
When Is Knee Surgery the Best Option for a Meniscus Tear?

Meniscus tears are a common knee injury, affecting as many as 1 million Americans each year. These tears happen when you turn or twist the knee while flexed with the foot planted. As you grow older, you’re more vulnerable to meniscus tears.
If you’ve torn your meniscus, don’t automatically assume you need surgery. The team of experienced orthopedists — Nic Gay, MD, Masi Reynolds, DO, and April Mancuso, MD, at Silicon Valley Orthopaedics in Fremont, California, frequently diagnose and treat meniscus tears.
Here’s when they recommend surgery.
What is the meniscus anyway?
You have two menisci in each knee. They are crescent-shaped pieces of cartilage that cushion the upper and lower leg bones where they meet in your knee. The one inside of the knee is called the medial meniscus, and the one on the outside is the lateral meniscus.
The menisci are smooth, rubbery, and flexible and act as shock absorbers for the knee cartilage that lines your knee joint. Healthy menisci keep your knee joint functioning. Damaged menisci make you more vulnerable to knee arthritis.
What happens with a meniscus tear?
A meniscus tear happens when the tissue undergoes stress or sudden impact. Often, you experience the tear when you turn or twist when your knee is flexed (straight) and the foot is planted. Incidents that lead to tears include lifting something very heavy or participating in contact sports.
As you age, your menisci wear down and weaken. That makes you more vulnerable to tears.
When should I suspect a meniscus tear?
When you tear your meniscus, you’ll likely notice sharp pain, along with locking and catching of the knee. You’ll notice your knee gets “stuck” when you walk or get up from a seated position.
Swelling is common, as is pain in the back of your knee.
When do I need surgery for a meniscus tear?
Our team at Silicon Valley Orthopaedics considers several factors when determining whether you need surgery for a meniscus tear. These include:
Tear size
If the tear is 5 millimeters or smaller, it’s likely that it will heal on its own. Temporary immobilization in a brace and physical therapy are the treatments of choice.
Your age
Younger patients are better able to heal from surgery. They’re eager to get back to full function, like sports play, and benefit from knee surgery.
Location of the tear
Tears on the outer edge of your meniscus respond better to surgical repair. Tears that occur within the inner two-thirds of the meniscus are less likely to heal well.
Type of tear
Your meniscus can tear in several directions. Vertical tears can be surgically repaired more easily and successfully compared to tears that are radial or flap.
Cause of the tear
A tear that results from a sudden injury responds to surgical treatment better than those that occur because of wear-and-tear. Sudden tears usually have smooth, clean edges that respond well to surgery.
What’s involved in meniscus surgery?
If you need surgical treatment, our team may recommend one of several procedures:
Arthroscopic repair
This minimally invasive procedure involves small incisions into which our team inserts an arthroscope — a small instrument with a camera. That gives us a good look at your tear and allows us to place small devices to stitch it up. These devices prompt healing and dissolve over time. Whenever possible, our surgeons recommend repair.
Arthroscopic removal
Also known as a meniscectomy, removal of the torn meniscus may be partial or total. Our surgeon removes a piece of the torn meniscus or the entire meniscus, depending on your case. Usually, our team avoids removing the entire meniscus when possible.
If you’re struggling with knee pain, contact Silicon Valley Orthopaedics. You may have a torn meniscus or another knee injury that requires expert care. Call today or use this website to schedule your visit.
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