MENISCAL REPAIR VS MEMISCECTomy
Meniscal tears are common injuries in the knee and can have detrimental effects on the joint and the quality of life you experience.
Meniscal tears can happen at any age, depending on level of activity. In younger patients, the cartilage is still thick and the meniscus quite mobile - so the injury is usually more severe and an obvious incident. In older patients there is a certain amount of degradation of the integrity of the cartilage and this makes the cartilage thinner and easier to tear. this is known as a degenerative tear.
Usually tears occur at the back of the knee while the knee is very bent(flexed). This puts a lot of point load on the meniscus and if any twisting motion is added to that, this often results in a tear. There are different types of meniscal tear and each type is treated slightly differently.
The problem with the meniscus is that it has very poor blood supply and therefore heals poorly. If a tear is unstable, it will not heal if the knee keeps moving it at the tear and it can become worse. Usually tears that start at the back(posterior) extend forward(anteriorly) with the normal motion of the knee. Therefore a minor meniscal injury can worsen and become a major one.
This make us quite aggressive in treating these unstable injuries and usually we would reccomend either a meniscectomy ofr a meniscal repair. This decision depends on the type of tear and the region where it is torn, your age will also be a factor.
We know that meniscal rtepair takes longer to recover from but we also know that it does help to proect the knee from arthritis later on. I always try to repair the cartilage if at all possible because we can always do a meniscectomy later if the repair fails.