How is a meniscal root repair actually done?

The goal of the operation

The meniscus only works as a shock absorber when both of its ends are fixed to bone. A root repair restores that fixation so the meniscus can carry load again and is less likely to slide out of the joint. It does not reverse arthritis that is already present, which is why it suits knees where the cartilage is still in reasonable condition.

Step by step

• Anaesthesia, usually general or spinal, with a nerve block for comfort afterwards
• Two or three small incisions for the camera and instruments
• Inspection of the whole knee, including the cartilage and ligaments
• Freshening the bone where the root attaches, to encourage healing
• Placing one or more strong stitches through the root
• Drilling a narrow guided tunnel from the front of the shin bone to the root site
• Pulling the stitches down the tunnel and fixing them over a small button or anchor on the shin bone

In some knees, an anchor is placed directly at the root site instead of using a tunnel. The operation typically takes around one to two hours.

Additional procedures sometimes done

If the knee is markedly bow-legged, a high tibial osteotomy may be recommended at the same time to take load off the repair. If the meniscus remains pushed out of the joint, some surgeons add a stitch to hold its edge in place. A lateral root tear with an ACL injury is usually repaired during the ACL reconstruction.

Before you decide

Dr. Gelber reviews your MRI, standing X-rays and examination at Aman Hospital in Doha to judge whether repair is likely to help. He explains the long protected recovery in advance, since it is a key part of success.