Meniscus Tear Surgery and Prevention

Dr. James - Orthopaedic Surgeon in Singapore

Medically reviewed by Dr. James Tan

The meniscus is a crucial piece of cartilage in the knee that acts as a shock absorber between your thigh bone and shinbone. A tear in this cartilage is a common injury, especially among athletes, and can lead to pain, swelling, and difficulty moving the knee. This guide aims to navigate the complexities of meniscus tear surgery, offering insights into the different types of surgical procedures available, what you can expect during recovery, and, importantly, how to prevent future injuries. Whether you’re facing surgery or looking to strengthen your knees to avoid a tear, this blog will provide valuable information and tips to help you on your journey to recovery and beyond.

Where Is The Meniscus Located

To understand where the meniscus is and how it can get torn, let’s discuss the basic anatomy of the knee. The knee joint is where the thigh bone (femur) and shin bone (tibia) meet with the kneecap providing a cover to this joint. The meniscus is a C-shaped cartilage that cushions between the thigh and shin bones.

The main function of the meniscus is to provide stability in the knee joint and act as a shock absorber during high-impact activities such as jumping, landing on the feet, and running. The meniscus also helps to distribute the weight evenly in the knee joint to promote stability and movement.

What can go wrong with the meniscus?

A meniscus tear can result from acute traumatic injuries or as a result of degeneration over a period of time. In case of acute injury, a torn meniscus is often caused when an athlete or sportsman abruptly twists the upper leg while the feet are planted firmly on the ground. The severity of the tear depends on its appearance and the exact location within the meniscus. These different types of meniscus tears require different treatment modalities.

Surgical Treatment Options For Meniscus Tears

For some meniscus tears, your orthopaedic doctor in Singapore will recommend surgery. The type of surgery will depend on the type of the tear, its location, severity, and other factors. Younger patients or athletes are good candidates for meniscus repair and reconstruction while older patients who have meniscus tears because of degenerative issues are usually treated through non-surgical treatment options. The doctor may choose one of the following surgical procedures to treat a meniscus tear.

Meniscus Repair

The surgeon recommends meniscus repair surgery if there is adequate blood flow in the area to promote healing and the tear is of that type that can be repaired. The meniscus repair surgery is performed through arthroscopy where small incisions are made on the knee. A tiny camera is inserted through one of the incisions that provide a live view of the injury and adjacent regions. The thin surgical instruments are inserted through the other incisions and the tear is then stitched together through sutures. Finally, the surgeon stitches the outside incisions and places a bandage on the knee. Arthroscopic meniscus repair surgery ensures a faster recovery and rapid healing as compared to an open surgery.

Partial Meniscectomy Surgery

If the surgeon suspects that the meniscus tear is in the knee region that has poor blood flow or if the tear is such that it is beyond repair, he will attempt a partial meniscectomy surgery in which the damaged tissue of the meniscus is removed. Often these damaged tissue pieces irritate the surrounding muscles and joints resulting in pain and inflammation as in the case of a flap tear. Removing these damaged pieces can help relieve the symptoms. Partial meniscectomy surgery is also performed through arthroscopy surgery where only tiny incisions are made. The surgery takes around 30 minutes and is performed as an outpatient procedure.

Meniscus Transplant

A meniscus transplant surgery is carried out on patients who have already had a meniscectomy and the major part of their meniscus has already been removed. If the remaining meniscus also develops a tear, it would have to be removed completely rendering the patient without a meniscus. A knee joint that does not have any meniscus is at an increased risk of developing arthritis and other painful conditions of the knee. In such a case, the doctor may perform a meniscus transplant. In this procedure, any remaining damaged meniscus is removed and a healthy meniscus of similar size is taken from a donor and replaced in the patient’s joint. This procedure may be done arthroscopically but an open procedure is preferred.

Meniscus Surgery Combined with Osteotomy

If a meniscus tear is accompanied by a misalignment in the knee joint or leg bones, the surgeon may perform a knee osteotomy along with a meniscus surgery. In knee osteotomy, the thigh or leg bones are realigned by making an incision in the knee where the bones need to be corrected. The bones and the knee joint are aligned correctly by removing a bone wedge or inserting a bone implant wedge to keep the bones and joints in place. Alongside, the surgeon may carry out any meniscus tear surgeries be it repair, meniscectomy, or transplant. In the end, all the incisions are closed through sutures followed by physical therapy and medication to manage pain and strengthen the joints and muscles.

Recovery and Rehabilitation

Whether you follow a non-surgical or a surgical mode of treatment for your meniscus tear, rehabilitation and physical therapy are crucial to ensure an eventless recovery and regaining of normal function. The rehabilitation process can be divided into three phases:

  • Early Recovery Phase: The early recovery phase focuses on managing pain and swelling during the initial days of injury or after surgery. Gentle exercises and therapies are utilised to reduce knee pain, stiffness, and inflammation. The range of motion of the knee is improved during this phase.
  • Strengthening Phase: Once the initial pain and swelling have subsided, the focus of therapy shifts towards strengthening the muscles. Rigorous training and exercises are added to the regimen to improve balance and stability in the knee. Proprioception exercises are utilised to improve the coordination and weight-bearing capacity of the knee joint.
  • Functional Training: The last phase is functional training, where the focus is on involving exercises that allow the patient to return to his normal daily activities or any other high-impact activities. If the patient is an athlete, the exercises replicate his sports movements to enable him to safely return to those activities and minimise the risk of re-injury.

Long-Term Outlook and Prevention

The long-term outlook after a meniscus injury is generally good especially if the patient adheres to the rehabilitation program after appropriate treatment. However, there is still an increased risk of re-injury or osteoarthritis in the patient’s injured knee. By following specific prevention steps and maintaining good knee health, patients can reduce their chances of re-injuring their meniscus. These prevention strategies include:

  • Regularly strengthening the knee joint and leg muscles can help enhance knee stability and balance.
  • Wearing proper footwear and using the correct techniques for moving your knee, landing on your feet, and twisting your legs during sports activities can help distribute the weight evenly on the knee and prevent injuries.
  • Managing your weight also helps reduce the stress on the knees and lowers the risk of meniscus and other tears.
  • Ongoing assessment with your orthopaedic doctor can help identify potential issues early, and consequently, measures can be taken to prevent any bigger injury.

Final Thoughts

Meniscus tear injuries are painful and can interfere with daily life activities. However, many different types of surgical options available for meniscus injuries can help you get back to your normal activities. Ray of Health is a healthcare clinic offering comprehensive meniscus tear treatment in Singapore and treatment for other musculoskeletal conditions. To talk with our qualified healthcare specialist Dr James Tan at Ray of Health, book a consultation today.

Frequently Asked Questions

What are the complications of a meniscus tear?

Untreated tears can lead to long-term knee instability, chronic pain, and an increased risk of osteoarthritis. Surgical treatment may introduce risks such as ruptured meniscus, especially in older patients, and potential complications including knee instability, stiffness, or fracture.

Can a meniscus tear heal on its own?

If it is a small tear, it may heal on its own if you follow the RICE protocol (Rest, Ice, Compression, and Elevation). However, most tears are relatively longer ones in the part of the knee where they just won’t heal by themselves. If the tear is on the outer one-thirds part of the meniscus, it may heal on its own since that area has a rich blood supply that aids in natural healing. However, if the tear is on the inner two-thirds part of the meniscus which lacks abundant blood flow, it will not heal on its own. If left untreated, it can cause much more damage that may require surgical intervention. Therefore, it is always a good idea to visit the doctor’s clinic to get evaluated and seek professional treatment to avoid any more damage.

When can I start walking after meniscus surgery?

Recovery times vary post-meniscus surgery, influencing when you can resume walking. Typically, walking assistance through crutches or a brace may be immediately necessary. The specific recovery timeline, ranging from days to weeks, depends on the surgery type—meniscectomy or meniscal repair. Consult with your doctor for a personalized recovery plan.

Is physical therapy necessary for walking recovery after meniscus surgery?

Physical therapy is crucial for knee strength and stability post-meniscus surgery, aiding in regaining motion and supporting walking recovery. The duration and intensity of therapy vary, tailored to individual needs for optimal rehabilitation.

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About The Author

dr james tan

Dr James Tan Chung Hui

Dr James Tan is a skilled orthopaedic surgeon at Quantum Orthopaedics who has more than 10 years of experience in sports surgery and exercise medicine in Singapore. Apart from partnering with the industry to introduce various treatment techniques, Dr Tan has treated athletes from the Singapore National Teams and professional footballers from the Singapore Premier League and the Young Lions.

Dr Tan specialises in treating sports injuries of the knee, shoulder and elbow joints, as well as cartilage and meniscus surgery. He is a member of the elite Asian Shoulder and Elbow Group and a founding member of the Singapore Shoulder and Elbow Surgery Society.

Qualifications and Achievements
MBBS - National University of Singapore (NUS), Faculty of Medicine
Member of the Royal College of Surgeons of Edinburgh (MRCS)
MMed - Master of Medicine in Orthopaedic Surgery (NUS)
Fellow of Royal College of Surgeons (Edinburgh)
Adjunct Assistant Professor | NUS, LKC
Senior Consultant Orthopaedic Surgery, Sports and Exercise Medicine
Head of Department | Orthopaedic Surgery and Sports Medicine Centre
Awards
Principal Investigator of Tissue Engineering
National Medical Research Council grants
Collaboration with Scientists at NTU, TUM, A*Star, Osteopore & Trendlines Medical Singapore

Accreditations

  1. Mount Elizabeth Orchard
  2. Mount Elizabeth Novena
  3. Farrer Park Hospital
  4. Mount Alvernia Hospital
  5. Aptus Surgery Centre
  6. Novaptus Surgery Centre

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