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Repairs are performed on tear near the outer third of the Meniscus where a good blood supply exist, or on large tears that would require a near total resection. The torn portion of the Meniscus is repaired by using either plain suture or Suture along with bioinert devices which help to keep the torn edges together with very minimally invasive technique.
Meniscus tear are addressed according to the symptoms and the grade of the tear.
The repairability of any Meniscus tear will depend not only on the type of tear but also the zone in which they have occurred.
The tear in the red on red zone are repaired the most as this area has good blood supply on both sides of tear and have a good chance of healing as compared to Red on white or white on white where the blood supply is poor.
Similarly the type of tear also affects the repairability.
A longitudinal tear are best repaired as they show good healing potential while horizontal tears do well after good debridement alone. In some cases of horizontal tear repair is possible with mattress suture.
Radial tyres initially were thought to be non-repairable but with newer repairing technique they too have shown promising results.
The degenerative tears and flap tears which are generally a result of wear and tear over the period of time may not respond well to repair and often have to be trimmed. Here also where possible an attempt is made to repair in order to preserve the anatomy and function of the knee.
Three different kinds of surgical techniques are used to repair the meniscus
Post surgery patient is not allowed to put weight on the operated leg for 2 to 3 weeks. A long leg brace is given for immobilisation. Physio should begin immediately after surgery which includes
Gentle range of movement exercises are started around three weeks targeting 0 to 45° of flexion only. This is followed by partial weight-bearing walking and regaining full range of movement by end of six weeks. At this stage full weight-bearing walking and advance rehab is started in preparation for return to sports.
Meniscus repair should be considered in a young patient to improve the functional recovery of the knee joint if the Meniscus is repairable.