Written by Dr Gowreeson Thevendran, MBChB (Bristol), MRCS.Ed, Dip. Sports Med.Ed, FRCS.Ed (Trauma & Ortho.), FAMS (Singapore)
Table of contents
- What Is The Meniscus
- What Is A Meniscus Tear
- Symptoms Of A Torn Meniscus
- What Are the Causes of Meniscus Tears?
- Diagnosing Meniscus Tear
- Non-Surgical Meniscus Injury Treatment
- Arthroscopic Meniscus Surgery
- Treatment Plans
- Recovery Time For Torn Meniscus Surgery
- Meniscus Tear Prevention Tips
- Why Choose OrthofootMD?
- Dr Gowreeson Thevendran
- Frequently Asked Questions about Meniscus Surgery
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, that 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.
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 Tear
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 proper diagnosis and appropriate treatment from a healthcare professional or orthopaedic surgeon in Singapore for effective recovery and long-term knee health.
What Are the Causes of Meniscus Tears?
Meniscus tears can stem from a variety of factors, encompassing both sudden traumatic events and gradual wear-and-tear processes.
Acute Injuries: Athletes frequently experience meniscus tears due to the dynamic nature of their activities. Sudden twisting or pivoting movements, direct impacts during contact sports, and deep squatting or constant kneeling can all exert excessive force on the meniscus, leading to tears.
Degenerative Changes: In non-athletes, meniscus tears often arise from age-related degeneration of the cartilage. As we age, the meniscus naturally weakens, making it more susceptible to injury even during everyday activities like standing up from a chair.
Risk Factors: Various factors can elevate the risk of meniscus tears, including:
- Previous knee injuries or surgeries
- Obesity, which places additional stress on the knee joints
- Occupations or sports involving repetitive kneeling, squatting, or heavy lifting
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 a proper diagnosis and repairs. Arthroscopic meniscus surgery is generally less invasive compared to 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 Repair Surgery
Meniscus repair surgery is a procedure aimed at restoring the integrity of a torn meniscus. During the meniscus repair surgery, the surgeon carefully stitches the damaged meniscus back together, facilitating the natural healing process. The sutures used are absorbable, meaning they will gradually dissolve as the tear heals, leaving no permanent foreign material within the knee.
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 supports efficient pain relief and a less extensive 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, it is advised that patients 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.
Treatment Plans
As mentioned, treatment for a meniscus tear is tailored to the individual patient, considering the severity of the injury, the patient's age, activity level, and overall health. A comprehensive treatment plan, comprising either conservative treatment options or surgical interventions, aims to address the pain, restore knee function, and prevent future complications.
After undergoing meniscus surgery, patients generally can return home on the same day. The recovery process entails a phase of rest and limited activity, followed by a tailored rehabilitation programme. The duration of recovery can differ based on the surgical approach and individual healing capacities, usually spanning a few weeks for partial meniscectomy to several months for meniscus repair or replacement.
Consistent follow-up appointments with your orthopaedic surgeon are vital throughout your treatment journey. These appointments enable your surgeon to monitor your healing progress, modify the treatment plan if necessary, and address any questions or concerns you may have.
Recovery Time 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.
General outline of the recovery timeline and associated milestones:
| Phase | Key Goals | Activities and Restrictions |
| Immediately after surgery |
|
|
| First few weeks after surgery |
|
|
| First few months after surgery |
|
|
| Return sports |
|
|
It is important to follow the advice of your doctor or surgeon to ensure proper healing and deter future injury.
Meniscus Tear Prevention Tips
While it's impossible to completely eliminate the risk of accidental injuries, proactive steps can be taken to minimise the likelihood of a meniscus tear:
- Strengthen Your Knee Muscles: Regularly engage in exercises that target the muscles surrounding your knee, particularly the quadriceps, hamstrings, and calf muscles. Strong muscles offer better support and stability to the joint, reducing stress on the meniscus.
- Consider a Knee Brace: If you have a history of knee instability or weakness, wearing a supportive knee brace during physical activities can provide additional protection and stability.
- Ease into Exercise: When embarking on a new exercise routine or intensifying your current one, it's important to progress gradually. Allow your body sufficient time to adapt to the increased physical demands, preventing undue stress on your knees.
- Prioritise Warm-Up and Cool-Down: Dedicate time to warm up your muscles and joints before engaging in any physical activity and cool down afterwards. This preparatory and recovery phase helps reduce the risk of injuries by enhancing flexibility and promoting circulation.
Why Choose OrthofootMD?
At OrthofootMD, we specialise in the diagnosis and treatment of lower limb conditions, including meniscus tears. Our team possesses experience in managing meniscus injuries, offering both non-surgical and surgical options tailored to your specific needs. We are committed to providing personalised care and guiding you through every stage of your recovery.
Our clinic's focus on lower limb orthopaedics translates to an understanding of the intricacies of the knee joint and the impact of meniscus tears on its function. With a patient-centred approach, we prioritise your comfort and well-being, utilising minimally invasive techniques whenever possible and providing comprehensive post-surgical rehabilitation to facilitate recovery.
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 treatment 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
Frequently Asked Questions about Meniscus Surgery
Wondering how to heal a torn meniscus naturally? 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.
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.
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. Additionally, there is also a small risk of a meniscus re-tear, which might require further surgical intervention. Muscle wasting and a potential loss of full range of motion are other concerns that could impact the long-term functionality of the knee. 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 surgical techniques and providing detailed post-surgery care instructions.
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 programme and get clearance from your healthcare provider before gradually resuming your sports activities.
Clinic Location
OrthofootMD@Novena
- Mount Elizabeth Novena
38 Irrawaddy Road #05-42 Mount Elizabeth Novena Specialist Centre Singapore 329563
OrthofootMD@Mount Alvernia Hospital
- (Mount Alvernia Hospital)
820 Thomson Road #01-01/02 Mount Alvernia Medical Centre A Singapore 574623