Many young athletes suffer meniscus tears in their knees playing sports. Unlike adults, their tears can often be repaired instead of trimmed out. What happens if a meniscus repair fails? In this Ask Dr. Geier column, I address that question from a young baseball player who fears that his meniscus repair hasn’t healed.
I’m Jared, and I love baseball. I had a horizontal tear in the posterior horn of my medial meniscus. I had surgery to get it repaired, but I can’t tell if it’s healing or not. My doctor said it would be 8 to 12 weeks, and I’m on week 6 and I could still feel the pain even though it’s not as bad as before. Should I be concerned? Also, if it doesn’t heal and he has to remove it, would it affect my baseball career?
That’s a reasonable question, Jared. Your surgeon can give you more specific answers, but I can discuss meniscal repairs in a general sense.
Meniscus tears in certain locations and orientations can be repaired, meaning the surgeon can sew the tear together with stitches. That is great when it is possible because it can preserve the entire meniscus rather than trimming out the torn portion. If it heals, the entire meniscus remains to serve as a shock absorber.
A meniscus repair can take 8 to 16 weeks to completely heal. The surgeon will often limit knee motion and stress on the repair for some of that time to increase the chance that it heals. He likely will keep the athlete out of sports for months after surgery to protect the repair. If the patient progresses well through rehab, the surgeon and physical therapist will progress him through a return-to-sports program.
Signs and symptoms when meniscus repair fails
If a patient develops pain along the joint line or locking or catching during his postoperative course, it is possible that the meniscus repair didn’t heal. An MRI in the early weeks after surgery can be confusing because the repair might not be expected to have fully healed yet. Also a regular MRI might fail to demonstrate the difference between scar tissue within the repair and a new or continued tear. An MR arthrogram, where dye is injected in the knee before the MRI, is more helpful. Dye can leak through the repair and show that it hasn’t healed.
If a meniscus repair fails, the surgeon usually performs a second surgery to trim out the tear. As with any partial meniscectomy, that trimming relieves pain but does decrease the amount of meniscus remaining. Concern for the development of arthritis changes years down the road does exist.
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