Physical Therapy in Pittsburgh for Knee

Q: I'm getting the impression that when you have a torn knee meniscus, it's always better to have it repaired, rather than removed. What are the success rates with meniscal repair versus removal?

A: Over the years, it has been discovered that removing the meniscus entirely is not a good idea. Too many people developed early osteoarthritis after a meniscectomy. So, the standard procedure has gradually changed from complete removal to repair of the torn meniscus whenever possible. And when it has to be removed, as little as possible is taken out whenever possible.

The meniscus is a C-shaped piece of thick cartilage in the knee. It has several main functions. One is to provide optimal weight-bearing through the knee. Another purpose is to absorb shock. The meniscus also helps stabilize the joint and help the joint slide and glide smoothly during movement.

There are two menisci: one on each side of the knee. Most often, the medial meniscus (side closest to the other knee) is damaged when athletes and sports players plant the foot on the ground and rotate or pivot the leg to change directions suddenly.

Studies show that the success rate for the arthroscopic repair of meniscal tears ranges from a low of 64 per cent to a high of 97 per cent. Why the extreme ranges? There is evidence to suggest the location of the tear is a big factor.

For example, patients with a full (all the way through the full thickness of the meniscus) but small (less than one centimeter long) tear are good candidates for a repair procedure. Partial removal (meniscectomy) is more likely when the rupture is located where the blood supply is poor or when the tear is too large to repair.

Compared with even 10 years ago, today there are newer and better surgical instruments that have helped improve the chances of reaching and repairing meniscal tears. Patients
aren't negatively impacted by how long they wait to have surgery or the type of sutures used to repair the damage as much as they are affected by the location of the rupture.

Reference: Thomas Stein, MD, et al. Long-Term Outcome After Arthroscopic Meniscal Repair Versus Arthroscopic Partial Meniscectomy for Traumatic Meniscal Tears. In The Journal of Sports Medicine. August 2010. Vol. 38. No. 8. Pp. 1542-1548.