Do you really want your meniscus tear repaired? #meniscustear

Everybody seems to be dialed into the fact that the meniscus is an important part of the cushioning of the knee joint.  In fact, an intact meniscus, along with neutral alignment, is the best way to prevent long term wear and tear arthritis, also known as osteoarthritis.  

That often gets translated into everybody wanting their meniscus “fixed” or sewn back up when it is torn.  The only problem is that not all meniscus tears heal when sewn together and the rehabilitation is twice as long following a repair compared to a meniscus trimming.  

Remember that only the peripheral half, or maybe even one third, of the meniscus has any sort of blood supply.  

Tears in the avascular zone are extremely unlikely to ever heal, even if sewn together.  So if you are going to do the 3-4 months of rehabilitation required of a meniscus repair, you’d like to know that it is worth it.  

Even in the ideal situation, a meniscus that just tore yesterday in the well vascularized portion of the meniscus and gets repaired, only about 85% of these will heal. That sounds great as a patient, but as a doc we like surgeries that are in the 95% chance of success.

 As we do repairs in the less vascularized portion of the meniscus, the odds of success can get down in the 50-50 category pretty quickly.  Other factors that can affect the percentage chance of success include how long ago the tear occurred, whether the meniscus itself is degenerative, as well as the health of the rest of the joint.  

Issues like pre-existing arthritis, instability and map-alignment, all play into the ability for a repaired meniscus to heal. If that repaired meniscus does not heal, you will typically need a second surgery, often just 9-12 months down the line.

So…..we all want to preserve as much of the cushion as we possibly can inside the knee.  From a patient’s perspective, help us look at the overall picture and make sure it is a “worth it” deal to have it repaired.  

Medicine is often about the numbers.  What are the realistic chances of a successful outcome following my repair? is a great question to ask before making an informed decision.

On the hugely plus side, we keep improving our methods to stack the deck in your favor.  Less invasive repair techniques and biologic enhancements with PRP, stem cells and other growth factors keep allowing more and more people to keep all of their “cushion” while they pursue their dreams and activities”.