Surgical Treatment

Reviewed by Greg Jaroszynski MD, FRCSC | Last updated May 2026

Surgery may be considered for displaced tears causing locking, repairable traumatic tears, selected root tears, or persistent symptoms despite appropriate non-surgical care. Modern treatment emphasizes preserving as much healthy meniscus as possible.

Meniscal repair

Technical details

Meniscal repair is usually performed arthroscopically through small portals. The tear is inspected, unstable edges are prepared, and sutures or repair devices are used to hold the tissue together. Techniques include all-inside, inside-out, and outside-in repair. Repair is most suitable when the tear is peripheral, traumatic, vertical/longitudinal, and the tissue quality is good.

Recovery

Recovery is slower than after partial meniscectomy because the repaired tissue needs to heal. Protocols may include crutches, a brace, limits on deep bending, avoidance of twisting or pivoting, and a structured physiotherapy program. Return to higher-impact activity often takes several months.

Outcome

The goal is meniscal preservation and long-term joint protection. Successful healing can provide good pain relief and return to activity, but some repairs fail and may require additional surgery.

Meniscal excision / partial meniscectomy

Technical details

Partial meniscectomy removes only the unstable torn fragment while preserving as much normal meniscus as possible. The remaining rim is contoured to a stable edge. This may be appropriate for non-repairable unstable fragments.

Recovery

Weight bearing and range of motion usually progress faster than after repair, depending on associated findings. Rehabilitation emphasizes swelling control, motion, gait normalization, and strengthening.

Outcome

Partial meniscectomy can improve catching or sharp mechanical symptoms in selected patients. Outcomes are less predictable when the tear is degenerative or when arthritis is the main pain generator. Because removing meniscal tissue can reduce load-sharing capacity, excision should be selective.

Selected references

1. American Academy of Orthopaedic Surgeons. Management of Acute Isolated Meniscal Pathology: Evidence-Based Clinical Practice Guideline. 2024.
2. Siemieniuk RAC, et al. Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline. BMJ. 2017;357:j1982.
3. Noorduyn JCA, et al. Effect of physical therapy vs arthroscopic partial meniscectomy in people with degenerative meniscal tears: five-year ESCAPE trial follow-up. JAMA Network Open. 2022.
4. American Academy of Orthopaedic Surgeons. Management of Osteoarthritis of the Knee (Non-Arthroplasty). 2021.
5. Health Canada. Regulation of autologous stem-cell products prepared at point-of-care for orthopedic applications. 2022.