Acute Meniscus Injury: What to consider with Exercise Therapy vs Surgical Review

The choice between surgery and physiotherapy for acute meniscus injury depends on various factors, such as the severity of the injury, the age and activity level of the patient, and the patient’s overall health status.

The blood supply to the menisci is of high relevance having important implications for the potential healing of a meniscal repair. It has been shown that only the outside 10-25% of the meniscus benefits from a blood supply. There are two distinct zones of the meniscus:

  1. Red-red vascular zone on the outside
  2. White-white avascular (no blood supply) region in the center.

They are separated by a red-white region. Tears in the white zone are unlikely to have a healing response due to poor blood supply.

In general, if the meniscus tear is small and located in the outer edge of the meniscus, physiotherapy and conservative management can be effective. This may include exercises to strengthen the muscles around the knee, as well as rest, ice, compression, and elevation (RICE) therapy.

Surgery for a meniscus tear is usually recommended when the tear is large, unstable, or causing significant pain or functional impairment that cannot be managed with conservative treatment. If symptoms such as “knee locking” exists and persists over time, generally surgical evaluation would be considered. The decision to undergo surgery also depends on several other factors, such as the location and severity of the tear, and the presence of other injuries or medical conditions.

In general, surgical treatment may be recommended for meniscus tears that fall into one of the following categories:

  1. Tears that do not respond to conservative treatment: Some meniscus tears may not heal properly with conservative treatment, such as rest, physical therapy, and anti-inflammatory medications. In such cases, surgery may be necessary to repair or remove the damaged tissue.
  2. Tears that are associated with other knee injuries: Meniscus tears may occur in conjunction with other knee injuries, such as ligament tears or fractures. In such cases, surgery may be necessary to address multiple issues and promote proper healing and recovery.

The decision to undergo surgery for a meniscus tear should be made in consultation with a qualified medical professional such as an orthopedic surgeon. The treating physiotherapist is able to recommend for a surgical review in the event where conservative management for a period of time has been unsuccessful.

If you have experienced a knee injury, our team of physiotherapists are able to provide you with a thorough assessment to determine the nature of your injury. Feel free to book online to receive an initial assessment and treatment plan to get you back to doing the activities that you enjoy.

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