In this Ask Dr. Geier column, I discuss a surgery about which I receive a huge number of questions – recovery from meniscus repair.

David in Australia writes:

I love your post and articles. I have a specific question. More about meniscus repair. I had surgery 6 months ago and been going to physiotherapy almost every 2nd week. Initially I was no weight bearing for 6 weeks but had a blood clot in that time, which may have prolonged the swelling.

My specific question is how long can you expect to go back to full recover and is swelling and pain normal after this long. It is okay when I don’t run or play basketball, but when I do, it feels stiff and I feel discomfort bending more than 100 degree in my knee. Will more intense training speed up the process?

I have been cycling for 10-20 minutes a day along with a 15-minute walk in the morning. I been doing leg weight and stability exercise. Should I be doing more, and what is the expected normal time I can return to sports in your opinion?

Types of meniscus surgery

Most surgeries for meniscus tears involve trimming part of the meniscus out. This procedure, a partial meniscectomy, is much more common than a meniscal repair, or actually sewing the meniscus back together. Only tears in certain location or certain types of tears are actually repairable. When they are, I believe it is important to try to repair them. Potentially saving the meniscus to provide a full shock absorber in future years could improve the long-term health of the knee.

Meniscus Repair
In this arthroscopic knee surgery, the surgeon places sutures in the meniscus to try to get a meniscal tear to heal.

Recovery from meniscus repair surgery

The challenge with a meniscus repair surgery is getting the meniscus to heal. The surgeon places stitches in the meniscus to hold it together while the tear heals. Basically the meniscus has to heal before the sutures break. If the patient pushes too fast, the meniscus might not heal. Therefore, we often limit weightbearing and knee range of motion early. We also usually delay return to sports for four to six months to optimize healing chances.

Healing rates of meniscus repair

Another fact about meniscus repairs that might affect rehab and return to activities is the success of the repair surgeries. For a number of reasons, meniscus repair surgeries performed by themselves and not as part of ACL reconstructions have good, but not great, success rates. Different studies place healing rates between 60% and 90%. Despite chances as high as 40% that the repair won’t hold, it is still a good idea to try for the long-term health I mentioned earlier.

More on meniscus tears and recovery:
Ask Dr. Geier – Is surgery necessary for a meniscus tear?
Ask Dr. Geier – Arthritis after a meniscus tear

These success rates become important as we get back to David’s question. At what point does the surgeon who performs a meniscus repair become concerned that the meniscus tear didn’t heal? Findings of a recurrent can be subtle, such as pain in the back of the knee with full knee flexion. It could also manifest as locking or catching similar to the original tear. Stiffness and swelling can persist for weeks or even months after these surgeries normally, which can complicate the situation.

Full recovery

However, the goal is for the patient to regain an essentially normal knee. While healing and recovery from meniscus repair might take four to six months, the knee continues to improve over a year or more. If it isn’t where a patient feels it should be, it can be important to have the knee reexamined to determine if the meniscal repair didn’t heal.

Recommended Products and Resources
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