Meniscus Injury: When to Preserve and When to Operate?

The meniscus is a crescent-shaped structure that plays a fundamental role in knee biomechanics. There are two menisci in each knee — the inner (medial) and outer (lateral) — and both are essential for the long-term health of the joint.

Function of the meniscus

The meniscus plays a fundamental role in load transmission, stability and energy dissipation in the knee joint. It functions as a natural shock absorber between the femur and tibia, distributing weight evenly and protecting the articular cartilage.

Types of injury

Meniscus injuries can be:

• Traumatic — acute tears from knee twisting, common in young athletes
• Degenerative — progressive wear, more frequent after age 40

The type, location and size of the tear, as well as the patient's age and activity level, determine the treatment strategy.

Conservative treatment

Not all meniscus injuries require surgery. Small, stable injuries in the vascularised zone may respond well to rest, ice, anti-inflammatories and targeted physiotherapy.

Surgical treatment by arthroscopy

Meniscal repair (suture)

When the injury is located in the vascularised zone of the meniscus (peripheral third), repair by suture is the preferred option. This technique preserves the meniscus and its protective function, preventing future development of osteoarthritis.

Partial meniscectomy

When repair is not possible, only the damaged portion is removed, preserving the maximum amount of healthy meniscal tissue. Recovery is faster — usually 2 to 4 weeks.

The meniscus should, whenever possible, be preserved through repair. Its absence, total or partial, leads to degenerative phenomena and osteoarthritis.

Recovery

After partial meniscectomy, most patients resume normal activities in 2-4 weeks and sport in 4-6 weeks. After meniscal repair, recovery is longer (3-6 months) to allow complete tissue healing.