This Ask Dr. Geier column addresses a question I am asked all the time. When can a patient or athlete do too much, meaning do more harm to the injured body part? Specifically, is it safe to play sports after meniscus surgery?
My 15-year-old son had a meniscectomy on both menisci of one knee. One meniscus was shaved a little, and the other meniscus had 60% removed. Is it still safe for him to do the triple jump in track? Of all of his sports, that is his favorite, and I have heard that is bad on the knees. His surgery was in August, and his recovery has been good. He has some locking, and a little pain, but rarely any swelling any more. I just don’t want to let him do TOO much. Since my son was so eager to get back into football, and now has been playing basketball, is there such thing as “too much”?
Carrie, that’s a great question. First of all, I will say that you will get different opinions on that same question if you ask several sports medicine physicians.
The long-term effects of trimming a meniscus tear
The premise of the idea that an athlete could do “too much” after a partial meniscectomy is based on the idea that the meniscus is a shock absorber in the knee. Each one lies between the femur and tibia and absorbs some of the stress with impact, protecting the articular cartilage and bone. When a meniscus tears, it almost never heals. (That doesn’t always mean that every patient with a torn meniscus needs surgery, but that is a subject for a different post.) Therefore, in a symptomatic athlete, sports medicine surgeons usually treat the meniscus tear surgically.
Surgery to repair a meniscus tear
The options for surgery involve either a meniscus repair (sewing the meniscus back together with stitches and/or anchors) or a partial meniscectomy (trimming the torn part of the meniscus out). Which of those two options is necessary depends on the location and orientation of the tear itself, and the patient and surgeon have little ability to affect that outcome.
Obviously, if the tear is repairable, that is good in the long term, although the rehab and overall recovery take longer and there is unfortunately a sizeable percentage of those repairs that don’t heal. But if the repair heals, the surgeon has preserved the entire meniscus to serve as a shock absorber.
Recovery from surgery to trim a meniscus tear
If it is the more likely scenario where part of the meniscus needs to be removed, that is a much shorter recovery and return to sports. And return to exercise and sports after meniscus surgery is very likely, especially in the short term. They get back at the same or higher level far more often than not.
Arthritis after meniscus surgery
The concern, if there is one, about trimming part of the meniscus out comes years later. What effect will removing part of that meniscus have? Like I said earlier, that is for the most part out of the hands of both the surgeon and patient, so one could argue that the worry is unnecessary. You can’t do anything about it anyway.
Potentially problems could result from removing some of the shock absorber in an athlete or exercise fan who continues to engage in repetitive impact. Over time, in theory that impact will start to take a toll on the articular cartilage and later, the bone, and lead to degenerative changes. But how much would a surgeon limit that athlete, if at all?
Sports after meniscus surgery
I typically don’t shut these patients down. If it is a high school or college athlete, I aim to get them back to sports after meniscus surgery. If it is an adult weekend warrior or someone who loves to run, I try to do that. I might suggest to someone that runs 6 or 7 days per week, for example, that she run 4 days a week and add non-impact activities like cycling, swimming, rowing, or weights into her routine the other days. But I don’t have someone stop playing a sport or give up a certain form of exercise. After all, that sport or form of exercise is usually what he or she likes to do. And the health benefits far outweigh the potential risk of earlier degenerative changes in the knee, in my opinion.
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