The meniscus is a pliable substance made up of soft tissue that sits between two bones in the knee joint, the femur (thigh bone) and tibia (shin bone). Some patients with meniscus tears can be treated with a combination of activity modification and a focused physical therapy program. Other patients with persistent symptoms or certain tear patterns require surgery.
Dr. Welch always tries to retain as much healthy meniscus as possible during surgery because patients are more likely to develop arthritis without a meniscus. Mensicus tears located on the periphery of the meniscus in the “red-red” zone are more likely to heal than other meniscus tears. Vertical-shaped tears are also more likely to heal than other tear-patterns, such as radial tears. In healthy patients, Dr. Welch will likely recommend repair of the meniscus if it is located in the “red-red” zone and if the tear is vertical. Dr. Welch does not recommend meniscal repair in all patients because some tears will not heal, even if Dr. Welch ties the meniscus tear back together with sutures. In those patients with meniscal tears that likely would not heal, Dr. Welch usually recommends that the torn area of the meniscus is removed (partial meniscectomy).
If Dr. Welch recommends meniscal repair, he will repair the meniscus with strong sutures using a minimally invasive technique (arthroscopic technique). During surgery, Dr. Welch passes the sutures through each side of the torn meniscus with sharp needles or a “suture-passing” device. Dr. Welch then ties square knots with the appropriate tension to repair the torn area.
Following surgery, patients are placed in a hinged brace that is locked straight. Dr. Welch recommends partial weight bearing for 4-6 weeks in the brace. When the patient is sitting or lying down, Dr. Welch encourages knee range of motion exercises with the brace removed. Dr. Welch also recommends intermittent icing and straight leg raises to strengthen the quadriceps muscles. Dr. Welch recommends starting formal physical therapy one week after surgery. Physical therapy focuses on reducing swelling in the knee, restoring full range of motion, and eventually, restoring strength to the knee. Most patients can start full weight bearing on the affected leg 4-6 weeks after surgery. Most patients start cutting activities and sporting activity approximately 4-6 months after surgery.