What is the treatment for a meniscus tear?
The meniscus cartilage can be separated into two components. The outer third portion of the meniscus, the “red zone”, contains a healthy blood supply that allows small meniscus tears to heal without surgery. A “white zone” that lacks a blood supply comprises the inner two-thirds of the meniscus. This lack of nutrients creates an unfavorable environment for meniscus tears to spontaneously resolve. When formulating an appropriate treatment plan, Dr. Patel will consider the patient’s age, activity level, extent and location of the injury, and the desired recovery outcomes.
Non-surgical therapies can be considered for patients with a small meniscus tear along the outer third portion of the meniscus that does not result in any joint instability. The pain and inflammation associated with this condition can be alleviated with a combination of rest, ice, and non-steroidal anti-inflammatory medications (NSAIDs). If these symptoms still persist with oral medications, a corticosteroid injection can be administered directly into the knee. A physical rehabilitation program will also be recommended to restore stability and strength to the knee.
In the event of failed conservative or non-surgical therapy, or a meniscus tear affecting the inner two-thirds of the meniscus, a minimally invasive surgical procedure may be necessary. This arthroscopic meniscus repair uses a small camera (arthroscope) and specialized surgical instruments to accomplish the necessary revisions. One or more of the following surgical techniques may be performed based on Dr. Patel’s intra-operative findings:
- Meniscectomy: This procedure removes the meniscus portions that are irreparably damaged. Patients with larger meniscus tears or who have exhausted all other treatment options are ideal candidates for this procedure.
- Meniscal Repair: This technique re-attaches the severed cartilage portions with special surgical anchors that are secured within the bone. This procedure is ideal for tears affecting the outer third portion of the meniscus that did not respond well to non-surgical therapies.
- Biologic Augmentation: The patient’s own bone marrow, known as Bone Marrow Aspirate Concentrate (BMAC), or a solution of platelet-rich plasma (PRP) can be introduced to generate new tissue at the injury site. These alternative therapies are often performed in conjunction with a meniscal repair.