A meniscus tear doesn’t usually heal by itself. Only smaller tears caused by degenerative processes can initially be treated conservatively.
Knee specialists can carry out numerous clinical tests. A magnetic resonance imaging (MRI) scan of the knee can also be performed if the diagnosis is uncertain. Besides determining the precise extent of the meniscus damage, this procedure can also be used to diagnose concomitant knee injuries.
A meniscus tear doesn’t usually heal by itself. Only smaller tears caused by degenerative processes can initially be treated conservatively. Acute meniscus ruptures are unlikely to heal by themselves. In fact, meniscus tears are likely to worsen as a result of the strain which the knee is subjected to during everyday life. The range of indications for arthroscopic surgery (keyhole surgery) is correspondingly wide. Decisions for or against surgery are mostly made on the basis of a clinical examination and the patient’s clinical symptoms, supplemented if applicable by the results of the MRI scan.
Endoscopic examination of the knee (arthroscopy)
The goal is always to remove as little meniscus tissue as possible. However, the problem is that the meniscus tissue in most parts of the knee tends to heal poorly. If the tear is located in a zone where it is likely to heal, the meniscus is stitched. The knee must then be rested for a period of several weeks after the surgery. However, only around 10% of all meniscus tears can be sutured in this way.
Around 90% of meniscus tears cannot be stitched. In these cases, the damaged part of the meniscus has to be removed. This is carried out as sparingly as possible to conserve as much of the remaining meniscus tissue as possible. This means that only the torn or frayed region is removed during the resection, while the majority of the meniscus is left intact. The greater the amount of meniscus tissue that has to be removed, the less of a buffer the knee will have with which to absorb shock. This increases the risk of the patient developing arthritis in the knee later on.
If meniscus tissue is removed, the postoperative treatment period is much shorter than that required for a sutured tear. Under normal circumstances, the patient is soon able to move and place their weight on the knee as before. In contrast, meniscus suturing requires the patient to rest their leg and restrict the movement of the knee for longer.
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University Hospital Zurich
Department of Traumatology