A torn meniscus is one of the most common knee injuries — causing pain, swelling, stiffness, and in some cases a locking sensation that prevents you from straightening your knee. Not all meniscus tears need surgery, and not all tears that need surgery need the same procedure.
Dr. Harish Talreja is an experienced orthopaedic specialist in Jaipur with a repair-first philosophy — preserving as much meniscal tissue as possible at Manipal Hospital Jaipur, using arthroscopic meniscus repair where the tear location and pattern allows, and partial meniscectomy when repair is not viable.
Each knee has two C-shaped fibrocartilage structures called menisci — the medial (inner) meniscus and the lateral (outer) meniscus. They sit between the femur (thigh bone) and tibia (shin bone), acting as shock absorbers, stabilisers and joint lubricators.
The menisci are critically important for knee health. They distribute load across the joint, protect articular cartilage, and contribute to rotational stability. Removing meniscal tissue permanently reduces this protection — which is why preserving the meniscus through repair is always preferable to removal when the tear location allows.
The medial meniscus is torn more commonly than the lateral — particularly in ACL injuries, where medial meniscus tears occur in 40 to 60% of cases. Lateral meniscus tears are more common in chronic ACL deficiency.
Meniscus tear symptoms vary by tear type, size and location — but these are the most common presenting features that should prompt an orthopaedic assessment and MRI.
Tenderness directly along the medial or lateral joint line — the most consistent clinical sign. Worse on palpation, twisting, squatting and stair descent.
The knee swells within hours to days after a sports tear — or gradually with degenerative tears. Stiffness is worse in the morning and after prolonged sitting.
A clicking or catching sensation when the knee moves — caused by the torn meniscal flap catching in the joint as the femur and tibia move over it.
A bucket handle tear can fold into the joint, mechanically blocking full extension. The knee is "locked" — cannot be straightened without a specific manoeuvre or surgical intervention.
The knee may give way, particularly on twisting movements — due to the torn meniscal flap disrupting the smooth mechanics of the joint.
The most important factor determining whether a meniscus can be repaired is its zone — how close it is to the outer edge of the meniscus, where the blood supply exists. This is why MRI is essential before any treatment decision.
The outer third of the meniscus has a rich blood supply from the peripheral capsular vessels. Tears in this zone have the highest healing capacity and are the best candidates for repair rather than excision.
The middle third of the meniscus has a partial blood supply. Tear healing in this zone is less predictable — repair may be attempted, particularly in younger patients and in conjunction with ACL reconstruction (which enhances healing).
The inner third of the meniscus has no blood supply. Tears in this zone cannot heal — making repair futile. The torn fragment is removed by partial meniscectomy, trimming only the unstable, symptomatic portion while preserving as much healthy tissue as possible.
Not all tears need surgery. The AI overview noted physiotherapy is effective for 85–90% of cases — but this is misleading without context: many stable, asymptomatic or degenerative tears can improve conservatively, while mechanical tears causing locking or progressive instability require surgical treatment.
Small stable tears — particularly in the red-red zone — that do not cause mechanical symptoms (no locking, minimal catching)
Degenerative meniscus tears in patients over 40 — a minimum 3-month trial of physiotherapy, activity modification and anti-inflammatory medication is recommended before considering surgery
Low-demand or elderly patients who can modify activities to manage symptoms without significantly impacting quality of life
Conservative: RICE, physiotherapy, quadriceps and hamstring strengthening, anti-inflammatories, activity modification
Bucket handle tear causing mechanical locking — urgent arthroscopic treatment required to restore knee extension
Mechanical symptoms (catching, locking, giving way) that prevent normal activities despite adequate conservative treatment
Large unstable tears in young, active patients — particularly in the repairable red-red or red-white zone where repair offers long-term joint protection
Combined ACL + meniscus tear — the meniscus is addressed simultaneously during ACL reconstruction in the same surgical session
These are fundamentally different procedures with different recovery timelines and long-term implications. The choice depends entirely on the tear zone, pattern, size, and patient age — not patient preference.
| Characteristic | 🩹 Meniscus Repair (Preservation) | ✂ Partial Meniscectomy (Removal) |
|---|---|---|
| What is done | Torn meniscus is sutured back together using inside-out, outside-in or all-inside techniques | Only the torn unstable fragment is removed; healthy tissue is preserved |
| Best for | Red-red zone tears, vertical longitudinal tears, bucket handle tears in vascular zone, young active patients | White-white zone tears, degenerative tears, complex/horizontal tears, avascular zone fragments |
| Weight bearing | Protected (toe-touch or non-weight bearing) for 4–6 weeks | Full weight bearing from Day 1 |
| Return to sport | 4–6 months with structured rehabilitation | 4–6 weeks for most patients |
| Long-term joint health | Significantly better — preserves load distribution and articular cartilage protection | Reduced cushioning; increased long-term osteoarthritis risk proportional to tissue removed |
| Success rate | 70–90% healing in red-red zone; 50–70% in red-white zone | Excellent symptom relief — 85–95% satisfaction for appropriate indications |
| Dr. Talreja's approach | First choice whenever tear location and pattern allows repair | Performed when repair is not viable — minimum tissue removed |
All meniscus surgery at Manipal Hospital Jaipur is performed arthroscopically — through 2 to 3 small keyhole portals under spinal or general anaesthesia. Most patients go home the same day as surgery.
Spinal or general anaesthesia. Patient positioned supine. Tourniquet applied. 2 to 3 keyhole portals created for arthroscope and instruments.
Arthroscopic inspection of the entire joint — ACL, articular cartilage, both menisci. Tear characteristics confirmed: location, zone, pattern and stability.
Repair: Meniscal tear sutured using all-inside implants, inside-out or outside-in techniques. Bleeding stimulated at tear site. Meniscectomy: Unstable fragment resected with motorised shaver. Smooth, stable rim left behind.
Portals closed. Compression bandage applied. Physiotherapy begins Day 1 (range of motion). Weight bearing protocol depends on procedure performed — immediate for meniscectomy, protected for repair.
Combined with ACL Reconstruction: When a meniscus tear is identified alongside an ACL tear, both procedures are performed arthroscopically in the same anaesthesia session. The meniscus is repaired or trimmed before the ACL reconstruction graft is passed — maximising efficiency and minimising overall recovery burden for the patient.
Recovery varies significantly between meniscus repair (longer, more careful) and partial meniscectomy (fast). The difference reflects the fundamental difference between healing sutured cartilage versus recovering from removal of a fragment.
The AI overview cited MRI ₹5,000–₹12,000 and surgeon fees ₹15,000–₹40,000. Here is a complete cost breakdown for Manipal Hospital Jaipur.
A personalised estimate is provided after consultation and MRI review.
Dr. Harish Talreja applies a repair-first philosophy to every meniscus tear — preserving as much cartilage as possible, with partial meniscectomy performed only when repair is genuinely not viable. This approach maximises long-term knee health for every patient.
Arthroscopic Procedures
Years Experience
First Approach Always
Book a consultation with Dr. Harish Talreja at Manipal Hospital Jaipur — accurate MRI-based tear assessment, honest treatment advice, and a repair-first approach that protects your knee for the long term.
Shop No. 2/34, A Block
Vaishali Estate Township, Gandhi Path West
Jaipur – 302021
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