Meniscal Repair (Arthroscopic )
Arthroscopic meniscal repair to preserve knee cartilage and support joint stability
Meniscal repair (arthroscopic) is a minimally invasive surgical procedure used to treat certain types of meniscal tears within the knee. The menisci are two specialised pieces of cartilage that act as shock absorbers and stabilisers between the thigh bone and shin bone. When the meniscus is torn, it can lead to symptoms such as pain, swelling, catching, locking, or instability within the joint.
Where appropriate, repairing the meniscus may help preserve the natural cartilage structure and function of the knee.
- What is arthroscopic meniscal repair?
- When arthroscopic meniscal repair may be recommended
- Preparing for arthroscopic meniscal repair surgery
- What happens during arthroscopic meniscal repair
- Understanding the risks and considerations
- What to expect after meniscal repair surgery
- Rehabilitation and recovery after surgery
- Long-term outcomes after arthroscopic meniscal repair
What is arthroscopic meniscal repair?
Arthroscopic meniscal repair is a minimally invasive (keyhole) procedure used to repair a torn meniscus within the knee joint.
The menisci are specialised pieces of cartilage that help provide shock absorption, stability, and protection within the knee. When the meniscus is torn, it can lead to symptoms such as pain, swelling, catching, or locking.
Rather than removing the damaged tissue, meniscal repair aims to preserve and stabilise the natural meniscus where possible. The procedure is performed using arthroscopic techniques, where a small camera and specialised instruments are inserted through small incisions around the knee.
Not all meniscal tears are suitable for repair. Suitability depends on factors such as the type and location of the tear, tissue quality, and overall condition of the knee.
The aim of arthroscopic meniscal repair is to support healing, knee stability, and long-term joint function, although outcomes can vary between individuals.
When arthroscopic meniscal repair may be recommended
Arthroscopic meniscal repair may be considered when a meniscal tear is causing ongoing symptoms and the tear pattern is considered suitable for repair rather than removal. Not all meniscal tears require surgery. Some may improve with physiotherapy, activity modification, and non-surgical management, particularly when symptoms are mild and the knee remains stable.
Meniscal repair may be discussed in situations such as:
- Tears in the peripheral (outer) zone of the meniscus, where blood supply is better and healing potential may be improved
- Acute or traumatic tears, often occurring during sport or twisting injuries
- Associated knee injuries, such as ACL tears or other ligament injuries
- Persistent symptoms, including pain, swelling, catching, locking, or instability despite rehabilitation and non-surgical treatment
The goal of repair is to preserve as much of the natural meniscal tissue as possible, helping support long-term joint function. In some cases, the location or complexity of the tear may mean that a partial meniscectomy (removal of the damaged portion of the meniscus) is more appropriate.
The decision to proceed with meniscal repair depends on factors such as the type, location, and age of the tear, as well as your symptoms, activity level, and overall knee condition.
Preparing for arthroscopic meniscal repair surgery
Preparing for arthroscopic meniscal repair surgery involves clinical assessment, physical preparation, and practical planning to support a smooth procedure and recovery.
Before surgery, Dr Scott Tulloch will perform a comprehensive evaluation of your knee, which may include:
- A detailed clinical examination
- Imaging, such as MRI and X-rays, to assess the meniscal tear and identify any associated injuries within the knee
This assessment helps determine whether the tear is suitable for repair and assists with surgical planning.
You will also receive pre-operative instructions, which may include guidance on:
- Fasting prior to surgery
- Managing or temporarily stopping certain medications
- Preparing for your hospital admission
- Organising crutches or a knee brace for use after surgery
Prehabilitation (pre-surgery physiotherapy) may be recommended to help optimise the knee before surgery. This can include:
- Reducing swelling
- Improving range of motion
- Strengthening the quadriceps and surrounding muscles
Optimising your general health may also support recovery. This can include maintaining a healthy weight, stopping smoking, and managing any underlying medical conditions. It is also helpful to prepare your home environment for your return after surgery, particularly if you will have temporary weight-bearing or movement restrictions in the early stages of recovery.
Dr Scott Tulloch will discuss your individual surgical plan, expected recovery, and rehabilitation pathway, helping you feel informed and prepared for your procedure.
What happens during arthroscopic meniscal repair
The Arthroscopic meniscal repair procedure is typically carried out under general anaesthesia or regional anaesthesia (such as a spinal anaesthetic), so you will be comfortable throughout.
Surgical technique
The surgery is performed using arthroscopic (keyhole) techniques, which involve small incisions and the use of a camera to visualise the inside of the knee.
During the operation:
- Small incisions are made around the knee to insert a camera (arthroscope) and specialised instruments
- Dr Tulloch carefully assesses the meniscal tear and surrounding joint structures, including the cartilage and ligaments
- The torn meniscus is prepared to encourage healing
- Specialised sutures or fixation devices are used to repair and stabilise the torn tissue
- Any associated injuries within the knee may also be assessed and addressed where appropriate
Once the repair is complete, the knee is checked for stability and movement. The incisions are then closed and dressed, and you will be transferred to recovery for monitoring.
Duration
The procedure typically takes around 1 hour, although this can vary depending on the complexity of the tear and whether additional procedures are required.
Understanding the risks and considerations
All surgical procedures carry potential risks, and arthroscopic meniscal repair is no exception. Understanding these risks and considerations can help you make an informed decision about your care.
General risks associated with surgery may include:
- Infection
- Bleeding
- Blood clots (deep vein thrombosis or pulmonary embolism)
- Reactions to anaesthesia
There are also considerations specific to meniscal repair. These may include:
- Persistent knee pain or swelling
- Stiffness or reduced range of motion
- Failure of the meniscus to heal, which may require further treatment or surgery
- Re-tearing of the meniscus, particularly with return to higher-demand activity
- Ongoing catching or mechanical symptoms in some cases
- Nerve irritation or numbness around the incision sites, which is often temporary
Not all meniscal tears are suitable for repair, and healing can depend on factors such as the location of the tear, blood supply to the tissue, and adherence to rehabilitation. Because the repair needs time to heal, recovery after meniscal repair is often more protective and gradual than after procedures where damaged meniscal tissue is removed.
What to expect after meniscal repair surgery
Recovery after arthroscopic meniscal repair is typically structured and progressive, with a focus on protecting the repaired meniscus while allowing the knee to heal.
Hospital stay
Meniscal repair is commonly performed as a day procedure, meaning many patients return home on the same day. In some cases, an overnight stay may be recommended depending on your individual circumstances.
Pain management
It is common to experience pain, swelling, and stiffness in the early stages after surgery. These symptoms are managed with:
- Medications prescribed by your care team
- Cold therapy (ice) to reduce swelling
- Elevation of the leg to support circulation
Assistive devices and mobility
You will usually begin mobilising soon after surgery with guidance from a physiotherapist.
Crutches are often required during the early recovery period to reduce load on the healing meniscus. A knee brace may also be recommended in some cases.
Discharge instructions
Before leaving hospital, you will receive guidance on:
- Wound care and dressing management
- Managing pain and swelling
- Weight-bearing and movement restrictions
- Use of crutches or bracing, if required
- Recognising signs of complications
Because the meniscus is being repaired rather than removed, activity levels are usually progressed more gradually to allow the tissue time to heal. Recovery timelines can also vary depending on the type of tear, repair performed, and individual response to rehabilitation.
Rehabilitation and recovery after surgery
Rehabilitation following arthroscopic meniscal repair is a structured and progressive process designed to protect the healing meniscus while restoring movement, strength, and knee function.
Early phase (first few weeks)
The initial focus is on:
- Managing pain and swelling
- Protecting the meniscal repair
- Regaining gentle range of motion
- Activating the quadriceps muscles
- Beginning walking with crutches, often with restricted weight-bearing as advised
A structured physiotherapy program usually begins soon after surgery, with exercises tailored to the type of repair performed.
Intermediate phase (weeks to months)
As healing progresses, rehabilitation focuses on:
- Improving range of motion
- Rebuilding muscle strength, particularly in the quadriceps and surrounding hip muscles
- Enhancing balance and movement control
Activity levels are gradually increased based on your healing progress and symptoms.
Later phase (return to activity)
Rehabilitation continues with:
- Advanced strength and conditioning exercises
- Gradual return to higher-level activities and sport, where appropriate
- Functional exercises aimed at improving confidence and knee control
Recovery timeline
Recovery after meniscal repair is often more gradual than after meniscal trimming procedures, because the repaired tissue requires time to heal. Improvement typically occurs over several months, with return to higher-demand activity guided by your progress and rehabilitation.
Following your rehabilitation program carefully is important, as returning to activity too early may place stress on the repair.