Meniscus Tear Surgery

Written by Dr Gowreeson Thevendran, MBChB (Bristol), MRCS.Ed, Dip. Sports Med.Ed, FRCS.Ed (Trauma & Ortho. ), FAMS (Singapore)

What Is The Meniscus

The meniscus is a piece of cartilage in the knee joint that acts as a shock absorber between the thigh bone (femur) and the shinbone (tibia). The meniscus serves a critical function in the knee joint, acting as a cushion and stabiliser, essential for smooth and pain-free movement.

What Is A Meniscus Tear

A meniscus tear is a common knee injury, particularly prevalent among individuals engaged in sports and physical activities. This happens when the meniscus, a C-shaped piece of cartilage, is injured or torn. Surgery or non-surgical treatments may be required to support recovery and rehabilitation after the injury has occurred.

A meniscus tear can occur due to various reasons such as:

  • Sudden twisting or turning of the knee 
  • Repetitive movements
  • Deep squatting or heavy lifting in the gym
  • Constant kneeling 
  • Ageing which may lead to cartilage weakening
  • Sports or vigorous exercises 

Meniscus tears can affect individuals of all ages and lifestyles, manifesting as pain, swelling, or a hindrance in knee mobility. Athletes or individuals who engage in sports and high-intensity activities are at a higher risk of a meniscus tear due to the intense physical demands and dynamic movements, leading to increased susceptibility to meniscus injuries.

Symptoms Of A Torn Meniscus

Common symptoms of a torn meniscus include: 

  • Knee pain
  • Swelling
  • Clicking or popping sensation 
  • Difficulty bending and straightening the knee
  • Instability of the knee joint 
  • Feeling like your knee is locked when you try to move it 

Meniscus injuries can affect anyone, from athletes to older individuals with age-related wear and tear. Patients who experience persistent pain, swelling, or difficulty bearing weight on the affected knee should seek intervention and treatment for a meniscus injury. 

Factors that can worsen a meniscus injury include: 

  • Engaging in high-impact activities such as running and jumping
  • Being overweight or obese
  • Having a previous knee injury or surgery
  • Having a degenerative joint condition such as osteoarthritis

Additionally, patients who delay seeking intervention and treatment for a meniscus injury may potentially add further damage to the knee joint. It is crucial to seek accurate diagnosis and appropriate treatment from a healthcare professional or orthopaedic surgeon in Singapore for effective recovery and long-term knee health. 

Diagnosing Meniscus Tear

The diagnosis of a meniscus injury usually begins with a physical examination, where your doctor will look for signs of swelling, tenderness, or limited range of motion in the knee.

Your doctor may also perform certain tests to assess the extent and severity of the injury such as:

  • McMurray test
  • Apley's compression test
  • X-rays
  • MRI scans
  • CT scans

Once the diagnosis is confirmed, the type of treatment recommended will depend on the extent of the injury, the patient's age, overall health, and activity level, as well as any other underlying medical conditions.

Non-Surgical Meniscus Injury Treatment

Treatment for a meniscus injury will depend on the severity of the tear, as well as the age and activity level of the patient. In mild cases of meniscus tears, conservative treatment options may be recommended. This includes rest, ice, compression, and elevation (RICE), as well as non-steroidal anti-inflammatory drugs to help manage pain and swelling. Physical therapy may also be recommended to help strengthen the muscles around the knee joint and improve flexibility. However, in more severe cases of meniscus tears, surgery may be necessary.

Arthroscopic Meniscus Surgery

Arthroscopic meniscus surgery is a minimally invasive procedure where a tiny camera, called an arthroscope, is inserted into the knee joint to diagnose and repair meniscus tears. Using small incisions and an arthroscope, it allows the surgeon to view the meniscus tear clearly and make accurate diagnosis and repairs. Arthroscopic meniscus surgery is generally less invasive compared to a traditional open knee surgery, resulting in potentially faster recovery times and less postoperative pain. Depending on the tear, the surgeon may opt to stitch the torn sections together (Meniscus repair surgery) or remove the damaged part of the meniscus (Partial meniscectomy).

Meniscus Injury Treatment

Treatment for a meniscus injury will depend on the severity of the tear, as well as the age and activity level of the patient. In mild cases of meniscus tears, conservative treatment may be recommended. This may include rest, ice, compression, and elevation (RICE), as well as non-steroidal anti-inflammatory drugs to help manage pain and swelling. Physical therapy may also be recommended to help strengthen the muscles around the knee joint and improve flexibility.

In more severe cases of meniscus tears, surgery may be necessary. Arthroscopic surgery is a minimally invasive procedure in which a small camera is inserted into the knee joint to view the tear and repair it. The surgeon may use sutures or anchors to hold the torn meniscus together, or they may remove the damaged part of the meniscus.

Following surgery, patients will need to rest and limit their activity for several weeks. Physical therapy may also be recommended to help with the healing process and to prevent further injury. Most patients can expect to return to their normal activities within 6-8 weeks following surgery.

Partial Meniscectomy

Partial meniscectomy is a surgical procedure focusing on removing the damaged parts of the meniscus, particularly from the "white zone", which indicates the area of the meniscus with limited blood supply and low healing potential. 

This surgical approach, aimed at preserving as much healthy tissue as possible, often leads to faster pain relief and a shorter recovery period than meniscus repair. However, it might increase the risk of osteoarthritis over time due to decreased cushioning in the knee.

Each of these procedures has its indications based on the type, location, and extent of the meniscus tear, as well as the patient's age, activity level, and overall health. It's essential to consult with an orthopaedic doctor to determine the most suitable approach for individual cases.

Before starting your treatment for a meniscus injury in Singapore, it is advised to patients to inform the doctor of any allergies or medical conditions they may have and to disclose any medications or supplements they are currently taking. Additionally, it is important to follow all recovery or aftercare instructions as directed by the doctor. 

Recovery Period For Torn Meniscus Surgery

Following the meniscus surgery, patients will need to rest and limit their activity for several weeks. Physical therapy may also be recommended to help with the healing process and to prevent further injury. Most patients can expect to return to their normal activities within 6-8 weeks following surgery.

Post-surgery care may include: 

  • rest, ice, compression, and elevation (RICE), 
  • taking medications as prescribed, 
  • physical therapy exercises, 
  • avoiding high-impact activities, and gradually increasing activity levels. 

It is important to follow the advice of your doctor or surgeon to ensure proper healing and deter future injury.

Dr Gowreeson Thevendran

Dr Gowreeson Thevendran is an orthopaedic surgeon in Singapore who specialises in orthopaedics and trauma surgery. His particular skill set is minimally invasive surgical techniques to address foot, ankle, knee, and hip/thigh conditions, including meniscus injury treatment. He pursued fellowship training for sports surgery at Chelsea & Westminster Hospital, UK and complex trauma and deformity correction at Royal Liverpool University Hospital, UK. He also continues to serve the Orthopaedic Department at Tan Tock Seng Hospital as a visiting consultant.

If you are experiencing persistent knee pain, swelling or any of the symptoms described above for meniscus injury, we recommend seeing an orthopaedic specialist as soon as possible.

Aside from meniscus injury treatments, Orthofoot MD also provides patellar tendonitis and knee replacement surgery for Singapore patients who have knee-related injuries and conditions.

Qualifications

  • Bachelor of Medicine and Surgery, University of Bristol, England
  • Fellow of the Royal College of Surgeons, Edinburgh
  • Diplomate Faculty of Sports and Exercise Medicine, Royal College of Surgeons Edinburgh
  • Fellow of the Academy of Medicine, Singapore

Awards

  • SICOT PIONEER Founders Award 2020
  • 2015 European Foot & Ankle Society ‘Best Podium Presentation’ Award
  • 2013 Singapore Orthopaedic Association Junior Travelling Fellowship
  • 2012 NHG Critical Talent Special Recognition Award
  • 1998 Enid Lindt Prize in Clinical Surgery
  • 1995 Public Services Department Full Medical scholarship

Meniscus Surgery Frequently Asked Questions

1Can a torn meniscus heal itself?

Most mild meniscus injuries typically heal within two to three weeks with conservative interventions like icing, compression, physical therapy or wearing a knee brace. However, moderate to severe meniscus tears may require six to eight weeks to heal. If pain and symptoms persist beyond three months, it's crucial to consult a specialist to evaluate the need for meniscus surgery in Singapore.

2Does insurance and Medisave cover meniscussurgery?

Orthofoot MD is on the panels of different health insurance plans and also accepts Medisave. Patients seeking meniscus surgery in Singapore should inquire with both their insurance provider and the clinic regarding their eligibility for insurance and Medisave coverage. While multiple treatments may be covered, the extent of coverage for meniscus injury treatment and surgery may vary and is subject to verification by the clinic.

3What are the causes of meniscustears?

Meniscus tears can result from both acute injuries and degenerative processes. Athletes often experience these tears due to twisting or pivoting movements, direct contact like a tackle, or squatting deeply. However, non-athletes can also suffer from meniscus tears due to degenerative changes in the knee as they age, where even mundane activities like standing up from a chair can lead to a tear. Factors such as previous knee injuries, obesity, and certain occupations or sports that place significant stress on the knees can increase the risk of a meniscus tear.

4What are the risks and complications of meniscus surgery?

While meniscus surgery, particularly arthroscopic surgery, is generally safe and effective, it's not without risks. Potential risks and complications may include infection, blood clots, nerve injury, and knee stiffness. In some cases, the meniscus surgery might not completely resolve your symptoms, or you may need additional procedures in the future. However, these risks are relatively low, and we take comprehensive steps to minimise them, including using advanced surgical techniques and providing detailed post-surgery care instructions.

5Can I participate in sports with a torn meniscus?

It is not advised to participate in sports with a torn meniscus. Engaging in sports when you experience a meniscus injury can exacerbate it and lead to further damage. The timeline for returning to sports varies depending on the severity of the meniscus tear, the type of treatment or surgery you have undergone, and your individual healing process. It is crucial to follow a structured rehabilitation program and get clearance from your healthcare provider before gradually resuming your sports activities.

Clinic Location

OrthofootMD@Novena

OrthofootMD@Mount Alvernia Hospital