Photograph of a normal meniscus. Note the smooth edge
Photograph of a meniscal tear
which is not repairable.
The tear has been trimmed off,
leaving a stable meniscal rim.
Meniscal tears are extremely common but, fortunately, seldom require surgery. Some meniscal tears can be repaired but most tears are not repairable and may need to be trimmed or excised. This operation is known as meniscectomy.
Knee Reconstruction and Arthroscopy
Arthroscopy (keyhole joint surgery) is used to examine and treat the inside of a joint without using a large, open incision. This minimises wound complications and allows faster recovery. Knee arthroscopy is performed through two or three small incisions around the knee and can usually be done as a day case procedure, avoiding an overnight stay. Problems that can be treated with knee arthroscopy include tears of the meniscus or cruciate ligaments or minor cartilage damage.
Photograph of a repairable meniscal tear (outlined in red)
Sutures are inserted into the meniscus after closing the tear
Repaired meniscus with closed tear outlined in red
Normal ACL outlined in red
Ligament reconstruction is most commonly performed for rupture of the anterior cruciate ligament (ACL), but the principles of reconstruction can be applied to all of the ligaments of the knee. The torn ligament is replaced with a tendon graft obtained from the patient (usually hamstring or kneecap tendon) and eventually heals to function as a new ligament. Not all torn ligaments require surgery but when required, the results are usually very good and knee stability can be restored. Complications, however, can occur.
A detailed explanation of the advantages and disadvantages of anterior cruciate ligament reconstruction can be seen by clicking on the image of the Patient Information booklet for ACL reconstruction.
Magnetic Resonance Imaging (MRI) scans showing a normal, intact ACL on the left (outlined in red) and a ruptured ACL on the right (outlined in red).
Photograph of a ruptured ACL, torn edge outlined in red
New graft passing through knee into bone tunnel
Completed ACL reconstruction. Graft emerging from old ACL stump on tibia (leg bone) and secured into bone tunnel on femur (thigh bone). Red line shows the edge of old ACL
Patient Information Booklet for ACL repair
Patient Information Booklet for Knee Arthroscopy