Meniscus repair could be the term in medicine that’s most like cell phone coverage ads on TV ̶ it all looks good on the surface, but the reality is different. So what is a meniscus repair and who gets one (versus cutting the meniscus out)? What are the meniscus repair complications you should be concerned about?
The knee meniscus is a shock absorber that helps protect the cartilage. When surgery is recommended, very few of these surgeries are actually meniscus repairs. One recent study found that only 4% of meniscus surgeries were repairs, while 96% were cutting out the torn portion of the damaged meniscus. If you end up being that rare patient who actually gets a meniscus repair-how well do they work? One study found that even in young patients who should have the best results, meniscus repair only works about 60% of the time. What are complications when it doesn’t work?
The image above is from a young woman who had a meniscus repair that was a failure. I saw this woman last week in the office as she was interested in taking the non-surgical stem cell injection route, having been soured on surgery. The ultrasound above shows the meniscus which has a huge tear despite the surgery and the dashed circle shows what’s left of an anchor the surgeon tried to use to repair her meniscus. That anchor has now scarred down and sits in the middle of her MCL ligament, where it shouldn’t be!
The video below shows her biggest complication at this point, likely created by the surgery. In this dynamic ultrasound I’m stressing her knee sideways, toward the surgical site. Rather than remaining stable, the knee joint gaps and the meniscus moves in and out of the joint. This instability is a real problem, as it’s a known cause of more arthritis as the joint will get more beat up over time. This is the most common post meniscus surgery finding I see in painful knees everyday.
The upshot? Knee meniscus repair is usually not done. However, when the surgery is performed, the success rate is lower than patients often realize and the problems can be legion. Just ask this poor woman!