What is involved in meniscal repair surgery?

The steps involved in meniscal repair surgery include:

Diagnostic Arthroscopy

2-3 small (< 1cm) portals are created to allow passage of a camera and surgical tools within the knee joint. The whole joint is inspected for damage.

Meniscal repair

The torn meniscus is repaired using stitches. If it all possible, a repair is preferable to a resection as the shock absorbing function of the meniscus is retained. Sometimes this can be performed completely via key-hole surgery using an “all-inside” surgical device.

If the tear is extensive, an accessory incision is made on the side of the knee, and sutures are passed from the inside of the knee to the outside through the open accessory incision. These stitches are then directly tied over the capsule to provide strong repair. This is considered the gold standard for meniscal repair.

Meniscal resection

In some situations, the torn meniscus is not suitable for repair and the torn portion is therefore trimmed to a stable margin. This can relieve the pain and mechanical symptoms associated with a tear. Trimming the meniscus will reduce its shock absorbing capacity and will put more pressure on the surrounding cartilage. This will cause the cartilage to wear out quicker than normal and lead to arthritis in the knee.