve healing. Rigid implants (e.g., screws) have not proven effective due to complications.

Various suturing techniques are used here. The video shows the procedure for arthroscopic meniscus surgery:

Meniscus Transplantation

• In cases of complete meniscus loss, especially in young patients
• Transplantation of donor tissue
• A highly specialized procedure, performed only in a few centers
• No need for long-term use of immunosuppressants

Long-term success depends heavily on the biological integration of the graft.

Collagen meniscus implant (CMI)

• Artificial meniscus made from animal collagen
• Is sutured into place arthroscopically
• The body replaces the implant with its own cartilage tissue
• Good results in younger patients with sufficient regenerative capacity

Preliminary results from an American study are encouraging. Doctors can insert the implant into both the medial and lateral menisci.

For the CMI to function properly, the ring on the outer wall of the meniscus must be intact. It serves as a mechanical anchor for the sutures and as a tissue from which cells can grow into the collagen scaffold. The CMI is not recommended for older people with limited biological regenerative capacity.

Proper aftercare is crucial to the success of meniscus surgery. The rehabilitation program depends on the procedure, the type of meniscus injury, and the individual’s healing process.

Important measures after the procedure include:

• Rest and reduced weight-bearing in the first few days (often with the help of crutches to avoid putting too much weight on the operated leg)
• Cold therapy to relieve pain and reduce swelling
• Physical therapy to restore mobility and improve strength
• Strengthening exercises for the muscles and to improve knee stability
• Gradual increase in activity with progressively higher training intensity

With meniscus sutures, weight-bearing on the knee is significantly restricted during the first few weeks after surgery. Full recovery can take up to 6 months.

As with any surgical procedure, meniscus surgery carries certain risks. However, these risks are relatively low with minimally invasive procedures.

Possible complications:

• Infections
• Bruising or swelling
• Joint stiffness or limited range of motion
• Incomplete healing of the meniscus suture
• Recurrence of symptoms
• Rare cases of nerve damage

In the long term, extensive meniscus removal carries an increased risk of osteoarthritis in the knee joint.

The prospects for a full recovery are very good when the procedure is performed for the correct indication and with proper follow-up care. Young, physically active patients in particular benefit from early surgery. Even for older adults with degenerative meniscus damage, surgery can improve quality of life and preserve mobility.

Important: Preserving as much functional meniscus tissue as possible significantly improves the long-term prognosis.

Meniscus surgery is a proven procedure for treating meniscus damage. It relieves pain, improves joint function, and can prevent long-term complications such as osteoarthritis. Depending on the extent of the injury, the surgery is performed either on an outpatient basis and/or as an inpatient procedure: Minor procedures, such as partial meniscus removal, are usually performed on an outpatient basis, while more complex surgeries or meniscus repair requiring longer postoperative care may necessitate a short inpatient stay. The appropriate method depends not only on the type of injury but also on the patient’s age, overall health, and individual needs. An early diagnosis and an experienced specialist are crucial for long-term success.

1. When is meniscus surgery necessary?
Meniscus surgery is necessary when a meniscus tear or injury causes severe pain, limited mobility, or locking of the knee. The goal is to preserve meniscus function, prevent secondary damage such as osteoarthritis, and reduce stress on the joint.

2. What procedures are available for meniscus surgery?
Depending on the type of damage, the meniscus can be sutured (meniscus repair), a portion of the meniscus can be removed (partial meniscectomy), or, in rare cases, it can be replaced with an implant or donor tissue. The procedures are usually performed using minimally invasive arthroscopy.

3. What does the postoperative care involve?
After meniscus surgery, rest, using crutches to reduce weight-bearing, icing, and physical therapy are important. The duration of rehabilitation depends on the procedure: After a partial resection, the knee can bear weight sooner; after meniscus refixation, healing takes significantly longer—up to several months.

4. What are the risks associated with meniscus treatment?
As with any surgery, there are risks such as infection, swelling, joint stiffness, or incomplete healing. In the long term, extensive meniscus removal may increase the risk of knee osteoarthritis.

5. Is meniscus surgery performed on an outpatient or inpatient basis?
Minor procedures, such as partial meniscus removal, are usually performed on an outpatient basis. More complex surgeries, such as meniscus suturing, often require a short inpatient stay to ensure optimal follow-up care and rehabilitation.

Glossary

• Arthroscopy: Examination of a joint using a camera and instruments
• Meniscus: A crescent-shaped piece of cartilage in the knee that acts as a shock absorber
• Partial resection: Partial removal of the meniscus
• Suturing technique: Repair by stitching together
• Transplantation: Replacement with donor tissue
• Collagen implant: Artificial meniscus replacement made from animal collagen