Meniscus injuries are quite frequent, especially in sportspmen, and the choice between meniscus repair and meniscectomy (removal of part or all of the meniscus) depends on the type, location, and the extent of the tear, the patient’s age, level of activity, and general state of health.

Meniscus Repair

Advantages:

1.     Preserves Meniscal Tissue: This prevents a collapse of the meniscus’s function in absorbing shock and providing stability to the joint.

2.     Reduces Risk of Osteoarthritis: Preserving the meniscus reduces the risk of osteoarthritis in the future because it helps to spread the load more evenly across the joint.

3.     Potential for Full Recovery: A successful repair can bring the knee close to its normal function.

Disadvantages:

1.     Longer Recovery Time: Rehabilitation may be a long process, which may include several months of non-weight bearing and physiotherapy.

2.     Risk of Re-Tear: It is possible that the repair will not heal up properly and there is a risk of re-tear.

3.     Complexity: It is more technically challenging and not all tears can be repaired particularly those in the avascular zone (inner two-third) of the meniscus.

Meniscectomy

Advantages:

1.     Quick Recovery: The time taken to recover is usually less than the time taken to repair, thus enabling a quick transition back to normal activities.

2.     Simplicity: The procedure is relatively simple and can be performed arthroscopically as a day case surgery.

3.     Symptom Relief: Offers an acute solution to symptoms like pain and mechanical blockage due to the torn meniscal fragment.

Disadvantages:

1.     Loss of Meniscal Function: Partial or complete removal of the meniscus weakens its function as a shock absorber and can cause more stress on the joint.

2.     Increased Risk of Osteoarthritis: Increased likelihood of future osteoarthritis as the meniscus is no longer acting as a shock absorber.

3.     Potential for Residual Symptoms: It is important to note that some patients may still have knee pain and instability after the procedure.

Decision Factors

1.     Type and Location of Tear:Type and Location of Tear:

·        Repair: Suggested for tears in the red-red zone (outer third) where there is adequate blood flow to facilitate healing.

·        Meniscectomy: Commonly employed for wounds in the white-white area (first third) that are not well supplied with blood.

2.     Patient’s Age and Activity Level:Patient’s Age and Activity Level:

·        Younger, Active Individuals: More likely to benefit from repair as they require joint preservation for future projects.

·        Older, Less Active Individuals: May choose meniscectomy for faster recovery and relief from symptoms.

3.     Associated Knee Injuries:

·        Other injuries like ACL tears may also be a factor towards repair since the rehabilitation process may be combined.

Conclusion

This paper aims at providing an understanding of meniscus repair and meniscectomy in order to help the patient make the right decision. Meniscus repair is more beneficial in maintaining the knee joint and avoiding future complications especially among the young and active population. Meniscectomy, on the other hand, provides quicker pain relief and healing for those who may not be suitable for repair. It is important for the patient to seek the services of an orthopedic surgeon to determine the extent of the tear and the patient’s general health.