Overview

This arthroscopic technique allows a torn meniscus to be repaired with internal stitches to suture the meniscus back into place, and then heal. In addition to internal sutures, a small incision may also be required to place stitches anchored outside the joint under the skin. Meniscal repair is reserved for certain types of meniscal tears which have a chance of healing, and which therefore need to have a good blood supply. It is usually therefore, reserved for younger patients, with success rates decreasing with age.

Diagnosis

The diagnosis of a meniscal tear that is suitable for a repair is made on history, examination and review of an MRI scan. Large meniscal tears that are suitable for repair may have displaced into a position in the knee which causes the knee to ‘lock’ – which means the knee cannot fully extend.

Management options

Large tears that are blocking movement and causing locking are very unlikely to go back into an anatomical position on their own. Surgery is therefore, usually required to ‘reduce‘ the meniscus to its anatomical position, and then allow a repair.

Results

The results of meniscal repairs generally depend on the size and positon of the tear. Rehabilitation is stricter than for simple meniscal trimming, to protect the repair. Success rates depend on the presence of other injuries to the knee, and are approxiamately 70 -75%. This means that 25-30% of meniscus tears that undergo repair, will have a further tear and may then need removing. In younger individuals, the removal of large quantities of meniscus may lead to arthritic changes in later life, and hence the desire to repair meniscal tears when possible.

Common questions

General anaesthetic or spinal anaesthetic may be used.

Anaesthetic takes approx. 45-75 minutes. Patients may stay in overnight, but usually go home the same day.

Post-operative rehabilitation is more prescriptive than for meniscectomy.  On crutches for 2- 4 weeks. Graduated, increasing flexion of the knee, with no bend beyond 90 degrees for 6 weeks. No squatting for 3-4 months. Return to full activities – at least 4, possibly 6 months.

Complications

Complications may include but are not confined to

Infection

Stiffness

Nerve or vessel injury

Re-tear of repair.