Meniscal Repair

Preserving the meniscus to maintain knee function and protect long-term joint health.

Meniscal Repair – Key Points

• The meniscus is a vital cushion that helps transmit load evenly through the knee
• Tears are common and can cause pain, locking, or instability
• Repair (stitching the meniscus) is preferred over removal where possible
• Preserving the meniscus helps reduce the risk of arthritis
• Surgery is keyhole (arthroscopic) and typically takes 60–90 minutes
• Recovery is longer than trimming procedures, with return to sport usually 4–6 months

What is the meniscus?

The meniscus is a C-shaped piece of cartilage in the knee that acts as a cushion and helps transmit load evenly across the joint. It plays an essential role in:

• Distributing forces through the knee
• Protecting the joint surfaces
• Contributing to stability and smooth movement

Damage to the meniscus can result in pain, swelling, catching or locking, and over time may increase the risk of arthritis.

Why is meniscal repair important?

Where possible, preserving the meniscus is the priority.

A successful meniscal repair:

• Relieves symptoms such as pain and locking
• Restores normal knee function
• Maintains even load transmission across the joint
• Reduces the risk of early arthritis

Not all tears are repairable, but modern techniques aim to preserve as much meniscus as possible.

Which tears can be repaired?

Meniscal repair is most suitable for:

• Tears in the outer (vascular) zone, where healing potential is highest
• Younger or active patients with otherwise healthy meniscus
• Vertical or longitudinal tears, which are more amenable to repair

Careful assessment is required to determine whether a tear is repairable.

Types of meniscal tears

Common tear patterns include:

• Longitudinal tears – run along the meniscus and are often repairable
• Bucket-handle tears – displaced tears that can cause locking of the knee
• Radial tears – extend from the inner edge and are less likely to be repairable
• Root tears – where the meniscus detaches from the bone
• Complex tears – involve multiple patterns and are more challenging to treat

Mr Smith has particular expertise in identifying and managing complex tear patterns to optimise outcomes.

Non-surgical treatment

Some smaller or stable tears can be managed without surgery.

Benefits

• Avoids surgery

Limitations

• Symptoms may persist
• Larger or unstable tears may lead to poorer long-term outcomes
• Loss of normal meniscal function can increase the risk of overload pain and arthritis

What does the operation involve?

Meniscal repair is performed using keyhole (arthroscopic) surgery.

• Small incisions are made around the knee
• A camera is used to assess the joint
• Specialised instruments are used to stitch the torn meniscus
• The repair technique is tailored to the type and location of the tear

The procedure usually takes 60–90 minutes and is typically performed as a day case.

Biological augmentation

Biological augmentation refers to techniques used during meniscal repair to enhance the body’s natural healing response. The meniscus has a limited blood supply, particularly in its inner regions, which can reduce its ability to heal. These techniques aim to improve healing potential and increase the success of repair.

Common methods include:

• Trephination – creating small channels from the outer, well-vascularised part of the meniscus into the tear to encourage blood flow and healing cells
• Rasping – gently roughening the tissue around the tear to stimulate a healing response
• Fibrin clot application – placing a clot (derived from your own blood) into the tear to act as a biological scaffold and promote healing

These techniques are often used in combination with meniscal repair, particularly in more complex tears or areas with limited blood supply.

Why is biological augmentation beneficial?

• Improves the healing environment within the meniscus
• Increases the likelihood of successful repair
• Expands the range of tears that may be suitable for repair
• Supports long-term preservation of the meniscus and knee joint health

Mr Smith routinely incorporates biological augmentation techniques where appropriate, using an evidence-based approach to optimise healing and improve outcomes following meniscal repair.

Risks of meniscal repair

Meniscal repair is generally safe, but potential risks include:

• Infection
• Blood clots (DVT)
• Failure of the repair (lack of healing)
• Knee stiffness
• Rare nerve or blood vessel injury
• General medical or anaesthetic risks

These risks will be discussed with you in the context of your individual case.

Recovery and rehabilitation

Recovery from meniscal repair is longer than meniscal trimming, as the repair requires time to heal.

Early recovery

• A brace may be required
• Crutches are usually needed
• Weight-bearing is often restricted for up to 6 weeks, depending on the tear

Rehabilitation timeline

• 0–2 weeks: Reduce swelling and restore controlled movement
• 2–6 weeks: Gradual improvement in movement and early strengthening
• 6–12 weeks: Progress to full weight-bearing and strengthening
• 3–6 months: Return to higher-level activity and sport

High-impact activities are avoided until the meniscus has healed.

Long-term outcomes

A successful meniscal repair can result in:

• Significant reduction in pain
• Improved knee function
• Return to normal activities and sport
• Preservation of long-term joint health

Outcomes depend on tear type, location, patient factors, and adherence to rehabilitation.

Why choose Mr Smith?

Mr Smith is a leading UK knee surgeon with a specialist interest in meniscal surgery, including complex repairs. His practice focuses on preserving the meniscus wherever possible, using advanced surgical techniques supported by a leading research programme in knee surgery.

You will receive a personalised treatment plan aimed at restoring function while protecting the long-term health of your knee.