Meniscus Repair
A meniscus repair is an arthroscopic surgery to stitch a torn meniscus back together, preserving the native tissue and allowing it to heal in place. The meniscus is a C-shaped cartilage disc between the femur and tibia that acts as a shock absorber, distributes weight across the knee, and contributes to joint stability. Each knee has two — a medial (inner) and lateral (outer) meniscus. When one tears in a location with adequate blood supply, repair is the preferred approach because it preserves the entire structure and protects the long-term health of the joint.
Meniscus tears that are candidates for repair typically involve the outer third of the meniscus, where blood supply is best. Common patterns include longitudinal tears, bucket-handle tears, and certain vertical tears. These injuries usually occur during a twist, pivot, or awkward landing — common in sports like soccer, basketball, and skiing. Patients typically report pain along the joint line, swelling, clicking, and sometimes a locking sensation when a displaced piece of meniscus gets caught in the joint.
I perform meniscus repairs regularly in my practice and consider it a critical part of preserving knee health. The goal is always to save the meniscus when the tear pattern and tissue quality support it, because the long-term consequences of removing meniscal tissue — including increased cartilage wear and a higher risk of arthritis — are well-documented. Repair takes longer to recover from than a simple meniscectomy, but the investment in healing time pays off for years to come.
Video Education
Dr. Merritt has filmed several in-depth videos on Meniscus Repair surgery with the aim of helping patients understand the condition, the procedure, and what to expect during recovery.
Treatment Options
Meniscus repair is performed arthroscopically through small incisions using a camera and specialized instruments. I use sutures to stitch the torn meniscus back together, allowing the tissue to heal against its native blood supply. The technique depends on the tear pattern and location — most commonly, I use an inside-out repair. This type of repair puts strong sutures in through the knee, and they are subsequently tied through a secondary incision towards the back of the knee. This is a slightly longer operation and more technically demanding, but provides the most stable repair possible.
The decision to repair versus trim (meniscectomy) depends primarily on where the tear is and what the tissue looks like. Tears in the outer portion of the meniscus, which has good blood flow, are strong candidates for repair. Tears in the inner portion, where blood supply is poor, typically will not heal even with sutures and are better treated with a partial meniscectomy. I discuss the likely approach with every patient before surgery based on the MRI, with the understanding that the final call is confirmed at the time of surgery when I can see the tear directly.
Most meniscus repairs are performed as outpatient surgery at Proliance Surgery Center at Valley. The procedure typically takes about 60 minutes. Meniscus tears often occur alongside other knee injuries — especially ACL tears — and when that happens, I address both in the same surgery.
Recovery and Results
Recovery after a meniscus repair takes longer than a meniscectomy because we are waiting for tissue to actually heal — a process that cannot be rushed. The specific protocol depends on the tear pattern and location, and I tailor it to each patient.
For most meniscus repairs, you can walk with weight on your leg right away — axial loading actually promotes blood flow to the repair and supports healing. The key restriction is range of motion: your knee is limited to 0 to 90 degrees of bending for the first six weeks to protect the repair from shear forces. You will wear a hinged brace during this period. Physical therapy starts 5 to 7 days after surgery, usually 2 times a week, focusing on quad activation, gentle motion within the allowed range, and swelling control. Most patients are walking without crutches by three to four weeks.
Some tear patterns — including root tears and complex radial tears — are more mechanically fragile and require strict non-weight-bearing for six weeks. I will discuss your specific plan with you before surgery so you know exactly what to expect.
After six weeks, the brace comes off and range of motion opens up gradually. Squatting and kneeling past 90 degrees while bearing weight is still restricted until five months to protect the repair during the final remodeling phase. Running typically begins around 4½ to 5 months (weeks 18 to 20) with my clearance, and full return to sport — including cutting and pivoting — is anticipated at six months, based on meeting objective strength and hop test criteria.
Success rates for meniscus repair are excellent. In appropriately selected patients, healing rates range from 75 to 90 percent. The keys to a good outcome are proper patient selection, a careful surgical technique, and a committed rehabilitation program. Patients who take their physical therapy seriously consistently do well.
Meniscus Tear
Repaired MeniscusÂ
Meniscus Repair Recovery Timeline
Weight-bearing protocol — drag the slider or select the post-operative time to explore each phase
Surgery & Physical Therapy Resources
Discover detailed instructions and protocols to guide patients through Pre-Op, Post-Op and Physical Therapy from Dr. Merritt.
Related Articles
Read more from Dr. Merritt about meniscus repair and recovery.
Common Meniscus Repair Questions
Injury Information
A: Meniscus tears commonly occur alongside ACL injuries, and I address both in the same surgery. The good news is that meniscus repairs done at the same time as ACL reconstruction tend to heal at even higher rates, likely because the biological healing response from the ACL surgery benefits the repair.
A: The meniscus repair site relies on early tissue ingrowth to heal. Bending past 90 degrees in the first six weeks creates shear forces at the repair that can disrupt this process before it has had time to mature. The 0 to 90 degree restriction protects the repair during its most vulnerable window. After six weeks, bending opens up gradually.
A: The main factors are tear location, pattern, and tissue quality. Tears in the outer third of the meniscus have the best blood supply and the highest healing potential. I evaluate this on MRI before surgery and confirm it when I see the tear directly during the arthroscopy. The tissue ultimately tells us what is possible.
A: The meniscus is a critical shock absorber in the knee. Removing tissue increases stress on the cartilage surface and raises the risk of arthritis over time. Repairing the meniscus preserves the entire structure and its protective function. When the tear is in a location that can heal, repair is always the preferred approach.
A:Â A meniscus repair is an arthroscopic surgery where I stitch the torn meniscus back together using sutures. This preserves the native tissue and allows it to heal, which is better for the long-term health of your knee compared to removing the torn portion.
Surgery Information
A: Healing rates for meniscus repairs in appropriately selected patients are 75 to 90 percent. Success depends on tear location, patient age, tissue quality, and commitment to the rehabilitation protocol. Repairs done at the same time as ACL reconstruction tend to have even higher healing rates.
A: A meniscus repair typically takes about 60 minutes. It is performed arthroscopically and you go home the same day. If combined with another procedure like ACL reconstruction, the total surgery time is longer.
Post-Op Recovery
A: Yes. Physical therapy starts 5 to 7 days after surgery, usually 2 times a week. Early exercises focus on quad activation, gentle range of motion within the 0 to 90 degree limit, and swelling management. Your therapist will follow a specific protocol I provide based on your tear pattern and repair.
A: If a repair fails to heal and you develop recurrent symptoms, the typical next step is a partial meniscectomy to trim the portion that did not heal. This is uncommon in well-selected repairs, but it is something I discuss with every patient so expectations are clear from the start.
A: Full return to cutting and pivoting sports is typically at six months. This is based on meeting objective criteria: quad strength at least 90 percent of the opposite leg and passing single-leg hop tests. Running usually begins around 4½ to 5 months (weeks 18 to 20), with my clearance. I do not rush this — a failed repair is a much bigger problem than a slightly longer recovery.
A: If you have a desk job, most patients are back within one to two weeks. Jobs that require walking and lifting often take 6-12 weeks. Physical or labor-intensive work takes longer — typically four to six months for full duties, depending on the demands of your job.
A: For right knee surgery, you must be off crutches, off narcotic pain medication, and able to brake hard, and the brace must not get in the way. This is usually about three to four weeks. For left knee surgery (automatic car), it is usually two to three weeks, once you are off narcotic pain medication. There is no set date, and it is not up to me to release you: the rule is that you must be a safe, unimpaired driver.
A: Most patients find the pain very manageable. We use a multi-modal approach including nerve blocks when appropriate, anti-inflammatories, and oral medications. Pain is typically worst in the first few days and improves steadily. Ice and elevation make a big difference. Most patients are off narcotic pain medication within 1 to 2 weeks.
A: Yes. After a meniscus repair, I use a hinged knee brace for six weeks to control your range of motion and protect the repair. The brace is set to limit bending to 90 degrees. You wear it for walking and sleeping; you can take it off for your bending exercises and for resting in bed, but you must never bend past 90 degrees. After six weeks, the brace comes off.
A: For most repairs, yes — you can put weight on your leg right away. Walking with weight actually promotes blood flow to the repair and helps healing. The main restriction is not weight-bearing, but bending: your knee is limited to 90 degrees of flexion for the first six weeks. Some complex tear patterns require a period of non-weight-bearing, which I will discuss with you before surgery.
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