A meniscal tear is an injury to the cartilage in the knee joint, often caused by twisting your knee. It is particularly common among sports people and is also associated with ageing. While you may not experience pain immediately if you tear your meniscus, it may intensify over time and your knee may become stiff.
The meniscus has a limited blood supply which means it does not always heal well from injury. Sometimes when you tear it, a piece of cartilage breaks loose and this can become caught in your knee joint, causing it to lock. Read more about the causes, symptoms and diagnosis of meniscal tears in our blog Meniscal Tears: Causes and Symptoms.
Surgical Treatment of Meniscal Tears
There are two main types of surgery offered to patients with meniscal tears:
- Debridement (also called arthroscopic menisectomy) involves removing the torn piece of meniscus. This is the most common surgical procedure for this type of injury and is an effective way to relieve symptoms. However, the disadvantage is that it leaves patients with a smaller meniscus than before and may also increase the risk of osteoarthritis.
- Surgical repair preserves the entire meniscus, however, it is not suitable for every type of tear due to the limited blood supply in the area. Tears near to the end of the meniscus have a greater chance of healing than those in the middle. Younger patients may also heal more effectively than older patients. Repairs to the meniscus are carried out arthroscopically (keyhole surgery) using stitches.
There are pros and cons to each approach. While debridement generally has a shorter recovery time, patients have a greater chance of developing osteoarthritis over time and if the condition becomes severe they may require knee replacement surgery.
Research into outcomes of meniscal tear debridement
A research study published in the journal The Knee in January 2021 looked at the outcomes of meniscal tear debridement in younger patients in the 20 year period following the procedure.
A group of researchers from The University of Turin and Villa Maria Pia Hospital in Turin looked at retrospective data for 225 patients aged from 18 to 50 who underwent a debridement for meniscal tear. They looked at patient outcomes 20 years after surgery, including how many of them went on to need a total knee replacement.
They found that 10 patients (4.4% of the sample) needed a total knee replacement in the follow-up period. The average time between undergoing a debridement and having knee replacement surgery was seven years. Certain factors made patients aged between 40 and 50 significantly more likely to need a knee replacement. These included: malalignment, lateral debridement, advanced chondral lesion and total menisectomy. Those most at risk were women aged between 40 and 50 with advanced chondral lesion.
The researchers concluded that patients undergoing meniscal tear debridement surgery have poorer outcomes if they have advanced chondral lesions or if they undergo a lateral debridement or total menisectomy. Age is also a factor and women are at greater risk than men.
If you have a meniscal tear, contact us to discuss your treatment options. Based on the location and extent of the tear as well as your age, sex and other factors, we will be able to advise you on the best type of surgery to achieve positive long-term outcomes.
