Meniscus: Repair or Replace?

A misstep on the sports field or an awkward move while twisting or turning at home or work. Sometimes it doesn't take much to tear the meniscus, the rubbery piece of cartilage protecting the knee. When there's a tear that won't heal, is it better for doctors to repair or replace?

Seventeen-year-old, Owen Joyce, loves to practice soccer with his brother Reilly. Owen is a three sport varsity athlete. During tryouts last spring, he made a sudden move and another player fell onto his leg.

Owen explained, "When I went to lift it up it caved in, and this part of my knee went straight to the ground and it kinda noodled out. And, it just felt like a huge release of pressure."

Owen had an ACL injury and a torn meniscus. Both required surgery.

"Many, many years ago, meniscus tears were thought to be best dealt with by just taking the whole meniscus out. Unfortunately, that led to a lot of arthritis," said John-Paul H. Rue, MD, Orthopedic Sports Medicine Surgeon at Mercy Medical Center in Baltimore.

Over the past ten years, studies show a growing number of patients are opting to have the meniscus repaired.

Dr. Rue continued, "As we've gotten better with technology and the surgical tools and our ability to fix these or repair these, we've become more skilled at preserving the meniscus."

Dr. Rue said surgeons weigh a patient's age and the extent of the injury. If the tear is in what they call the "red zone", an area where there's good blood supply that helps with healing. One drawback, recovery after repair is slow, six to eight weeks.

It's been several months since doctors repaired Owen's ACL and meniscus. He is almost full strength.

Owen's advice to others, "Your time will come soon enough when you are gonna be able to get back on that field and play the way you used to."

As we age, the meniscus becomes more brittle, making it more susceptible to tears. Minor tears can go away in two or three weeks. Moderate to severe tears often require treatment. The good news is that Owen has just been fully cleared to play soccer again.