Terrell Joseph, MD is a board-certified orthopaedic surgeon and sports medicine specialist at Vail-Summit Orthopaedics & Neurosurgery. Dr. Joseph has a strong clinical focus on meniscus surgery. As a fellowship-trained orthopedic surgeon, Dr. Joseph remains on the cutting-edge of sports medicine innovation. He has treated many meniscus repair patients with successful results. Patients are concerned about when to have meniscus surgery, and Dr. Joseph wants patients to have the facts on when to have meniscus surgery.
What is a torn meniscus?
The two menisci of the knee — the inner medial meniscus, and the outer lateral meniscus — are C-shaped cartilage cushions which provide stability and weight distribution across the knee. A torn meniscus can occur with sudden rotation, twisting, quick pivots, and direction changes. These movements are commonly seen in sports like basketball and soccer. A meniscus tear is classified as partial, or full — typically occurring at the edges of the meniscus.
What are the symptoms of a torn meniscus?
Patients with a torn meniscus experience a range of symptoms:
Pain - localized to the affected side of the knee
Swelling - inflammation at the tear causing swelling
Stiffness - limited range of motion, straightening, and bending
Sensation - clicking, popping, catching caused by displaced torn tissue
Locking knee - torn fragment, displaced within joint, and locks knee
Instability - knee giving-way from loss of cushioning
How do I know I have a torn meniscus?
Dr. Joseph’s multi-step diagnostic protocol will determine the location and degree of a torn meniscus. The patient completes a medical history including specifics of current symptoms and prior knee injury. The doctor performs a physical examination involving palpitation and pressure to different areas of the knee assessing tenderness, swelling, and pain. Range of motion and joint stability are evaluated. The doctor will physically maneuver, flex, rotate, and extend the knee assessing for clicking, popping and pain. Diagnostic imaging will complete the evaluation, including x-ray and/or MRI.
The clinical findings and imaging will inform Dr. Joseph’s diagnosis, location and grade of torn meniscus.
When to have meniscus surgery
The decision of when to have meniscus surgery will usually follow a course of non-surgical treatments. Rest, pain management, physical therapy, activity modification, and injection therapies are among possible options. If, after a period of up to several weeks to a few months, symptoms persist, or if daily activity is affected, meniscus repair may be indicated. Factors impacting urgency for meniscus surgery:
Large, complex and white zone tears: Meniscus tears that are large, complex or located in the white zone of the tendon with its limited blood supply are less able to heal. Meniscus surgery can repair or remove the damage.
Catching or locking of the knee: This symptom, caused when a torn fragment impedes function indicates meniscus repair, to clean the damage and restore function.
Younger active patients: Long-term knee function and a return to full activity are key benefits for younger patients; a favorable risk/reward ratio for meniscus surgery.
Associated knee instability: A meniscus tear may generate knee instability due to ligament injury, laxity. Meniscus repair treats both.
Dr Joseph’s patient-centered approach to care ensures that each patient will receive the highest standard of non-surgical treatment. When indicated, Dr. Joseph and his patient will work together on the decision of when to have meniscus surgery. Patients value his individualized approach to this important decision.
What is the recovery after a meniscus repair?
Recovery from meniscus surgery begins in the immediate postoperative period. Surgeon instructions are provided, including pain medication, ice packs, and instructions to elevate the leg. Rest, limited weight-bearing, and use of crutches or a walker will be prescribed for a period of time. A targeted course of physical therapy will begin as soon as the doctor releases the patient. Follow-up appointments, and a gradual return to activities, under guidance from the surgeon and physical therapist are essential. Recovery time ranges from several weeks to a few months. Patient compliance throughout recovery is crucial for optimal results.
Dr. Joseph’s personalized approach to care is a top reason patients seek his expertise for the important question of when to have meniscus surgery. Request a consultation with Dr. Joseph today.
Call (970) 476-7220 today to make an appointment or submit a request using their online form.