Meniscus Tears: Why Surgery May Not Include Repair - Orthopedics

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Meniscus tears are a common injury, particularly in athletes or individuals who engage in activities that put stress on the knee joint. When it comes to surgical intervention for meniscus tears, the decision to repair or not can depend on several factors, including the type of tear, its location, the patient's age, activity level, and the presence of other knee injuries, such as an anterior cruciate ligament (ACL) tear.

In your case, you mentioned undergoing surgery for a torn ACL and a meniscus tear. It's important to understand that not all meniscus tears are treated the same way. There are two primary types of meniscus tears: those that are repairable and those that are not. The ability to repair a meniscus tear often depends on its location within the meniscus itself. The meniscus has two regions: the outer third, which has a good blood supply (the red zone), and the inner two-thirds, which has a poor blood supply (the white zone). Tears in the red zone are more likely to heal when repaired, while tears in the white zone may not heal well and are often removed rather than repaired.

During your surgery, the surgeon likely assessed the meniscus tear and determined that it was not suitable for repair. This could be due to the type of tear, its location, or the extent of the damage. In some cases, if the tear is in a region with poor blood supply, the surgeon may opt to remove the damaged portion of the meniscus (a procedure known as meniscectomy) rather than attempt a repair that may not be successful. This decision is often made to prevent further complications and to facilitate a quicker recovery.

Another reason for not repairing the meniscus during ACL reconstruction surgery could be the surgeon's focus on addressing the more critical injury first. The ACL is a key stabilizing ligament in the knee, and repairing it may take precedence over addressing the meniscus tear, especially if the tear is not causing significant symptoms at the time of surgery.

Regarding your current situation, where you are experiencing pain when bending your knee, it is not uncommon for patients to have discomfort during the recovery process. The knee joint is complex, and pain can arise from various sources, including inflammation, scar tissue formation, or even the healing process itself. Your doctor’s recommendation to monitor the situation and consider further surgery if the pain persists is a standard approach. If the pain does not improve or worsens, further imaging studies, such as an MRI, may be warranted to assess the condition of the meniscus and surrounding structures.

In summary, the decision not to repair a meniscus tear during ACL surgery can be influenced by the tear's characteristics, the surgeon's assessment, and the overall treatment plan. If you have ongoing concerns about your knee pain or the surgical decisions made, it is essential to communicate openly with your healthcare provider. They can provide you with more personalized insights based on your specific case and help you understand the rationale behind the surgical decisions made during your procedure.