meniscectomy

A meniscectomy is a surgical procedure to remove all or part of a damaged meniscus in the knee. The menisci are two crescent-shaped fibrocartilaginous discs that cushion and stabilize the joint, distributing load between the femur and tibia.

Indications include symptomatic meniscal tears, especially with persistent pain, swelling, or mechanical symptoms such as locking or catching; tears that are unlikely to heal with nonoperative treatment; and degenerative tears in older patients.

The procedure is most commonly performed arthroscopically. In a partial meniscectomy, only the torn portion is removed and the remaining meniscal rim is smoothed to preserve as much tissue as possible. Total meniscectomy, once common, involves removing the entire meniscus and is associated with higher risk of early osteoarthritis; it is now rarely performed.

Recovery varies with extent of meniscal removal and any associated injuries. Patients typically begin physical therapy soon after surgery; weight-bearing and range of motion are progressed as tolerated. Return to normal activities may take several weeks to months, with higher-impact sports requiring longer rehabilitation.

Outcomes are usually favorable for relief of mechanical symptoms and pain, though some patients may continue to have symptoms or experience later degeneration of the joint. Complications include infection, nerve or blood vessel injury, knee stiffness, thromboembolism, and progression of cartilage degeneration. Alternatives include nonoperative management, meniscal repair when feasible, or meniscal transplantation in selected cases.