Meniscal tear seen on a MRI scan

Each knee joint has two crescent-shaped cartilage menisci. These lie on the medial (inner) and lateral (outer) edges of the upper surface of the tibia (shin bone). They are essential components, acting as shock absorbers for the knee as well as allowing for correct weight distribution between the tibia and the femur.
Cartilage (meniscal) tears usually occur as a result of a twisting injury, such as when the knee is overloaded during a sporting activity. However, they can occur in non-sporting activities when the knee is twisted and wrongly loaded, such as when getting in and out of a car.

A cartilage (meniscus) tear) can produce sudden onset of knee pain and swelling can occur over the subsequent 24 hours. If there is a large tear, the fragment of loose tissue can block movement of the knee and cause the knee to lock. The appropriate treatment for a meniscal tear is an arthroscopy, where a telescope is inserted into the knee joint and the meniscus is repaired or cut away if it is too damaged to repair.
Meniscal Repair:
Sometimes the meniscus can be repaired using small sutures (stitches) to hold the torn section together. However, menisci do not heal very well, due to poor blood supply, so not all tears can be repaired.
Partial meniscectomy:
Partial meniscectomy is where the damaged part of the meniscus is removed during arthroscopic surgery.
Are there any risks from this type of surgery?
Complications following meniscal surgery are rare. However, they can include:
Infection
The chance of infection is less than 1% and can usually be treated effectively with antibiotics. Usually only the skin is affected, but if bacteria get into the knee itself then it may be necessary to have a further arthroscopy to wash the knee out with saline solution and give stronger antibiotics via a drip
Deep vein thrombosis (DVT)
The risk of this is less than 1% and is unusual if you move around as much as possible after surgery. Symptoms include pain, swelling, warmth and redness of the calf. Less commonly, a DVT can also present in the thigh area
Swelling
A small amount of swelling is very common after meniscal surgery, often just above the kneecap or around the incision sites.
Stiffness
Most people experience some stiffness in the joint after an operation, but this should improve with exercise and physiotherapy
Follow-up appointments
Everyone is different, so healing and post-operative programmes vary from person to person. However, the follow-up appointments below are typical: Two weeks: wound check and removal of stitches
Six weeks: this appointment is usually only necessary for patients who have had a meniscal repair
If there are any complications with your rehabilitation your physiotherapist may refer you back to your consultant for a further review and will liaise directly with the consultant about any issues.
Knee Arthroscopy:
How many cuts (incisions) will I have and how long will they be?
You will have 2 (sometimes 3) incisions made either side of the knee joint measuring 1cm in length; they are closed with nylon stitches (sutures) which are removed 10-14 days after the operation.
Can I get the knee wet, for example, in the bath?
You may take a shower but not a bath. Once the sutures are removed around 10-14 days after surgery, you can bath again. You will be given some replacement dressings before you leave hospital in case the dressings fall off in the shower.
When can I drive?
When considering a return to driving following surgery it is essential that you consider the safety of yourself and other road users.
Left knee: it is usually safe to return to driving after one week, provided you have regained sufficient mobility and strength in the knee to use the clutch pedal.
Right knee: it may take two to four weeks for the right knee to be strong enough and react quickly enough to use the brake pedal in an emergency stop.
Although your specialist will advise you about when it is safe to start driving again, you should also check with your vehicle insurer to confirm you are covered.
When can I return to work?
This depends on the type of work you do and how quickly you recover. As a general guide, if your job involves sitting down for most of the time, you should be able to return to work a few days after surgery. If it involves being on your feet for longer periods of time, but does not require manual duties such as heavy lifting and kneeling, you may return to work within two to three weeks. Jobs that require a greater degree of manual work and physical demand, for example lifting and running, may require four to six weeks or more following partial meniscectomy and up to three months or more following meniscal repair.
When can I return to sport?
People recover at different rates for many reasons so returning to sport will be based on how ready you are both physically and psychologically, rather than on a set timeframe.
Following a partial meniscectomy you may be able to return to road cycling at two to four weeks and jogging or light individual sports, for example non-competitive golf, at four to six weeks. These timeframes are doubled following meniscal repair.
The time it takes to return to high performance/contact sports, for example rugby, football and skiing following partial meniscectomy will be six to eight weeks or more. Again, this timeframe will be doubled for meniscal repair.
Am I more likely to get osteoarthritis after meniscal surgery?
One of the important roles of the menisci is to spread your body weight over as big an area of your knee joint lining as possible. If the menisci are injured and can no longer do this properly, then areas of your joint lining are put under more load. Sometimes the lining is put under too much load and can slowly deteriorate over time eventually leading to loss of the lining of the knee. This is called osteoarthritis (OA).
The risk of developing OA in later life may increase if you have a meniscal injury while you are young or if the injury means a large amount of meniscus is lost. Wherever possible, your surgeon will try to preserve as much meniscal tissue as possible to minimise this risk.
Post Operative rehab:
Following the operation you will have a small dressing around your knee.
You will be allowed to weight bear once you have recovered from the anaesthetic.
If you have had a partial meniscectomy you will be allowed to fully weight-bear as pain allows straight away
If you have had a meniscal repair you may not be able to fully weight-bear to start with
Following a meniscal repair you may need to wear a brace to restrict movement in your knee while it heals
You may need to have crutches to help you to walk
Your knee may be swollen and bruised so you should keep your leg elevated (raised) when you are not walking or exercising
A physiotherapist will give you some simple exercises to help with your recovery
The phases and goals for both partial meniscectomy and meniscal repair are the same, although the expected timescales are approximately doubled following a meniscal repair, meaning a full recovery will take a little longer. If you have had a meniscal repair your surgeon or physiotherapist will advise you about returning to your usual activities including, for example, temporary restrictions on how much to bend your knee.