Meniscus tears are the most frequently treated knee injuries. Recovery will take about 6 to 8 weeks if your meniscus tear is treated conservatively, without surgery.
- 1 How long does it take to recover from a torn meniscus?
- 2 Is walking good for a torn meniscus?
- 3 Can you fully recover from a meniscus tear?
- 4 How long is physical therapy for torn meniscus?
- 5 Will a knee brace help a torn meniscus?
- 6 Does a torn meniscus hurt all the time?
- 7 What aggravates a torn meniscus?
- 8 What happens if you leave a torn meniscus untreated?
- 9 What is the best exercise for a torn meniscus?
- 10 How long does a torn meniscus take to heal without surgery?
- 11 Can you live with a torn meniscus?
- 12 What percentage of meniscus tears require surgery?
- 13 What should I avoid with a torn meniscus?
- 14 What exercises not to do with a torn meniscus?
- 15 Why does meniscus tear hurt at night?
- 16 Meniscus Surgery: Recovery Time
- 17 Credits
- 18 Do I Need Physical Therapy (PT) for a Meniscus Tear?
- 19 Can I Do PT Instead of Surgery?
- 20 What Will It Be Like?
- 21 How Long Will I Need to Do PT?
- 22 Do I Need Surgery for a Meniscus Tear?
- 23 What Are My Treatment Options?
- 24 How Long Is Recovery?
- 25 Torn Meniscus Healing Time Without Surgery
- 26 What Is a Meniscus Tear?
- 27 What Are the Symptoms of a Torn Meniscus?
- 28 What Are Non-Surgical Options for Treating a Torn Meniscus?
- 29 What Is the Meniscus Tear Recovery Time Without Surgery?
- 30 Contact Us for Physical Therapy
- 31 Meniscus Surgery: Who Needs It, What to Expect Before & After
- 32 Procedure Details
- 33 Risks / Benefits
- 34 Recovery and Outlook
- 35 When to Call the Doctor
- 36 What is the Recovery Time for Meniscus Tear Surgery?
- 37 These are the typical times for returning to activities.
- 38 What do I need to know about meniscus tear and how to fix it?
- 39 How does a meniscus get torn?
- 40 What happens when you have a torn meniscus?
- 41 What are the symptoms?
- 42 How is a torn meniscus treated?
- 43 What are the different procedures for a torn meniscus?
- 44 Is meniscus repair surgery effective?
- 45 What are the benefits of surgery?
- 46 How do I know that I am fit for meniscus repair surgery?
- 47 What should I do if I feel like there’s something wrong with my knees?
- 48 Virtual Care from Sports Doctors and Specialists
- 49 The best thing you can do is prevent.
- 50 9 meniscus tear exercises to improve strength and reduce pain
- 51 How Long Does It Take To Recover From Meniscus Surgery?
- 52 Arthroscopic Knee Surgery – Your Meniscectomy Recovery Plan
- 53 Arthroscopic Knee Surgery Recovery
- 54 Week-by-Week Rehabilitation
- 55 Meniscus Tear: Rehabilitation Exercises
- 56 Meniscus Tears – OrthoInfo – AAOS
How long does it take to recover from a torn meniscus?
Though the surgery to repair a meniscus tear alone is not terribly long, the recovery time can last anywhere from three weeks to six months for a full return to activity.
Is walking good for a torn meniscus?
Can you walk on a torn meniscus? Whether you can walk on a torn meniscus will depend on the injury’s location and severity — and perhaps also your own personal tolerance for pain. A slight tear might not feel so bad to you. You may very well be able to stand and walk on a leg that has a torn meniscus in the knee.
Can you fully recover from a meniscus tear?
Small tears often heal on their own, while others may require arthroscopic surgery. Most people fully recover from a torn meniscus and can get back to doing their favorite activities without knee pain.
How long is physical therapy for torn meniscus?
As part of a conservative treatment, you’ll probably try PT for around 4 to 6 weeks, on a regular schedule. Also, you must regularly exercise at home the way you are taught. If it doesn’t work, then it may be time for surgery.
Will a knee brace help a torn meniscus?
Yes. Although knee braces do not heal or treat your meniscus tear directly, they can provide extra support and stability for your knee while your meniscus injury heals. A good brace will protect your knee and take the pressure off your meniscus, allowing it to rest.
Does a torn meniscus hurt all the time?
Do all meniscus tears hurt? Yes, at some point in time most all meniscus tears will hurt. But that doesn’t mean they will hurt for a long time. In many cases the pain from a meniscus tear will either improve significantly or go away without surgery.
What aggravates a torn meniscus?
Performing activities that involve aggressive twisting and pivoting of the knee puts you at risk of a torn meniscus. The risk is particularly high for athletes — especially those who participate in contact sports, such as football, or activities that involve pivoting, such as tennis or basketball.
What happens if you leave a torn meniscus untreated?
An untreated meniscus tear can result in the frayed edge getting caught in the joint, causing pain and swelling. It can also result in long term knee problems such as arthritis and other soft tissue damage.
What is the best exercise for a torn meniscus?
Meniscus Tear: Rehabilitation Exercises
- Meniscus Tears.
- Quad Sets.
- Straight-Leg Raise to the Front.
- Straight-Leg Raise to the Back.
- Hamstring Curls.
- Heel Raises.
- Heel Dig Bridging.
- Shallow Standing Knee Bends.
How long does a torn meniscus take to heal without surgery?
Meniscus tears are the most frequently treated knee injuries. Recovery will take about 6 to 8 weeks if your meniscus tear is treated conservatively, without surgery.
Can you live with a torn meniscus?
Not necessarily. Left untreated, a meniscus tear can limit your daily life and ability to participate in exercise and sports. In serious cases, it can develop into long-term knee problems, like arthritis.
What percentage of meniscus tears require surgery?
Less than 10 percent of meniscal tears occurring in patients age 40 or older can be repaired. This is often because the tissue degeneration affects blood flow to the cartilage, making healing less likely after surgery. A doctor may recommend removing the damaged tissue and suggest physical therapy exercises.
What should I avoid with a torn meniscus?
The only way to prevent and avoid a torn meniscus is to avoid activities that cause the knees to twist, bend, or rotate in an extreme fashion. If a person cannot avoid these activities, they should take as much care as possible while participating in them.
What exercises not to do with a torn meniscus?
Avoiding twisting activities may decrease the symptoms from a torn meniscus. Additionally, one should do quadriceps setting exercises with the knee straight or mini-squats, bending only to 15 degrees, to prevent giving way and keep the quadriceps muscle from atrophying.
Why does meniscus tear hurt at night?
There are a couple of reasons why your knee pain is worse at night: Pain is perceived to be worse at nighttime. As you climb into bed and start to quiet your mind pain becomes more pronounced than when you were active during the day distracted by your activities. An active day may cause your knee joint to swell.
Meniscus Surgery: Recovery Time
Reconstructive surgery is required. Rehabilitation is required after atorn meniscus surgery, albeit the length of time required varies based on the severity of the damage, the type of surgery performed, and the preferences of your orthopedist. A period of rest, walking, and a few specified activities is usually required following meniscus surgery in the majority of cases. Every recovery is unique and is dependent on a variety of factors. However, the following are some average periods for returning to normal activity.
|Activity||Uncomplicated meniscectomy||Meniscus repair surgery|
|Bear weight (put weight on your knee while standing or walking)||Right away, as tolerated||Right away, but only with a brace|
|Walk without crutches||2 to 7 days||4 to 6 weeks|
|Drive, if the affected leg is to be used for gas and brake or for clutch||1 to 2 weeks, if:|
- You have restored motion with the least amount of discomfort. You are not using opioids at this time.
|4 to 6 weeks|
|Regain full range of motion||1 to 2 weeks||Bending is typically restricted to not more than 90 degrees for first 4 to 6 weeks to allow the meniscus to heal.|
|Return to heavy work or sports||4 to 6 weeks, if|
- You’ve regained your mobility and strength, and you’re feeling great. Your knee does not appear to be swollen or uncomfortable.
As of November 16, 2020, the information is current. Dr. William H. Blahd, Jr. MD, FACEP – Emergency Medicine, wrote the medical review. Author:Healthwise Staff Dr. Adam Husney is a Family Medicine specialist. Dr. Kathleen Romito is a Family Medicine specialist. Doctor Patrick J. McMahon, MD, practices Orthopedic Surgery. On the date of its publication: November 16, 2020 Author: Healthwise StaffMedical Review: William H. Blahd Jr. MD, FACEP – Emergency MedicineWilliam H. Blahd Jr. MD, FACEP – Emergency Medicine Dr.
Doctor Patrick J.
Do I Need Physical Therapy (PT) for a Meniscus Tear?
If you have just discovered that the pain and swelling in yourknee is caused by a torn meniscus, you will most likely need to make a decision about how to treat it. What’s ideal for you will depend on the severity of the tear, your age, and how quickly you want to return to your typical activities thereafter. In each knee, you have two menisci (that’s the plural form of the word meniscus). They’re formed of cartilage, which is a durable, rubbery material. They’re essentially shock absorbers that prevent your thighbone in the upper leg from slamming into your shinbone in the lower leg when you’re running.
Following that, you may require physical therapy (PT), surgery, or a combination of the two.
Can I Do PT Instead of Surgery?
Physical therapy is frequently used as part of what doctors refer to as “conservative treatment” in order to prevent surgery, at least in the early stages. People who are middle-aged or who have osteoarthritis are more likely to rupture their meniscus simply because it has become worn down over time. Physical therapy may be just as helpful as surgery in some cases. Even if you’re younger, more physically strong, and more athletic, taking a conservative approach is frequently a smart place to begin your journey.
However, if the injury causes your knee to become locked, you will almost certainly require surgery.
If you’re a top-level athlete or are unable to work as a result of your injuries, you may not have the luxury of testing if a cautious strategy is effective.
Even if you undergo surgery, you will require physical therapy afterward. A physical therapist may be recommended by your doctor, but at the absolute least you will receive PT exercises to complete at home. This will assist you in restoring complete health to your knee.
What Will It Be Like?
No matter whether you are doing physical therapy as part of a conservative treatment plan or as part of a post-operative recovery program, the aim is the same: to regain range of motion, strength, and control. The PT procedure is typically followed by the following steps:
- Exercises that focus on range of motion, such as flexing and extending your knee as far as you can without pain, are the first to be attempted. Afterwards, you perform exercises to maintain your leg muscles free. You begin with fundamental exercises such as straight leg lifts and toe raises. If you are able to complete all of these exercises without experiencing discomfort, you can on to more complex activities such as toe lifts with weights, squats, and more difficult stretches.
Those are the main stages, but depending on your requirements and abilities, they can blend together into one another. Rather than waiting until later, you might begin stretching and simple exercises sooner rather than later. Take into consideration the fact that now is not the time to persuade yourself that “no pain, no gain.” Because your primary goal is to recuperate, you should refrain from beginning more difficult exercises until you are confident that you can perform the fundamentals without being injured.
How Long Will I Need to Do PT?
How long it takes to recover depends on your age, the type of tear and the sort of surgery you underwent if it was necessary. Physical therapy (PT) will most likely be used as part of a conservative treatment plan for 4 to 6 weeks on a regular basis. Additionally, you must consistently exercise at home in the manner that you have been instructed. If it doesn’t work, it could be necessary to have surgery. You should expect to be out of commission for three to six weeks following surgery to remove a portion of the meniscus.
Do I Need Surgery for a Meniscus Tear?
In between your thigh bone and your shinbone are two C-shaped discs of cartilage (soft tissue), which act as a connector. These are referred to as menisci. They function similarly to shock absorbers for your bones. They also aid in the stability of yourknees. Athletes who participate in contact sports such as football and hockey are more likely to have meniscus injuries. However, you can also get this injury if you kneel, squat, or lift anything that is too heavy. As you grow older, the likelihood of suffering an injury increases as the bones and tissues surrounding the knee begin to deteriorate.
When you twist your knee, you may have pain, and you may be unable to fully straighten your leg.
What Are My Treatment Options?
Treatment for an ameniscus tear will be determined by the extent of the rip, the kind of tear, and where it is located within the cartilage. Rest, pain medications, and icing your knee will most likely be recommended by your doctor in order to reduce swelling and keep your knee from becoming worse. Physical treatment may also be recommended by your doctor. This will aid in the strengthening of the muscles surrounding your knee and the stabilization of the joint. If none of these treatments are effective – or if your damage is serious – your doctor may propose surgery.
In addition, they may use an arthroscope to examine the tear.
It provides doctors with the ability to view within your joints.
If your doctor’s examination reveals that your meniscus tear is minimal (Grade 1 or 2), you may not require surgical intervention. If it’s Grade 3, there’s a good chance you will. Your doctor may decide to do one or more of the following procedures:
- The repair of the arthroscopic joint. Your doctor will make a few tiny incisions in your knee to examine it. In order to obtain a good look at the tear, they’ll install an arthroscope. Then they’ll sew it back together with little devices that look like darts that they’ll insert along the rip. These will be absorbed by your body over time
- Partial meniscectomy performed through arthroscopy. Arthroscopic complete meniscectomy is a procedure in which your doctor removes a section of your torn meniscus so that your knee may function normally again. This operation involves your doctor removing the whole meniscus from your knee.
Meniscus repair is a low-risk procedure. Complications are extremely rare. Skinnerve injuries, infections, and knee stiffness are all possible complications. Antibiotics may be prescribed by your doctor in order to assist prevent infection. They may also advise wearing compression stockings to assist prevent blood clots from forming.
How Long Is Recovery?
It is possible that you will need to wear a brace or cast to keep your knee stable. You’ll most likely need to wear crutches for at least a month to keep the weight off your injured knee as well. Physical therapy may be recommended by your doctor as part of your healing process. It will aid in the expansion of your range of motion as well as the strengthening of your knee. They may also provide you with some workouts that you may do at your leisure. If you get a partial or whole meniscectomy, you should anticipate to be out of commission for around one month.
Torn Meniscus Healing Time Without Surgery
In each knee, your meniscus is a crescent-shaped cushion consisting of cartilage and muscle fibers that acts as a shock absorber. They are placed between the thigh bone (also known as the femur) and the shin bone of your lower leg, in the area known as the tibia (called the tibia). The primary role of the meniscus is to do the following:
- Weight distribution on the knee during running and walking is important. When there is rotation in the knee, stabilize it. Apply lubricant to the joint
For those of you who have a torn meniscus, we want to tell you about the non-surgical treatment options available for meniscus recovery tears, as well as the time it takes to heal from a meniscus tear.
What Is a Meniscus Tear?
A meniscus tear is a type of knee injury that occurs as a result of the twisting motions that are frequent in sports such as football, soccer, basketball, and tennis, among others. When twisted, it can also occur in older individuals whose meniscus has begun to degrade and is therefore more susceptible to tearing.
What Are the Symptoms of a Torn Meniscus?
Even if you continue to participate in your sport, you may not experience any discomfort at first following the rupture. However, after one or two days, there will be pain, edema, and stiffness in the knee joint. If the rip is severe enough, it might prevent you from bending your knee adequately, resulting in the knee being “locked.” A minor rip, on the other hand, may just appear to be a sign that your knee is unstable. When you come into our office, we will thoroughly evaluate you to determine whether you have a meniscus tear or not.
What Are Non-Surgical Options for Treating a Torn Meniscus?
Patients commonly inquire if it is possible to rehab a damaged meniscus without surgery. In most cases, the answer is “yes,” but only if the tear is not particularly long in duration. The first line of treatment for a meniscus tear in a stable knee is to refrain from engaging in activities that generate discomfort. Then, apply ice to your knee for 15 minutes at four-hour intervals and elevate your knee over your heart. Repeat this process four more times. The use of crutches in conjunction with a leg cuff may be recommended to relieve discomfort and protect the knee.
Physiatric therapy is the next step in the nonsurgical treatment process.
Minor rips are usually treated with muscle strengthening and physical therapy under the supervision of a doctor. After the inflammation has subsided, your knee will resume its usual function.
What Is the Meniscus Tear Recovery Time Without Surgery?
If you have a meniscus tear, you will most likely be urged to decrease your sporting activity while it heals. This might take anywhere from 4 to 8 weeks. However, the length of time required is dependent on the degree and location of the tear. During this time, you should focus on strength training to help improve your core and gluteal muscles, among other things. This allows you to have more control of your femur when you’re out on the trails. Remember to contact with your doctor before returning to full sports activities after a period of inactivity.
Contact Us for Physical Therapy
If you have a meniscus tear or are experiencing discomfort in your knee when running, please contact us immediately. No matter what sort of tear you have, we can treat it without the need for surgery. Our physical treatment helps you heal more quickly and strengthen your leg muscles, all while lowering the likelihood of a recurrence of the rupture.
Meniscus Surgery: Who Needs It, What to Expect Before & After
Surgery to remove or repair the atorn meniscus, which is a portion of cartilage in the knee, is known as meniscus surgery.
What is a meniscus?
There are two menisci in each knee. They are rubbery, C-shaped cushions that act as shock absorbers in the knee joint and help to reduce pain and swelling. If your meniscus is injured or torn (sometimes referred to as torn cartilage), your healthcare practitioner may offer surgery to remove the damaged section of the meniscus or to repair the torn cartilage.
Who needs to have meniscus tear surgery?
An injury to the meniscus and subsequent surgery are prevalent, particularly among persons who participate in sports. A meniscus can be torn as a result of a violent twist, turn, or impact. Older persons are also more prone to meniscal injuries than younger people. Over time, the menisci become weaker and more susceptible to tearing. In reality, meniscus tears can be a common occurrence as a result of the aging process and should not be taken lightly. Having a torn meniscus is a common reason for patients to have surgery.
Does every meniscus injury need surgery?
Some people require surgery to repair a torn meniscus, while others do not. The choice is based on the following factors:
- Your age, as well as the kind, size, and location of the tear Your degree of physical activity and way of life
- Injury-related complications (e.g., ACL rupture)
- There are symptoms present, such as (but not limited to) discomfort, swelling, locking, and buckleling.
Your age, as well as the type, size, and location of the rip; It all depends on how much you do and how you live; Ankle, knee, and hip injuries (for example, ACL tear); Pain, swelling, locking, and buckling are all signs of a sprain.
- RICE (rest, ice, compression, and elevation)
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Physical therapy
- Knee injections, such as ascortisone
If you and your surgeon decide to proceed with surgery to repair a torn meniscus, you may be required to undergo several tests before the procedure. For example, blood tests, an electrocardiogram (EKG), and a chest X-ray can all be used to establish whether or not you are in good enough condition to have surgery.
In most cases, these tests are not required if you are in reasonably good condition. Depending on your needs, an anesthesia team member will decide on the sort of anesthesia (pain control) you should have:
- Local anesthetic is an injection that just numbs the region around your knee. Regional anesthesia is an injection that numbs your entire body from the waist down
- It is used during surgery. General anesthesia is a medicine that puts you to sleep
- It is used during surgery.
It is possible that you will be sedated in addition to receiving local or regional anesthetic, to assist you relax. The majority of the time, a general anesthetic will be used for this sort of operation. Your healthcare professional will do the following procedures a few days before surgery:
- Provide you with a prescription for drugs to help you cope with the discomfort following the operation
- Make appointments for physical therapy or for a crutch fitting
- And Tell you what you need to do to prepare for surgery. It is possible that you will be required to cease taking certain medications and refrain from eating or drinking for a period of time before to the surgery.
What happens during arthroscopic meniscus surgery?
Knee arthroscopy is the most often performed treatment for a torn meniscus. It is normally completed in less than an hour. First and foremost, you will be given anaesthetic. The surgical team cleans the skin on your knee and wraps the remainder of your leg with a surgical drape to protect the rest of your leg. The team may apply a clamp on your upper thigh to aid with placement throughout the operation. The surgeon creates a series of small stab incisions (cuts) in your knee that are referred to as portals.
The fluid aids in the management of small bleeding in the joint and the removal of debris, which allows the surgeon to see more clearly inside the joint.
Arthroscopes are narrow tubes with a small light and video camera at the end that are used to examine joints.
The physician examines the tear with the arthroscope and then determines which surgical approach to use:
- In meniscus repair, the surgeon stitches together sections of cartilage that have ripped apart in order for them to mend themselves. The kind of tear and the blood supply, on the other hand, determine that less than 10% of tears are genuinely repairable. Partially reconstructed meniscectomy: The surgeon trims and removes the diseased cartilage while leaving the good meniscus tissue in situ.
Depending on the procedure employed, your surgeon may implant more surgical instruments. When the meniscectomy or meniscus repair procedure is completed, the surgeon seals the portals with sutures or surgical strips to prevent infection. After that, the staff will apply a bandage on your knee to protect it.
What happens after meniscus repair or meniscectomy?
The majority of persons who have meniscus repair or meniscectomy do not need to stay in the hospital overnight. You’ll be kept in a recovery room until the anaesthetic wears off completely. When you are ready to depart, you will require the assistance of another person to transport you home.
Risks / Benefits
Meniscus tear surgery can be beneficial in the following ways:
- Restore your participation in sports or other activities
- Increase your movement
- Make your knee more stable by doing the following: Reduce the likelihood of developing arthritis or to decrease its progression. Pain can be reduced or eliminated altogether.
What are the risks or complications of arthroscopic meniscus surgery?
It is quite safe, with only the following problems occurring in rare cases:
- Later-life onset of arthritis
- A blood clot in the knee region
- Blood on the knee
- Injury to nerves and blood vessels in the area around the knee
- A feeling of stiffness in the joint Heart or lung difficulties as a result of anesthesia
- Anesthesia-related complications
Recovery and Outlook
The length of time it takes to recuperate after meniscus surgery is determined on the type of surgery you have. A meniscus repair takes longer to recover than a meniscectomy because of the way the meniscus is repaired. Recovery after meniscus surgery might take anywhere from six weeks to three months depending on the severity of the injury. Following surgery, you may require the following types of care:
- Crutches are used to relieve pressure on the knee as it recovers. Knee brace to keep the joint stable while you’re recovering
- Prescription pain relievers
- Physical therapy
- Exercises should be performed at home to help you regain your mobility, range of motion, and strength
- RICE (rest, ice, compression, and elevation) is an acronym that stands for Rest, Ice, Compression, and Elevation.
Will I have pain after meniscus surgery?
It is typical to have some discomfort soon following surgery and for several weeks afterwards. Your healthcare professional will prescribe drugs to assist you in managing your pain and discomfort. The drugs will assist you in completing the workouts necessary for recovery.
How long after meniscus surgery will I be able to walk, exercise and work?
Most patients are able to walk with crutches within a few days of having meniscus surgery. Many people are able to return to their regular activities within six to eight weeks.
Instead of high-impact activities, your healthcare practitioner may advise you to engage in low-impact ones (such as walking rather than running). If you work in a physically demanding profession, you may require more time off to recover.
When to Call the Doctor
Your healthcare professional will inform you when it is necessary to schedule a follow-up appointment. However, you should contact us if you develop:
- Fibrosis (fever more than 101 degrees Fahrenheit)
- On the dressing, there is a lot of leakage (blood or fluid)
- Symptoms include leg pain or edema that is not eased by elevating or resting the leg
- If there is pus or foul-smelling discharge from any wounds, this is a sign of infection. Breathing difficulties
An announcement from the Cleveland Clinic Meniscus surgery is a procedure that can repair a meniscus that has been damaged or torn in the knee joint. If you are experiencing knee discomfort that is interfering with your daily life, employment, or activities, consult your healthcare provider. An arthroscopic operation can help you minimize discomfort, increase mobility and stability, and get back to doing the things you like.
What is the Recovery Time for Meniscus Tear Surgery?
When you have meniscus tear surgery, the amount of time you will need to recuperate may vary depending on the severity of your injury. It also relies on the type of surgery that was performed and the preferences of your orthopaedic physician. A typical aftercare and rehabilitation regimen includes time spent relaxing, followed by walking and particular activities. Be aware that the figures we provide are averages, and that each recovery is unique. Keep this in mind as you read on. Getting back on your feet necessitates a variety of actions.
These are the typical times for returning to activities.
|Progress||UncomplicatedMeniscus Removal or Meniscectomy||Meniscus Repair Surgery|
|Bear some weight put weight on your knee||Right after the intervention, if you can tolerate it.||After the surgery, with the help of a brace.|
|Walk with no crutches||2-7 Days||4-6 weeks|
|Drive||1-2 weeks, if:|
- You are able to walk about with little or no discomfort
- You are not taking narcotic medications
|Full movement capacity||1-2 weeks||Bending is usually restricted to under 90 degrees for the first 4-6 weeks while the meniscus is still healing.|
|Come back to athletic activity||4-6 weeks, if:|
- If your range of motion and strength have returned
- Your knee is neither swollen or painful
- This is good news.
What do I need to know about meniscus tear and how to fix it?
The meniscus is a cartilage that is found within the knee joint. It’s a c-shaped chunk of rubbery yet robust cartilage that’s challenging to break. The meniscus is an extremely important element of your body since it serves as a stress absorber between the shinbone and the thighbone during movement.
How does a meniscus get torn?
It is possible for the meniscus to be torn if you twist your knee quickly while you are bearing weight on it. This is one of the most common knee injuries, especially among sportsmen, and is one of the most severe.
What happens when you have a torn meniscus?
When athletes suffer from torn knee cartilage, it is typically because they engage in a lot of physical activity that is harsh on the knees. As a result, patients generally complain of discomfort in the area where the tear is located, as well as swelling in the knee. When the patient performs pivot motions, squats, or other intense actions that are often associated with sports, the discomfort and swelling get worse. When torn meniscus fragments become entrapped in the knee joint, the outcome is the sense of being in pain.
Athletes who suffer from this problem must have their meniscus repaired immediately, or else the situation may deteriorate and have long-term to permanent implications.
What are the symptoms?
The following are some of the signs and symptoms of a torn meniscus.
- When you get a popping feeling, you may also experience edema or stiffness. When you twist or rotate your knees, you will experience more discomfort. Inability to straighten the leg in a timely manner
- When you try to move your knee, it feels as though it is stuck in place. Having the sensation that your knee is giving way
How is a torn meniscus treated?
Thearthroscopic meniscus repair is a technique that is performed to repair damaged knee cartilage, which is most commonly seen in sports. If the meniscus has been torn, the damage can be repaired using a minimally invasive treatment, depending on the severity of the lesion. Aftercare and rehabilitation necessitate postoperative protection in order to facilitate healing. Physical therapy, which is performed in order for the patient to restore full function of the knee, aids in the recovery process.
It is possible to recover from meniscus tear surgery in as little as three months, or as long as six months. Meniscus removal, sometimes known as meniscectomy, meniscus repair surgery, and, in rare situations, meniscus replacement are all options for treating this condition.
What are the different procedures for a torn meniscus?
Meniscus repair surgery is performed with the purpose of preserving the meniscus, and it is the method of choice when the tear is repairable. When the injury is irreversible, a meniscectomy is performed, which involves the removal of the affected tissue. In the near term, meniscectomy provides outstanding benefits for the patient. However, it increases the likelihood of the patient acquiring arthritis in as little as 10 to twenty years. The patient has fantastic outcomes after having meniscus repair surgery.
Additionally, restoration necessitates the fact that the meniscus is not fully destroyed and is still repairable.
Patients who have acquired discomfort in the knee but do not show extensive degeneration of the articular or gliding cartilage or gliding surface may be candidates for meniscus replacement.
Is meniscus repair surgery effective?
There is a much higher proportion of effective recovery when meniscus repair surgery is performed by a skilled orthopaedic surgeon with extensive expertise. A whooping 90 percent of patients recover completely and return to their previous levels of activity. It is common for people who have hurt their knees to experience increased chances of developing arthritis in the near future. However, when it is effectively healed, the progression of arthritis is considerably slowed, if not stopped altogether.
What are the benefits of surgery?
The meniscus is an extremely important element of the body since it is responsible for stress absorption and load transfer in the knees and ankles. You put a lot of strain on your knees while you’re active, since they may be subjected to up to 5 times your body weight at times. The meniscus is responsible for transmitting 50% of the force applied to a straight knee. Furthermore, it absorbs 85 percent of the impact when the knee is bent at a 90-degree angle. When you lose a portion of your meniscus, the strain on your articular or gliding cartilage increases considerably, resulting in degeneration of the cartilage itself.
It takes longer to recover from a surgical meniscus repair than it does after a meniscectomy.
How do I know that I am fit for meniscus repair surgery?
When an athlete is in good health and desires to continue participating in their sport, he or she should consider meniscus repair surgery. Furthermore, it should only be performed when the patient knows the nature of rehabilitation and surgery, as well as all of the hazards involved. A repair can also be performed only if the meniscus tear is located on the periphery of the meniscus and if the tissue quality is high and the repairable tissue is present.
Most essential, you must be certain that the surgeon has extensive experience in meniscus repair before proceeding. If you want to save money, it’s essential to choose quality above pricing because inconsistent operations can cost you both money and your knees.
What should I do if I feel like there’s something wrong with my knees?
If you are an athlete who engages in high levels of physical activity on a regular basis and you are concerned about the way your knees are feeling, you should see a doctor as soon as possible. If you wait too long, your injuries may worsen, necessitating the need for more difficult and expensive treatment. So make an appointment with your doctor for a check-up. During a physical examination, the doctor can determine whether or not you have a meniscus tear. The practitioner will move your knee and leg into various articulations, as well as monitor how you walk and squat, in order to determine what is causing your symptoms and signals.
Virtual Care from Sports Doctors and Specialists
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The best thing you can do is prevent.
Leg strengthening exercises should be performed on a regular basis to avoid the possibility of a torn meniscus. Leg exercises can help to increase the stability of your knee joint and, as a result, will help to keep it safe from damage. It would also be beneficial if you used protective equipment when participating in sports. When participating in intense exercises, you can also utilize a brace to support your knee. If you or someone you know is an athlete or is interested in sports, we provide a comprehensive website where you can learn more about sports injuries in general.
9 meniscus tear exercises to improve strength and reduce pain
Exercise that is too strenuous can tear the meniscus, a layer of cartilage in the knee, and some mild activities may be beneficial in the rehabilitation process. Meniscus tears are fairly prevalent; according to studies, around 61 out of every 100,000 persons in the United States suffer from this health problem. We’ll take a closer look at this issue and detail nine workouts that can help strengthen and restore the atorn meniscus in the section below. Before experimenting with them, speak with your doctor.
It is beneficial in the following ways:
- In order for the knee joint to function properly, it must fit together correctly, absorb shock from walking and other activities, and offer stability to the knee.
A tear can occur as a consequence of excessive strain, which might occur as a result of activity. Among the most common signs and symptoms are: This type of injury is more prevalent in military members on active duty as well as other persons who engage in a lot of physical activity.
Males over the age of 40 are at a greater risk of developing prostate cancer.
Meniscus rips that are not too serious can heal in 4–8 weeks. Others may require surgery, which might take as long as six months to complete. Gentle exercises may be recommended by doctors for those who have less severe tears. It is common for these workouts to produce some discomfort at the beginning. If any workout causes you discomfort, however, you should stop performing it immediately.
1. Mini squats
Exercises such as mini squats can assist to develop the quadriceps, which are big muscles located at the front of the leg, without putting undue strain on the knees. Mini squats should be performed as follows:
- Holding yourself up against a wall, with your back, shoulders, and head against the wall
- Ideally, the feet should be shoulder width apart and approximately one foot apart from the wall
- Knees should be slightly bowed, buttocks should be brought closer to the ground Stop when you reach around 15 degrees of the bend. Hold the posture for 10 seconds, then gently raise the body back up to the beginning position, keeping the back and shoulders on the wall
- Repeat the process. Carry out two sets of 8–10 repetitions on each side. Each set should be followed by a 30 second to 1 minute rest period.
The importance of keeping the back and shoulders against the wall cannot be overstated, since this decreases stress on the knees.
2. Quadriceps setting
This is an isometric workout, which means that it works the muscles while maintaining the body in a static posture. To execute the quadriceps setup, follow these steps:
- Take a seat or lie down on the ground with your legs stretched out from your body. Quadriceps contraction: contract the quadriceps and use them to drive the backs of the knees toward the ground. Hold this posture for 10–20 seconds
- Then change positions. Perform two sets of ten contractions, with a 30-second to 1-minute break in between each set.
3. Straight leg raise
This workout stretches and strengthens the hamstrings as well as the quadriceps. Straight leg lifts should be performed as follows:
- Lie down on the floor with your left foot flat on the ground and your right leg outstretched
- Maintaining a neutral spine and pelvis, flex the right foot and contract the right thigh muscles, gently raising the right leg off the floor
- Repeat on the other side. Gradually drop the right leg back down to the floor once it has been raised up to approximately 45 degrees. Perform two sets of ten repetitions on the right leg before switching to the left leg.
4. Prone hang
This exercise is designed to enhance the range of motion in the knee. To accomplish the prone hang, follow these steps:
- Spread your legs over the side of a bed and lie facedown on your stomach. Relax and let gravity to gradually draw the left knee down until it is fully stretched. For 15–30 seconds, keep the left knee in this posture before bringing it back up. Repeat this three times, and then repeat the process for the right knee.
5. Hamstring curls
The hamstrings, which are the muscles in the backs of the thighs, are strengthened by performing this exercise. To execute hamstring curls, follow these steps:
- Lie down on your stomach, keeping your legs as straight as possible
- Slowly bending the right knee and elevating the right foot toward the buttocks is the goal. Slowly bring the right foot down
- Perform two sets of 8–10 repetitions each, with a 30-second break in between each set. Repeat the process with your left leg.
6. Hamstring heel digs
This is another another hamstring exercise that may be used to strengthen the abdominal muscles as well as the lower back. To do hamstring heel digs, follow these steps:
- Assume a supine position with the knees bent and feet flat on the floor. Only the heels of the feet should make contact with the floor. Digging the heels into the ground and slowly moving them away from the torso around 5 inches is recommended. Return to the beginning posture by sliding the heels backwards a little. Perform two sets of 8–10 repetitions, with a 30-second to one-minute break in between each set.
7. Standing heel raises
This exercise is beneficial for increasing the strength of the calf muscles. Standing heel lifts should be performed as follows:
- Maintain a hip-width distance between your feet, with your hands resting on a hefty, solid piece of furniture for further support. Slowly raise your heels off the floor as far as you are comfortable doing so
- Keep the heels in this posture for a moment, then slowly descend them to the floor
- Perform three sets of eight to ten repetitions, pausing for 30 seconds to one minute between each set.
It utilizes a variety of muscles, including the hip abductors and the buttocks muscles, throughout this exercise. Clams are performed as follows:
- Lie down on your left side, keeping your hips and feet aligned at all times, and do the following: Straighten your legs at the knees 45 degrees and steadily elevate your upper knee as high as you can without shifting your lower back or pelvis
- Gradually bring the upper knee back to its starting position. Perform two sets of 8–10 repetitions each, with a one-minute break in between each set of repetitions. Repeat the process on the other side.
9. Leg extensions
Leg extension exercises help to increase muscle in the thighs and calves. They are safe to conduct several times a day by a single individual. Leg extensions should be performed as follows:
- Place your feet flat on the floor while sitting in a chair or bench. Right foot flexed, then lifted, resulting in the right leg being straightened
- Using your right foot, slowly return to the beginning position. Continue to repeat this for ten times, then repeat it with the left leg.
A number of workouts are too hard for those who have suffered a meniscus tear. A person should refrain from doing the following:
- Deep squats are recommended, as well as any activity that requires pivoting or otherwise twists the knee. Use free weights to make any of the workouts listed above more difficult
A torn meniscus should be evaluated by a medical professional, especially if the symptoms do not resolve within a few weeks. Consult with a doctor before beginning any light fitness program, such as the ones listed above, to ensure that the program is safe for you. A torn meniscus may be extremely painful and unpleasant to deal with. Certain workouts, on the other hand, can aid in the speeding up of the recuperation process. They can also lessen the likelihood of the injury recurring in the future.
How Long Does It Take To Recover From Meniscus Surgery?
The c-shaped portion of cartilage between the tibia and femur bones has a significant role in the function of such a little area of the body. The meniscus is a portion of cartilage that acts as both a stabilizer and a shock absorber for the knee joint. And you’ll be aware if you’ve injured your meniscus. When a meniscus injury necessitates surgery, the issue is what occurs and how long it takes to recover from the procedure. The answer is: it depends. AlterG’s Meniscus Repair Rehabilitation Protocol is worth reading.
- Let us first discuss the underlying reason before moving on to treatment.
- Meniscus injuries are most common in contact sports, such as football, soccer, and ice hockey, because of the force involved.
- The reasons for this differ.
- What to Expect Immediately Following Meniscus Surgery After a meniscus injury, doctors utilize magnetic resonance imaging (MRI) to identify the degree of the injury and whether or not surgery is necessary.
Whether or not an injury will heal on its own is determined by the likelihood of healing and the severity of the harm. For individuals who have sustained an injury that necessitates surgery, this is what to expect afterward:
- The importance of rest, healing, and recovery time: Patients will be placed on the RICE regimen (restraint, ice, compression, and elevation), along with pain and inflammatory medication if necessary, as soon as the injury occurs. Despite the fact that the operation to repair a meniscus tear is not very time-consuming, the recovery period can range anywhere from three weeks to six months before the patient is able to return to full activity. When it comes to meniscus surgery, recovery time is dependent on several factors, including the degree of the operation (complete removal or repair, for example), the location of the injury, and any other damage that has been done to the knee during the procedure. The length of time required for rehabilitation will also vary. Crutches, a brace, and a gradual return to weight-bearing: this is all it takes. After surgery, the majority of patients will be on crutches, wearing a brace, or a combination of the two for at least a couple of weeks after the procedure is completed. This helps to minimize the amount of force on the knee, allowing the repaired tissue to begin healing and the danger of re-injury to be reduced. The physical therapy program consists of the following components: Following an initial time of recuperation, the majority of patients will begin a physical therapy program to help them return to their previous levels of activity in a steady and progressive manner. In this case, a gradual return to weight-bearing activities is recommended. Because the integrity and regularity of this program will have a direct influence on the patient’s recovery period, the following areas of emphasis may be included:
Reducing recovery times through the use of precision unweighting Once a patient has been cleared to return to weight-bearing activities, their physical therapist will customize the duration and intensity of their treatments based on the degree of the meniscus damage that they have sustained. Aside from typical procedures, many physical therapists are also incorporating unweighting exercises, such as pool treatment, or instruments like as theAlterG Anti-Gravity TreadmillTM, to help patients re-introduce walking and running movements while reducing the risk of injury and discomfort.
By introducing weight-bearing in smaller, bearable stages and properly managing those increases, we may achieve more stability.
Arthroscopic Knee Surgery – Your Meniscectomy Recovery Plan
Arthroscopic knee surgery is a procedure in which a tiny incision is made through the skin to allow surgeons to assess and treat knee issues. A tiny camera is put into the incision and displays pictures of the knee as it is being operated on. Surgeons can use this space to implant small medical devices and perform a surgical debridement, which is the removal of dead, damaged, or contaminated tissue from the body. This procedure aids in the healing of the healthy tissue in the affected location.
- Areas of cartilage injury are repaired by removing torn meniscus tissue, removing loose bodies, and cleaning up damaged cartilage. Other minimally invasive procedures that do not require any repairs include the following:
What is a Knee Meniscectomy?
A meniscectomy is the surgical excision of a torn meniscus, and it is a type of arthroscopic knee surgery that is performed under local anesthesia. The meniscus acts as a shock absorber for your knee and helps to keep your knee stable by distributing your weight evenly. Meniscus rips are most commonly found in the knee joints, and they are typically caused by a sudden twisting or turning of the leg.
Arthroscopic Knee Surgery Recovery
Following a meniscectomy, your surgeon will most likely recommend physical therapy to help you get back on your feet as quickly as possible. You will need to see your physical therapist the day after your operation to ensure that you have received the following services:
- Make a change in your dressings
- Take your first measurements Learn how to set up a basic home fitness regimen.
Your physical therapist will also go over information with you on what to anticipate, how to care for your incisions, and how to manage your pain after your surgery. There will be handouts available that outline everything you will learn. Appointments for physical therapy will be planned twice a week for roughly 6 to 8 weeks at this time.
Walking with Crutches
Some patients are discharged from the operating center on crutches, but the vast majority are able to walk shortly thereafter. If you have been prescribed crutches, we will most likely recommend you to cease using them as soon as possible after you have been prescribed them.
Returning to WorkDaily Activities
The majority of people may return to desk jobs, school, or other sedentary activities 3 to 5 days after their operation. Depending on how your right knee was operated on, it might take up to 2 weeks before the knee is strong enough to press the brakes in order to drive.
It may take 4 to 6 weeks before the leg is strong enough to allow for heavy lifting and functioning. If you are still using prescription pain medicines, you should never go behind the wheel or operate heavy machinery.
Returning to Sports
Patients often begin to practice higher level exercises during physical therapy appointments about 4 weeks after surgery, depending on their individual circumstances. You will begin the gradual transition back to your sport with the help of your physical therapist between 4 and 6 weeks after your injury. Your surgeon, on the other hand, will make the final decision on whether or not you may resume full exercise.
Using crutches, you should be able to bear as much weight as tolerated during the first several weeks following your arthroscopic knee surgery recovery. You should be able to move to full weight bearing without the need of crutches at this point in time. Flexibility and Range of Motion (ROM) Exercises for Rehabilitation
- Quad sets, glute sets, ankle pumps, hamstring and calf stretches are all excellent options. Isometrics for quads with several angles (from 90 to 60 degrees)
- Leg lifts in the straight position (multi-plane)
- Extension of the knee joint, with the chain opened 90 to 40 degrees
- Mobs of patellar flies
- Tolerance is achieved by sliding the heel. Cycling for range of motion (ROM)
- Passive range of motion (PROM) focusing on developing full extension range of motion (ROM)
- Weight changes when standing
- Mini squats from 0 to 30 degrees while standing
- In standing, perform low-level balance and proprioceptive activities.
- Proprioceptive workouts are those that train the body’s capacity to detect movement inside joints.
Weeks 2 to 4
Flexibility and Range of Motion (ROM) Exercises for Rehabilitation
- Continue with the workouts from weeks 0 to 2 as well as all passive and active ROM
- Standing hamstring curls
- Bilateral protected ROM leg press
- Mild cardiovascular endurance on a stationary bike with minimal resistance
- Bilateral protected ROM leg press Step-ups, calf lifts (standing bilaterally or unilaterally), and a stationary mini-lunge forward are all good options. Using wall slides, progressing standing balance and proprioceptive exercises, and a pool walking program after the wound has closed completely,
Weeks 4 to 6
Exercises for Rehabilitation
- Continue with the exercises from the previous weeks, as well as any passive and active ROM that is required. Squats (with greater range of motion)
- Lateral step-ups
- Stepper machine for the stairwell a period of 20 minutes Carry on with the exercises until you have achieved terminal knee extension. Cycling for cardiovascular endurance with mild to moderate resistance is recommended.
Weeks 6 to 8
This week and the subsequent weeks are free of limitations on activities of daily life, as are the following weeks (ADLs). Exercises for Rehabilitation
- Exercises from previous weeks should be continued. Closed kinetic chain (CKC) and functional workouts are being advanced. Start a walking regimen to improve your cardiovascular endurance. Increase the amount of time spent on the stair stepper gradually to build cardiac endurance. A functional mobility screen (FMS) was performed after 8 weeks.
Weeks 8 to 12
Exercises for Rehabilitation
- If you have decent hip and knee mechanics, you may do light plyometrics (jump training) and work your way up. Linear forward jogging in brief bursts, with jog intervals becoming increasingly difficult to maintain
- Training in adverse conditions (also known as improving reaction times)
- It is possible to begin mild yoga. Start with an elliptical machine to build cardiovascular endurance. Begin with forward agility drills, graduating to lateral agility activities as needed. Obtaining a strength and conditioning program, such as Access Acceleration, is recommended.
During this time period, your surgeon must give you the go-ahead before you can return to your sporting activity. Exercises for Rehabilitation
- Increase the intensity of your jogging program, intervals, and/or sprint training. Specific sport-specific training as required: cutting, leaping, deep squats, and so forth.
Meniscus Tear: Rehabilitation Exercises
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Meniscus Tears – OrthoInfo – AAOS
The resumption of non-essential orthopaedic treatments that had been postponed as a result of COVID-19 has occurred in several locations. Questions and Answers for Patients Regarding Elective Surgery and COVID-19 are provided for informational purposes. Patients whose treatments have not yet been postponed should follow these guidelines: In the event that your orthopedic surgery is postponed, here’s what you should do. Injuries to the meniscus are among the most prevalent types of knee injuries.
- A torn meniscus, on the other hand, can occur at any age.
- The femur and the tibia are the two bones that come together to form your knee joint.
- Between your femur and tibia, there are two wedge-shaped sections of fibrocartilage that function as shock absorbers.
- Besides assisting in the transfer of weight from one bone to another, the menisci also serve a critical function in maintaining knee stability.
- Tears are distinguished by the way they appear as well as the location of the tear in the meniscus.
- Meniscus injuries sustained while participating in sports are frequently associated with other knee ailments, such as anterior cruciate ligament (ACL) tears.
- These can result from a contact or non-contact injury — for example, a rotating or cutting injury — and can be life-threatening.
- Tissue that has become old and worn is more prone to tearing.
- When you tear the meniscus, you may hear a popping sound.
The knee, on the other hand, would progressively get increasingly rigid and swollen over the course of 2 to 3 days. The following are the most prevalent signs of a torn meniscus:
- Itching and swelling
- Catching or locking of your knee
- And other symptoms. The sense that your knee is about to give way
- Knee pain that prevents you from moving your knee through its entire range of motion.
After talking with you about your symptoms and medical history, your doctor will do an examination of your knee. They will feel for discomfort along the joint line, where the meniscus is located, and report back to the doctor. This is frequently indicative of a tear. The McMurray test is one of the most often used procedures to detect meniscus injuries. Your doctor will bend your knee, then straighten it and rotate it in the other direction. A torn meniscus is put under additional strain as a result.
In light of the fact that other knee injuries might produce symptoms that are similar to yours, your doctor may prescribe imaging tests to assist confirm the diagnosis. X-rays. X-rays are used to create pictures of dense structures, such as bone, in the body. Although an X-ray will not reveal a torn meniscus, your doctor may request one to rule out other potential reasons of knee discomfort, such as osteoarthritis, in order to diagnose the condition. Scanners that use magnetic resonance imaging (MRI).
- Depending on a variety of criteria, including your age, symptoms, and amount of activity, your doctor may prescribe a particular course of therapy.
- The outer one-third of the meniscus has a plentiful supply of blood flowing through it.
- Among the types of tears that can occur is the longitudinal tear.
- Tears in this “white” zone with restricted blood flow will not heal unless they receive nutrients from the blood.
Many meniscus injuries will not necessitate urgent surgical intervention. Depending on whether or not your symptoms continue and whether or not you have any locking or swelling of the knee, your doctor may prescribe nonsurgical therapy. RICE. The RICE procedure has been shown to be beneficial in the treatment of most sports-related injuries. It is abbreviated RICE, which stands for Rest, Ice, Compression, and Elevation.
- Rest. Give up the activity that caused the injury and rest for a few days. It is possible that your doctor would advise you to use crutches in order to prevent placing any weight on your leg. Ice. For best results, apply cold packs for 20 minutes at a time numerous times throughout the day. It is not recommended to apply ice straight to the skin. Compression. Make use of an elastic compression bandage to keep swelling and blood loss from increasing further. Elevation. When you relax, recline your chair and raise your leg higher than your heart to help prevent swelling.
Nonsteroidal anti-inflammatory medications (NSAIDs) (NSAIDs). Anti-inflammatory medications such as aspirin, ibuprofen, and naproxen are used to alleviate pain and inflammation. Injection of steroid. Corticosteroid medicine may be injected into your knee joint by your doctor to assist alleviate pain and swelling in your knee joint.
Other nonsurgical options are available. Injections of biologics, such as platelet-rich plasma (PRP), are currently being researched and may show potential in the treatment of meniscus tears in the future.
If your symptoms do not improve with nonsurgical therapy, your doctor may recommend arthroscopic surgery to relieve them. Procedure. Knee arthroscopy is one of the most often performed surgical procedures, accounting for around 20% of all surgeries. In this treatment, the surgeon makes a tiny incision (portal) in the knee and inserts a micro camera into the joint. This allows for a clean picture of the inside of the knee joint to be obtained. After that, the surgeon inserts surgical instruments via two or three additional tiny portals in order to trim or heal the rip.
- Meniscectomy with partial removal of the meniscus. The meniscus tissue that has been injured is removed during this surgery. This method normally allows for rapid weight bearing and complete range of motion following surgery
- However, this is not always the case.
- Repair of the meniscus. Some meniscus injuries can be healed by suturing (stitching) the torn portions of the meniscus back together again. The kind of tear, as well as the general state of the torn meniscus, determine whether or not a tear may be effectively healed. Because the meniscus must knit back together, the recovery period for a meniscectomy is longer than the recovery time for a repair.
Once the first healing process is complete, your doctor will prescribe rehabilitation activities to aid in the recovery process. It is vital to engage in regular exercise to help regain your knee mobility and strength. You will begin by performing exercises to increase your range of motion. You will progressively incorporate strengthening workouts into your recovery program. Most rehabilitation may be done at home, however your doctor may urge that you engage with a physical therapy professional in some circumstances as well.
Meniscectomy recovery period is shorter, ranging from 3 to 6 weeks after the surgical procedure.
Patients are frequently able to recover to their pre-injury levels of function after receiving adequate diagnosis, treatment, and rehabilitation.