Meniscectomy for a Meniscus Tear

Surgery Overview

Meniscectomy is the surgical removal of all or part of a torn meniscus. A meniscus tear is a common knee joint injury. Surgeons who perform meniscectomies (orthopedic surgeons) will make surgical decisions based on the meniscus's ability to heal as well as your age, health, and activity level.

Your doctor will likely suggest the treatment that he or she thinks will work best for you based on where the tear is, the pattern of the tear, and how big it is. Your age, your health, and your activity level may also affect your treatment options. In some cases, the surgeon makes the final decision during surgery, when he or she can see the how strong the meniscus is, where the tear is, and how big the tear is.

• If you have a small tear at the outer edge of the meniscus (in what doctors call the red zone), you may want to try home treatment. These tears often heal with rest.
• If you have a moderate to large tear at the outer edge of the meniscus (red zone), you may want to think about surgery. These kinds of tears tend to heal well after surgery.
• If you have a tear that spreads from the red zone into the inner two-thirds of the meniscus (called the white zone), your decision is harder. Surgery to repair these kinds of tears may not work.
• If you have a tear in the white zone of the meniscus, repair surgery usually isn't done, because the meniscus may not heal. But partial meniscectomy may be done if torn pieces of meniscus are causing pain and swelling.

There are different types of meniscus tears. The pattern of the tear may determine whether a tear can be repaired. Horizontal and flap tears typically require surgical removal of at least part of the meniscus.

How it is done

The choice of type of surgery is based on the size and location of the tear, your age and activity level, the surgeon's experience, and your preferences. Orthopedic surgeons most often perform meniscus surgery with arthroscopy, a procedure used to both examine and repair the inside of a joint. A thin tube (arthroscope) containing a camera and light is inserted through small incisions near the joint. Surgical instruments are inserted through other small incisions. Arthroscopic surgery may limit knee damage from surgery and may promote fuller recovery. But some tears may require open knee surgery.

In a total meniscectomy, the entire meniscus is removed. In a partial meniscectomy, the surgeon removes as little of the meniscus as possible. Unstable meniscal fragments are removed, and the remaining meniscus edges are smoothed so that there are no frayed ends.

You may have general or regional anesthesia for a meniscectomy. Arthroscopic partial meniscectomy is commonly done in an outpatient surgical center.