Meniscal Surgery Explained: Meniscectomy vs Meniscal Repair vs Arthroscopy

Understanding the Types of Meniscal Surgery

When dealing with a torn meniscus, there are several surgical options available, including meniscectomy, meniscal repair, and arthroscopy. Each approach has its own purpose, recovery timelines, rehabilitation protocols, and potential outcomes. In simple terms, a meniscectomy involves removing the damaged part of the meniscus, a meniscal repair focuses on stitching and saving the meniscus, and arthroscopy is the minimally invasive technique used for both procedures. Understanding these key differences is essential for patients considering surgery for knee pain, swelling, or instability due to meniscal injuries.

What Is a Meniscectomy?

A meniscectomy is one of the most common surgical treatments for a torn meniscus. During this procedure, the surgeon removes the damaged portion of the meniscus, leaving as much healthy tissue as possible. The aim is to relieve pain and restore knee function quickly. Since this procedure removes part of the cartilage cushion, recovery is often quicker than more complex repairs, but it may slightly increase the long-term risk of developing osteoarthritis in the affected knee. Meniscectomy is typically chosen for tears that are unlikely to heal on their own or in areas with low blood supply where natural healing is limited.

Meniscal Repair: Saving the Meniscus

Unlike a meniscectomy, a meniscal repair aims to preserve the natural cartilage by sewing the torn sections together. This option is usually recommended for younger, active patients or when the tear is in a region with good blood supply, which boosts healing potential. Meniscal repair procedures take longer to heal compared to meniscectomy because the tissue must naturally mend. However, preserving the meniscus provides better protection for the knee joint and may help prevent arthritis in the long run. Surgeons use specialised techniques and anchors to stitch the meniscus, relying on the body's natural healing capabilities to ensure repair success.

Arthroscopy: The Minimally Invasive Approach

Arthroscopy is a modern surgical method that uses a tiny camera and special instruments inserted through small incisions to treat meniscal injuries. Whether performing a meniscectomy or a meniscal repair, surgeons usually use arthroscopy because it offers less trauma to the joint, reduced pain, and a smaller risk of infection compared to traditional open surgery. Patients benefit from quicker postoperative mobilisation, minimal scarring, and generally faster initial recovery. Arthroscopy can diagnose, clean up, and fix various knee problems, making it the gold standard for most meniscal surgeries today.

Healing Times and Rehabilitation Differences

Recovery after meniscectomy is usually swift, with many patients returning to light activities within a few weeks. Walking soon after surgery is often encouraged, and a physiotherapy programme focused on restoring knee strength, balance, and function can be started early. In contrast, meniscal repair requires more caution. Patients may need to use crutches for several weeks, limit weight-bearing, and follow a structured rehabilitation protocol to protect the healing tissue. Rehabilitation after meniscal repair can last several months, focusing on gradual improvement of range of motion, muscle strength, and joint stability to maximise the chance of a successful repair. Arthroscopy supports quicker healing for both procedures but does not alter the fundamental difference in recovery timelines between meniscectomy and meniscal repair.

FAQ

What is the main difference between a meniscectomy and meniscal repair?

A meniscectomy involves removing the damaged part of the meniscus, while a meniscal repair aims to stitch and save the torn tissue. The primary difference is that meniscectomy offers quicker recovery but removes some of the cartilage cushion, whereas repair keeps more natural tissue, often needs longer to heal, but better preserves long-term knee function.

How does arthroscopy help in meniscal surgeries?

Arthroscopy is a minimally invasive surgical technique used to see inside the knee joint and perform procedures like meniscectomy and meniscal repair. It results in smaller incisions, less pain, quicker recovery, and lower risk of infection compared to traditional open surgery methods.

Which surgery has the shortest recovery time?

Meniscectomy typically allows for the quickest recovery, with many patients resuming light activity in two to four weeks. Meniscal repair, due to the need for the tissue to heal properly, may require three to six months of rehabilitation before returning to full activities.

Will I need physiotherapy after my surgery?

Yes, physiotherapy is a key part of recovery after both meniscectomy and meniscal repair. The therapist will develop a programme to restore knee strength, flexibility, and stability, ensuring the best possible outcome post-surgery. Early physiotherapy can also help prevent stiffness and muscle wasting.

Are there risks of developing osteoarthritis after meniscal surgery?

There is a slightly higher risk of developing osteoarthritis after meniscectomy because removing cartilage reduces the knee’s natural padding. Meniscal repair, by preserving more tissue, helps protect the joint over time and may lower this risk. Deciding which surgery is best depends on the type and location of the tear, as well as patient age and activity level.

When should I consider consulting a surgeon for a meniscus tear?

If you experience persistent knee pain, swelling, locking, or instability after an injury and conservative treatments have not helped, consult an orthopaedic surgeon. Early assessment allows for optimal treatment planning and better long-term results, especially for active individuals or those wishing to maintain joint health.