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Does a Torn Meniscus Always Need Surgery?

“I tore my meniscus so I am probably going to need surgery” —it’s a common thought.  But, it’s also a misconception.

Non-operative treatment of meniscus tears exists and can be effective. An orthopedic surgeon’s treatment recommendation depends on a variety of factors.

How to Determine if a Torn Meniscus Can Be Treated Without Surgery

 There are three things to look for:

  1. Blood supply. The meniscus is classified into two zones, the red zone and white zone. A torn meniscus that has sufficient blood supply (red zone) can often heal without surgery. But, a torn meniscus with a poor blood supply (white zone) often requires surgical repair.
  2. Knee stability. If there is no ligament damage and the knee is stable, the tear can often heal and normal function can be maintained.
  3. Patients who suffer a tear but experience little to no symptoms is likely to be treated non-operatively.

Once your sports medicine specialist has made a diagnosis, a treatment plan can be put into place that will best address the pathology and the resulting limitations.

Non-Operative Treatment of a Torn Meniscus

The first step in treatment is to reduce pain and swelling, usually only taking a few days to improve. At this point, physical therapy is prescribed with the goal being to strengthen muscles of the knee so the joint maintains/improves stability and function. Depending on the severity of injury and symptoms, therapy can be short (2-3 weeks) or long-term (6-8 months), with a progression to a home exercise program and maintenance routine.

Surgical Procedures for Meniscus Tears

As mentioned above, the meniscus is divided into the red zone and the white zone.  The type of procedure recommended is based on where the tear has occurred.

A Tear in the Red Zone

The Red Zone is the outer edge of the meniscus that does have some blood supply. Due to this blood supply, the healing potential is usually much greater and the cartilage can become strong and healthy again.

The most common procedure to treat the Red Zone tears is a Meniscus Repair. This procedure involves using a small puncture to access the meniscus. Once the incision is made, a small camera (arthroscope) is inserted into the knee and surgical tools are used to stitch the meniscus back to its original position, approximating the edges and allowing the tear to heal.

A Tear in the White Zone

The White Zone is the inner 2/3 of the meniscus that is avascular, meaning it has little to no direct blood supply. For this reason, tears in this area not stitched back together because they will not heal.

If surgery is needed for a tear in the White Zone, a procedure known as Meniscectomy is usually performed. This procedure involves using a small camera (arthroscope) to visualize into the knee joint and the torn portions of the meniscus are trimmed, relieving pain and allowing one to return to activity, following a course of physical therapy.

Contacting an Orthopedic Surgeon

Sometimes, surgery isn’t needed for meniscus tears, but only a sports medicine specialist or orthopedic surgeon can determine the best course of action. Give us a call to schedule an appointment and evaluation. One of our specialists will provide you with everything you need to know.

The Orthopaedic & Sports Medicine (OSM) Center has 5 locations throughout Fairfield County.  We utilize the collective skills of our exceptional providers to deliver the most complete musculoskeletal care available. From your first appointment, you are cared for by a team specifically built based on the best treatment for your condition. If surgery is necessary, you will be paired with an OSM surgeon who has the expertise and experience in your specific condition. Our surgeons use the latest minimally invasive techniques where appropriate to ensure fast recovery.  Contact us today to schedule a consult.