Meniscus Tear Treatment Options
Treatment options depend on several factors including age, activity level, comorbidities, symptoms, and the type and location of the tear. There are two areas of the meniscus – the red zone and the white zone.
Red zone tears
The red zone is the outer portion of the meniscus which has a good blood supply. A good blood supply is essential for healing. About 30% of meniscus tears occur in the red zone. Small tears in the red zone may be treated with conservative management and may be able to heal naturally. However, when symptoms persist or there is a large tear arthroscopic surgery to repair the meniscus may be recommended.
White zone tears
The white zone has a limited blood supply. Without healing nutrients in the blood these tears cannot heal on their own. About 70% of meniscus tears occur in the white zone. If symptoms do not improve with conservative management, arthroscopic surgery may be recommended. Dr. Patel will discuss methods to augment meniscus tears in this zone to provide nutrients and enhance healing potential.
What are the treatment options for meniscus tears?
Available treatment options are conservative management, partial meniscectomy, and meniscus repair. The goal is to preserve the meniscus because it is an indispensable part of biomechanical knee function and stability. Meniscus allograft transplantation is another option when someone has a large deficiency of the meniscus, especially at a young age. It involves replacement of the damaged meniscus with a graft meniscus.
Conservative management is often first line treatment for red zone tears in a stable knee, and for degenerative tears. Treatment includes rest, icing, compression, elevation, over the counter and prescription anti-inflammatory medication (NSAIDS), and physical therapy to improve range of motion and strength. Cortisone injections may help reduce pain and swelling. Orthobiologics such as platelet rich plasma (PRP) are also arising as an option for certain tear types.
If conservative management and injection therapy are insufficient to resolve symptoms, knee arthroscopy may be recommended.
Repair is favored over partial meniscectomy because repair restores joint biomechanics and recognizes the importance of preserving the meniscus. Repair is the treatment of choice for acute traumatic tears, tears in young patients, and other tears in the red/white zone. Dr. Ronak Patel, utilizes biological augmentation to enhance healing capabilities. New strategies to enhance the success of meniscus repair include orthobiological enhancement and tissue engineering. Orthobiological enhancement with platelet rich plasma may be recommended to accelerate healing.
Various innovative techniques are available to salvage the damaged meniscus. During this procedure the torn pieces of cartilage are sutured back together. Dr. Patel will use a combination of techniques to mechanically restore the integrity of the meniscus.
Most people who have arthroscopic meniscus repair gradually improve in regards to pain and function. There is a period of crutch use and bracing. Physical therapy allows patients to return to normal activities. A full recovery for a meniscus repair can take 4-6 months.
This is a procedure to remove torn cartilage fragments and trim the meniscus to restore a stable meniscus. The goal is to relieve mechanical symptoms like catching and locking, and pain. Arthroscopic partial meniscectomy is the most frequently performed orthopaedic surgery in the world.
Many arthroscopic partial meniscectomies are performed in middle aged and older populations with degenerative tears, to improve knee pain and function and quality of life. Early postoperative physical therapy is recommended for degenerative tears.
Physical therapy begins right away after surgery. Rehabilitation and return to everyday activities take about 2-6 weeks.
Meniscal replacement is also known as meniscus transplantation. Dr. Patel is one of the few surgeons in the area who is trusted to perform such complex surgeries. Meniscus transplantation places an entire new meniscus in the patient’s knee and is meant to preserve the knee joint from arthritis.
Dr. Ronak M. Patel is a double board-certified orthopaedic surgeon and sports medicine physician trained at Northwestern University and received a fellowship at the Cleveland Clinic. He specializes in the treatment of all knee injuries and degenerative conditions. Contact him to schedule a consultation to learn more about how he can help you return to the life you love and the activities that make life worth living. He serves teens and adults in Chicagoland and NW Indiana.
At a Glance
Ronak M. Patel M.D.
- Double Board-Certified, Fellowship-Trained Orthopaedic Surgeon
- Past Team Physician to the Cavaliers (NBA), Browns (NFL) and Guardians (MLB)
- Published over 49 publications and 10 book chapters
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