Meniscus Repair
Surgical treatment of a torn meniscus, performed by a senior orthopaedic specialist with over 30 years of experience.
A twist while squatting. A wrong step getting out of the car. A knee that clicks, catches or locks up. Meniscus tears can happen suddenly (from a sports injury or awkward movement) or slowly (from wear and tear over the years). Either way, the right treatment depends on the type of tear, where it sits in the meniscus, and what your knee needs to do.
Dr Elie Khoury takes a considered, evidence-based view of meniscus surgery. Not every meniscus tear needs an operation. When surgery is the right call, the goal is to preserve as much of your meniscus as possible.
What Is The Meniscus And Why Does It Matter?
Each of your knees has two menisci — the medial meniscus (on the inside of the knee) and the lateral meniscus (on the outside). They're C-shaped pieces of tough cartilage that sit between the thigh bone (femur) and the shin bone (tibia).
The meniscus does a lot of important work. It cushions the joint, spreads load across the knee, helps with stability, and protects the smooth cartilage that lines the bones. When the meniscus tears, that cushioning and load-sharing is reduced. Symptoms can include pain, swelling, clicking, catching, locking, or a feeling that the knee isn't quite right.
There are two main approaches to meniscus surgery:
Meniscus repair — the torn meniscus is stitched back together. This is the preferred option when the tear is in a part of the meniscus with a blood supply, because it preserves the meniscus and protects the knee long-term.
Partial meniscectomy — the small piece of torn meniscus is trimmed away. This is used when the tear can't be repaired, usually because of where it sits or the type of tear it is.
Wherever possible, Dr Khoury aims to repair rather than remove. Preserving the meniscus reduces the risk of arthritis developing later in life.
When Meniscus Surgery Is Recommended
Many meniscus tears don't need surgery. Some heal on their own. Others can be managed well with physiotherapy, activity changes and time. Surgery is considered when the tear is causing significant symptoms that aren't settling, or when the tear is the type that's better treated surgically.
You may be a candidate for meniscus surgery if:
You have ongoing knee pain, clicking, catching or locking after a meniscus tear
Imaging (usually MRI) shows a tear that's suitable for repair, or a tear that's causing mechanical symptoms (catching or locking)
The tear is associated with another knee injury (like an ACL tear) that's being treated at the same operation
Non-surgical treatment has been tried without enough improvement
The type and location of the tear suggest surgical treatment will give a better outcome
In older patients with degenerative meniscus tears (wear-and-tear tears, often alongside early arthritis), the evidence supports non-surgical management as the first step. Surgery in this group doesn't always help and can sometimes accelerate the progression of arthritis. Dr Khoury will give you an honest view of whether surgery is genuinely likely to help your knee.
Dr Khoury's Approach to Meniscus Surgery
The meniscus does important work in protecting your knee long-term. Preserving as much of it as possible is the goal. The decisions about when to operate, when to repair, and when to trim depend on the tear itself, the rest of your knee, and your life.
Dr Khoury's approach is built around three principles.
Preserve the meniscus where possible Repair is preferred over trimming when the tear is suitable. A repaired meniscus continues to protect the knee. A trimmed meniscus is gone for good, and the area it used to protect is now bearing more load.
Surgery only when it's the right answer Many meniscus tears can be managed well without surgery, especially in older patients with degenerative tears. Dr Khoury will recommend non-surgical care first when it's reasonable, and surgery only when it's genuinely likely to help.
The whole knee matters, not just the tear A meniscus tear rarely exists in isolation. Cartilage, ligaments and alignment all influence the outcome of meniscus surgery. Dr Khoury assesses the whole knee, not just the tear on the scan.
What To Expect - Before, During and After
Before surgery Once you've decided to go ahead, you'll meet with Dr Khoury's pre-surgery team. Your imaging is usually already done by this stage.
You may be asked to:
Have any final imaging and blood tests done
Stop or adjust some medications
See a physio before surgery to prepare you for rehab
Arrange transport home after surgery and support for the first few days to a week
Surgery day Meniscus surgery is usually performed under general anaesthetic. It's done through 2 to 3 small incisions (keyhole technique) using a thin camera (arthroscope) and specialised instruments. The surgery typically takes 30 minutes to 1 hour, depending on the type and complexity of the tear.
During the operation, Dr Khoury assesses the tear, the rest of the meniscus, and the surrounding cartilage and ligaments. The decision to repair or trim is sometimes finalised during the surgery itself, once the tear is fully visualised.
Most patients go home the same day.
Early recovery (weeks 1 to 6) The recovery is different depending on whether your meniscus was repaired or trimmed.
After a meniscus repair, the recovery is more protected to give the stitched meniscus time to heal. You may use crutches for several weeks, and weight-bearing and bending are usually limited for the first 4 to 6 weeks.
After a partial meniscectomy (trimming), the recovery is generally quicker. Most patients are walking comfortably within a few days, with weight-bearing as tolerated.
Full recovery
After a partial meniscectomy: most patients are back to normal activity by 4 to 6 weeks, and back to sport by 6 to 12 weeks.
After a meniscus repair: full return to sport typically takes 4 to 6 months, because the repaired meniscus needs time to heal before being loaded.
Frequently Asked Questions
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Some can. Tears in the outer part of the meniscus (where there's a blood supply) sometimes heal with time and physiotherapy. Tears in the inner part of the meniscus (where there's no blood supply) don't heal on their own.
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Not always. Many meniscus tears can be managed with physiotherapy, activity changes and time. Surgery is considered when symptoms are significant and aren't settling, or when the tear is the type that does better with surgical treatment.
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That depends on the tear. Tears in the outer (vascular) part of the meniscus are usually repaired. Tears in the inner (non-vascular) part of the meniscus, or complex degenerative tears, are usually trimmed. The decision is sometimes finalised during the surgery itself.
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After a partial meniscectomy: most patients are back to normal activity within 4 to 6 weeks. After a meniscus repair: 4 to 6 months for full return to sport, because the repaired tissue needs time to heal. [SIGN-OFF]
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Losing meniscus tissue (through trimming, or through the tear itself) raises the long-term risk of arthritis in that part of the knee. That's why preserving the meniscus is preferred where possible.
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Yes, especially after a meniscus repair if you return to sport too early. Following the rehab program reduces the risk.
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Yes. To see Dr Khoury, a referral from your GP is required. Once you have it, our rooms will help you book a consultation that suits you.
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Dr Khoury consults at three locations: St Kilda Road Melbourne, the Mornington Peninsula at The Bays Hospital, and Albury at the Gardens Specialist Centre. Our team will help you find the most convenient one.
Related Procedures and Conditions
If you're researching meniscus repair, you may also want to look at:
Dr Khoury’s Approach to Hip Arthroscopy
Hip arthroscopy is the right operation for some hips and the wrong one for others. The first job at consultation is working out which group your hip is in. Dr Khoury and his team will take the time to assess your symptoms, review your imaging and walk you through the options without pressure.
To book, you'll need a referral from your GP. If you don't have one yet, your GP can refer you directly to Dr Khoury at any of our three locations.