Meniscal Tear Repair Surgery

The meniscus is a crescent-shaped piece of cartilage that sits between the femur and tibia in each knee — one on the medial (inner) side and one on the lateral (outer) side — acting as a shock absorber, load distributor, and stabilizer that protects the joint surface during every step, pivot, and landing. Meniscal tears are one of the most common knee injuries, frequently occurring during sports activities that involve twisting, pivoting, or sudden deceleration, though they can also result from degenerative wear in older patients. Symptoms typically include pain isolated to one side of the knee, swelling, clicking or popping, and in more severe cases mechanical locking where the knee gets stuck mid-motion. Because the meniscus plays such a critical role in distributing load across the joint — and because removing damaged meniscal tissue accelerates the development of osteoarthritis — preserving and repairing the meniscus whenever possible is one of the most important principles in modern knee surgery.

Dr. Jonathan Glashow is a board-certified orthopedic surgeon and Clinical Associate Professor of Orthopedic Surgery at NYU Grossman School of Medicine, with published research in the Journal of Bone and Joint Surgery on ACL and meniscal diagnosis — including one of the earliest double-blind studies evaluating MRI accuracy for detecting meniscal lesions. This research directly shaped the diagnostic standards used in clinical practice today. With over 30 years of arthroscopic experience, fellowship training at the Southern California Orthopedic Institute/UCLA, and membership in the Arthroscopy Association of North America, Dr. Glashow has repaired thousands of meniscal tears and is a strong advocate for meniscal preservation over removal whenever the tear pattern and tissue quality support repair. As Chief Medical Officer for the New Jersey Devils and Philadelphia 76ers, he manages acute meniscal injuries in professional athletes where saving the meniscus can be the difference between a long playing career and early-onset arthritis. Named a Castle Connolly Top Doctor every year since 2000, he performs meniscal repair and root reattachment surgery at his Upper East Side practice in New York City.

Symptoms & Signs That You may Need Meniscal Repair or Reattachment

• Swelling of the knee which usually begins the same day or next day after an injury
• Pain is usually isolated to one side of side of the knee
• Locking of the knee is taking place.
• Persistent pain in the knee.
• Clicking or popping of the knee is present.
• Pain immediately present after a sporting injury.

Unfortunately, only about 15 to 25% of meniscal cartilage tears are actually surgically repairable by an orthopedic surgeon. This percentage goes down the longer the gap is between the injury and the actual arthroscopy. This means yous should seek the immediate medical attention of a Meniscal repair specialists such as the NYC orthopedic surgeon, Jonathan Glashow, MD, Also, these figures apply to patients under the age of 40. If the Mensical is irreparable a menicsus reattachment surgery, or other type of orthopedic knee surgery may be necessary such as a meniscal transplant.

Even though the recovery is longer for a meniscus repair than for a meniscectomy, any repairable meniscus should generally be repaired. Meniscus repair is considered when:

• The patient is healthy and wishes to remain physically active.
• The patient understands the rehabilitation.
• The meniscus tear is located in the periphery of the meniscus.
• The meniscus tissue is of good quality.

What is Meniscal Reattachment / Meniscal Root Repair?

The root attachments of the posterior horns of the medial and lateral meniscus are very important for joint health and optimal performance. When these are severely torn, the loading of the joint is equivalent to having no meniscus whatsoever on the affected side. The orthopedic surgery technique of a meniscus root repair involves isolating the root and placing a sutures in the remaining meniscal to surgically engage attachment. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be re-positioned and attached.

It is best to seek a consultation with our NYC orthopedic surgeons to discuss your surgical options for your specific case.

If you are experiencing knee pain, swelling, locking, or clicking after a sports injury or twisting movement, a meniscal tear may be the cause — and early evaluation gives you the best chance of a repair rather than removal. Dr. Glashow offers same-day MRI and comprehensive arthroscopic evaluation at his Upper East Side practice. Contact our office to schedule your consultation.

 

Frequently Asked Questions About Meniscal Repair Surgery

What is the difference between a meniscal repair and a meniscectomy?

A meniscal repair involves stitching the torn meniscal tissue back together so it can heal, preserving the full structure of the meniscus and its load-distributing function within the knee. A meniscectomy involves trimming or removing the damaged portion of the meniscus — which relieves symptoms more quickly but permanently reduces the joint’s shock-absorbing capacity and increases the long-term risk of osteoarthritis. Dr. Glashow prioritizes repair over removal whenever the tear location, pattern, and tissue quality support it, because preserving meniscal tissue is one of the most effective ways to protect the knee joint long-term. When the meniscus is too damaged to repair and a significant portion must be removed, a meniscal transplant may be recommended to restore the joint’s shock-absorbing function and prevent accelerated cartilage breakdown.

Why can only some meniscal tears be repaired?

The meniscus has a variable blood supply — the outer third (called the “red zone”) receives adequate blood flow and has good healing potential, while the inner two-thirds (the “white zone”) has little to no blood supply and heals poorly. Tears in the red zone or at the junction between the red and white zones (the “red-white zone”) are the most amenable to repair. Tears in the avascular white zone, chronic degenerative tears with poor tissue quality, and complex tear patterns with fragmented tissue are generally not repairable. Additionally, the longer the delay between injury and surgery, the lower the likelihood of successful repair — which is why Dr. Glashow recommends prompt evaluation for any suspected meniscal tear.

What is a meniscal root tear, and why is it different from other tears?

A meniscal root tear occurs where the meniscus attaches to the tibia — at the very back (posterior horn) of the medial or lateral meniscus. This attachment point anchors the meniscus in place and allows it to function as a load distributor. When the root is torn, the meniscus can no longer resist the outward forces generated during weight-bearing, and the joint loading becomes equivalent to having no meniscus at all on the affected side. Root tears accelerate cartilage breakdown rapidly and are treated with a specific surgical technique — root repair and reattachment — in which sutures are placed through the meniscal root and secured through a bone tunnel in the tibia to restore the anatomic attachment.

How long does recovery take after meniscal repair?

Recovery from meniscal repair is longer than from meniscectomy because the repaired tissue needs time to heal. Most patients use crutches and limit weight-bearing for four to six weeks, with gentle range-of-motion exercises beginning within the first one to two weeks. A progressive physical therapy program advances through strengthening and functional training over the following months. Return to daily activities typically occurs around two to three months, and return to sports generally takes four to six months. Dr. Glashow coordinates rehabilitation closely with physical therapists to ensure the repair heals fully before the knee is loaded with sport-specific demands.

Can a meniscal tear heal on its own without surgery?

Small tears in the outer (vascularized) portion of the meniscus — particularly stable, longitudinal tears that do not produce mechanical symptoms — may heal with conservative treatment including rest, anti-inflammatory medications, and physical therapy. However, most symptomatic meniscal tears — especially those causing locking, catching, or persistent pain — do not heal on their own and require arthroscopic treatment. Dr. Glashow evaluates each tear with MRI and clinical examination to determine whether a trial of conservative management is appropriate or whether surgical intervention is needed to prevent further damage.

What happens if a meniscal tear is left untreated?

An untreated meniscal tear can lead to worsening mechanical symptoms — including increased catching, locking, and pain — as well as progressive damage to the articular cartilage on the femur and tibia as the torn meniscal fragment disrupts the smooth gliding surfaces of the joint. Over time, this cartilage damage leads to osteoarthritis, which is irreversible. Additionally, the torn portion of the meniscus can enlarge and become more complex over time, reducing the likelihood that it can be repaired rather than removed. Early evaluation and treatment give the best chance of preserving the meniscus and protecting the joint.