Patient question
I tore my ACL and meniscus. Will both be fixed in the same operation?
Dr. Pablo GelberOrthopaedic Knee Surgeon
Quick answer
Usually yes. When an ACL tear comes with a repairable meniscus tear, both are normally treated in one arthroscopic operation. Meniscus repairs done alongside ACL reconstruction tend to heal well, and the new ligament protects the repair from the shifting that tore it, explains Dr. Pablo Gelber, knee surgeon at Aman Hospital in Doha.
Why the two injuries travel together
When the ACL tears, the shin bone shifts forward and rotates under the thigh bone, and the menisci can be caught and split. Some tears happen at the moment of injury. Others develop later, if the knee keeps giving way during sport with no functioning ACL. Tears at the very back of the medial meniscus, called ramp lesions, are a typical pattern and can be hard to see on MRI, so the surgeon checks for them during arthroscopy.
What happens in the operation
The arthroscope is used to inspect the whole knee first. The meniscus is repaired with the technique that suits the tear, and then the ACL graft tunnels are drilled and the new ligament placed. Doing both together means one anaesthetic and one rehabilitation period.
The drilling for the ACL releases blood and healing factors into the joint, which may be one reason meniscus repairs in this setting heal well.
Why fixing the meniscus matters for the ACL
The medial meniscus acts as a secondary stabiliser that resists the shin sliding forward. A knee that loses it puts more strain on the ACL graft. Saving the meniscus therefore helps protect the new ligament, as well as the cartilage, over the long term.
How recovery changes
- Bending is usually limited to around 90 degrees for the first weeks, a little stricter than after ACL reconstruction alone
- Weight-bearing may be restricted for some repairs, particularly root and radial repairs
- The overall return to sport is guided by the ACL timeline, commonly nine months or more
Dr. Gelber explains the combined plan at Aman Hospital before surgery, so you know what to expect from day one.
Frequently asked questions
What if the meniscus cannot be repaired during ACL surgery?
Then the unstable part is trimmed, keeping as much meniscus as possible. Recovery may be a little quicker in the early weeks, but the ACL timeline still sets the return to sport.
Should I have the ACL surgery soon to protect my meniscus?
For active people who want to return to pivoting sport, delaying reconstruction for a long time while the knee keeps giving way increases the risk of new meniscus tears. Timing is discussed individually.
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