The menisci are two C-shaped cartilage cushions in the knee, one on the inner side (medial) and one on the outer side (lateral). They spread load across the joint, absorb shock and help keep the knee stable. When a meniscus tears, the goal of modern treatment is to save the meniscus whenever possible, because losing meniscus tissue increases the stress on the joint cartilage and the risk of arthritis later. Dr. Andrew Dold, a board-certified, fellowship-trained sports medicine surgeon in Frisco, Texas, repairs meniscus tears arthroscopically, including complex meniscal root tears, a topic he has published on.
- Meniscus repair stitches the torn meniscus back together so it can heal
- Done arthroscopically through small incisions, usually as outpatient surgery
- Best for tears with a good blood supply, root tears, tears that occur with an ACL tear, and younger, active patients
- Recovery is longer than a “trim”: patients are often on crutches for about six weeks, and the repair typically takes about 6 months to heal
- Saving the meniscus helps protect the knee cartilage over the long term
Meniscus repair vs. partial meniscectomy
There are two main surgical options for a torn meniscus:
| Meniscus repair | Partial meniscectomy (“trim”) | |
|---|---|---|
| What is done | The tear is stitched together so it can heal | Only the torn, unstable piece is trimmed away, keeping as much healthy meniscus as possible |
| Best for | Tears in the outer zone with good blood supply, vertical/longitudinal and bucket-handle tears, root tears, tears with an ACL reconstruction, younger patients | Tears in the inner zone with little or no blood supply that cannot heal, causing catching or locking |
| Recovery | Longer: often about six weeks on crutches; about 6 months to heal | Shorter: crutches usually not needed for long |
| Long term | Preserves the knee’s shock absorber | Faster return, but less meniscus remains |
The American Academy of Orthopaedic Surgeons’ 2024 clinical practice guideline on acute meniscal tears supports preserving functional meniscus tissue whenever possible. Dr. Dold makes the final decision on repair vs. trimming during surgery, once he can see the tear directly, and discusses both possibilities with you beforehand. You can see his techniques in his videos on arthroscopic partial meniscectomy and meniscal root repair.
Am I a candidate for meniscus repair?
Repair works best when the tear has a good chance of healing. Factors Dr. Dold considers include:
- Location: the outer “red zone” of the meniscus has a good blood supply and heals most reliably; the inner “white zone” has almost none
- Tear pattern: vertical, longitudinal, bucket-handle and root tears are often repairable; degenerative and complex tears often are not
- Age and activity: younger, active patients benefit most from keeping their meniscus
- Other injuries: tears found with an ACL tear are often repaired during the ACL reconstruction
- Arthritis: repair is less likely to succeed in a knee with moderate or advanced arthritis, where other treatments may be better
Not every meniscus tear needs surgery. Many, especially degenerative tears in older adults, improve with physical therapy, activity changes, anti-inflammatory medicine, injections or PRP. Learn more about symptoms and diagnosis on our meniscus tears page.
What happens during meniscus repair surgery?
Meniscus repair is performed arthroscopically: a small camera and instruments are inserted through small incisions around the knee. Dr. Dold prepares the torn edges to encourage healing, then places sutures across the tear. Depending on the tear, techniques include all-inside repair (devices that place the stitches entirely from within the joint), inside-out repair (stitches tied through a small extra incision) and outside-in repair. Most patients go home the same day.
Meniscal root tears and root repair
The meniscal “roots” anchor each meniscus to the shinbone. A root tear can make the meniscus stop working as a shock absorber, a little like a meniscus being missing, and the meniscus can slide out of the joint (extrusion). Root tears are often repaired by passing sutures through small tunnels drilled in the tibia to reattach the root to bone. Dr. Dold has published research on transtibial meniscal root repair (Knee Surgery, Sports Traumatology, Arthroscopy, 2017).
Watch Dr. Dold: meniscus repair video
Meniscus repair recovery
Recovery after a repair is longer than after a trim, because the stitched tissue needs time to heal. Your exact plan depends on the type and location of the tear and any other procedures done at the same time. As a general guide:
| Time after surgery | Typical focus |
|---|---|
| First 6 weeks | Crutches, often non-weight-bearing or limited weight bearing to protect the repair; a brace may be used; physical therapy to regain motion and activate the quadriceps |
| 6 weeks to 3 months | Wean off crutches as directed, normal walking, strengthening, stationary bike |
| 3 to 4 months | Progressive strengthening and, when cleared, a gradual return to running |
| 4 to 6 months | Sport-specific training and return to full sport, based on healing, strength and function |
Deep squatting and heavy loaded knee bending are usually avoided early on, because they put high stress on a healing meniscus.
Risks of meniscus repair
Meniscus repair is generally safe, but risks include stiffness, infection, blood clots, injury to nearby nerves or blood vessels, and failure of the repair to heal, which may require further surgery. Dr. Dold reviews these with you before surgery.
Patient experience
Watch Dr. Dold: meniscus repair
Some of these videos show real surgery, so some viewers may prefer not to watch.
More videos on Dr. Dold’s YouTube channel.
What the research shows
- Saving the meniscus protects the knee: a systematic review found that repair, compared with removing torn tissue, is associated with better long-term function and less arthritis, even though repairs are re-operated on more often. European consensus guidelines now encourage repairing many tears once considered irreparable.
- Age is not a barrier: repair failure rates in patients 40 and older are similar to those in younger patients, and adolescents do very well.
- Realistic healing rates: most repairs heal, but failure rates range from about 15% for bucket-handle tears to about 26% for isolated medial repairs in a stable knee in recent meta-analyses. Repairs done with ACL reconstruction heal more reliably.
- Root tears matter: a torn meniscal root leaves the meniscus unable to absorb load. Repairing medial root tears in knees without significant arthritis slows arthritis and is cost-effective compared with meniscectomy, while severe cartilage damage or bow-legged alignment predict poorer results.
- Hidden tears: “ramp” tears at the back of the medial meniscus often accompany ACL tears and are easily missed on MRI, so they are specifically looked for during surgery and repaired if unstable.
- Technique and rehab: all-inside and inside-out repairs have similar results. Early motion and weight-bearing do not appear to harm isolated repairs, and protocols are tailored to the tear. Biologic augmentation such as PRP is promising but not yet proven.
Why see Dr. Dold
- Board certified by the American Board of Orthopaedic Surgery, with subspecialty certification in Sports Medicine
- Sports medicine and arthroscopy fellowship at NYU Langone / Hospital for Joint Diseases; orthopedic residency at the University of Toronto
- Fellow of the American College of Surgeons (FACS), the American Academy of Orthopaedic Surgeons (FAAOS), the American Orthopaedic Association (FAOA) and the Royal College of Surgeons of Canada (FRCSC)
- Published research on knee ligament and meniscus surgery, including The Posteromedial Corner of the Knee (JAAOS, 2017) and transtibial meniscal root repair (KSSTA, 2017)
- Team physician and surgical consultant to Rugby Canada; has cared for professional and Olympic athletes from the NFL, NBA, NHL, MLS, PGA Tour, Major League Rugby and USA Gymnastics
- D Magazine Best Doctors (Collin County), 2019–2026 · Rated 4.9 on Google
Frequently asked questions
Can a torn meniscus heal on its own?
Small tears in the outer part of the meniscus, which has a good blood supply, can sometimes heal or settle down without surgery. Tears in the inner part have almost no blood supply and usually do not heal on their own. Many tears improve enough with physical therapy that surgery is not needed.
Is it better to repair or remove a torn meniscus?
When a tear can heal, repairing it is usually preferred because it preserves the knee’s shock absorber and may lower the risk of arthritis later. Tears that cannot heal are trimmed, removing only the torn piece and keeping as much healthy meniscus as possible.
How long is recovery after meniscus repair?
Patients are often on crutches for about six weeks to protect the repair, and the repair typically takes about 6 months to heal. Recovery after a trim (partial meniscectomy) is much shorter.
How long will I be on crutches after meniscus repair?
Often about six weeks, sometimes with limited or no weight on the leg, depending on the tear. Root repairs follow a similar plan of about six weeks of protected weight bearing, with running usually starting at about 5 to 6 months. Dr. Dold will give you a plan specific to your repair.
Is meniscus repair outpatient surgery?
Yes. It is done arthroscopically through small incisions, and most patients go home the same day.
When can I return to sports after meniscus repair?
Most athletes return at about 4 to 6 months, based on healing, strength and function rather than a fixed date.
What is a meniscus root tear?
The root is where the meniscus attaches to the shinbone. A root tear can stop the meniscus from working as a shock absorber and let it slide out of the joint. Root tears in suitable knees are often repaired by reattaching the root to bone through small tunnels.
Will I need a brace after meniscus repair?
A brace is often used for a period after repair to protect the healing meniscus. Whether you need one, and for how long, depends on your tear and surgery.
What happens if a meniscus tear is not treated?
Some tears settle down with time and therapy. Others keep causing pain, catching or locking, and a torn meniscus that no longer works as a cushion can increase wear on the cartilage over time. An evaluation helps decide which applies to you.
Research cited on this page
- Paxton ES, Stock MV, Brophy RH. Meniscal repair versus partial meniscectomy: a systematic review comparing reoperation rates and clinical outcomes. Arthroscopy. 2011;27(9):1275-1288. PubMed
Repairs needed a second operation more often than trimming (about 21% vs 4% at long-term follow-up), but repair was associated with better long-term knee scores and less arthritis on X-ray. - Stein T, Mehling AP, Welsch F, et al. Long-term outcome after arthroscopic meniscal repair versus arthroscopic partial meniscectomy for traumatic meniscal tears. Am J Sports Med. 2010;38(8):1542-1548. PubMed
For traumatic tears, 81% of repaired knees showed no arthritis progression at long-term follow-up, compared with 40% after trimming; 96% vs 50% returned to their pre-injury activity level. - Faucett SC, Geisler BP, Chahla J, et al. Meniscus root repair vs meniscectomy or nonoperative management to prevent knee osteoarthritis after medial meniscus root tears: clinical and economic effectiveness. Am J Sports Med. 2019;47(3):762-769. PubMed
For medial root tears, a model built on pooled studies projected 10-year arthritis rates of 53% after root repair, compared with 99% after meniscectomy and 95% without surgery. - Petersen W, Karpinski K, Bierke S, et al. A systematic review about long-term results after meniscus repair. Arch Orthop Trauma Surg. 2022;142(5):835-844. PubMed
Studies with more than 7 years of follow-up found good long-term results after meniscus repair; failure rates were higher in children and teens than in adults. - Kopf S, Beaufils P, Hirschmann MT, et al. Management of traumatic meniscus tears: the 2019 ESSKA meniscus consensus. Knee Surg Sports Traumatol Arthrosc. 2020;28(4):1177-1194. PubMed
ESSKA consensus: long-term outcomes are worse after partial meniscectomy than after meniscus preservation; many tears once considered irreparable should be repaired. - Everhart JS, Higgins JD, Poland SG, et al. Meniscal repair in patients age 40 years and older: A systematic review of 11 studies and 148 patients. Knee. 2018;25(6):1142-1150. PubMed
Systematic review: repair failure rates in patients 40 and older are comparable to younger patients. - Tagliero AJ, Kennedy NI, Leland DP, et al. Meniscus repairs in the adolescent population-safe and reliable outcomes: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2020;28(11):3587-3596. PubMed
Systematic review: good to excellent outcomes after meniscus repair in adolescents. - Eberbach H, Zwingmann J, Hohloch L, et al. Sport-specific outcomes after isolated meniscal repair: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2018;26(3):762-771. PubMed
Systematic review: isolated meniscus repair gives good sport-specific outcomes and high return to sport in recreational and professional athletes. - D’Ambrosi R, Meena A, Raj A, et al. In elite athletes with meniscal injuries, always repair the lateral, think about the medial! A systematic review. Knee Surg Sports Traumatol Arthrosc. 2023;31(6):2500-2510. PubMed
Systematic review in elite athletes: repair and partial meniscectomy had similar return-to-sport rates; repair took longer but carries less long-term risk. - Farinelli L, Meena A, Montini D, et al. Failure rate of isolated medial meniscus repair in the stable knee: Systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2025;33(4):1333-1344. PubMed
Meta-analysis: isolated medial meniscus repair in a stable knee had a 26% failure rate. - Costa GG, Grassi A, Zocco G, et al. What Is the Failure Rate After Arthroscopic Repair of Bucket-Handle Meniscal Tears? A Systematic Review and Meta-analysis. Am J Sports Med. 2022;50(6):1742-1752. PubMed
Meta-analysis: bucket-handle tear repair failed in about 15% of cases; medial and isolated repairs failed more often. - Ardizzone CA, Houck DA, McCartney DW, et al. All-Inside Repair of Bucket-Handle Meniscal Tears: Clinical Outcomes and Prognostic Factors. Am J Sports Med. 2020;48(13):3386-3393. PubMed
Systematic review: all-inside repair of bucket-handle tears failed in 29% at about 13 months. - Dzidzishvili L, Berreta RS, Jackson GR, et al. All-Inside and Inside-Out Repair Techniques for Bucket-Handle Meniscus Tears Both Result in Improved Patient Outcomes and a Broad Range of Failure Rates: A Systematic Review. Arthroscopy. 2024;40(9):2477-2490.e1. PubMed
Systematic review: all-inside and inside-out repair of bucket-handle tears both improved scores, with similar failure ranges. - Fillingham YA, Riboh JC, Erickson BJ, et al. Inside-Out Versus All-Inside Repair of Isolated Meniscal Tears: An Updated Systematic Review. Am J Sports Med. 2017;45(1):234-242. PubMed
Systematic review: no differences in failure, function or complications between all-inside and inside-out repair. - Grant JA, Wilde J, Miller BS, et al. Comparison of inside-out and all-inside techniques for the repair of isolated meniscal tears: a systematic review. Am J Sports Med. 2012;40(2):459-68. PubMed
Systematic review: no difference in clinical failure between inside-out and all-inside repair; more nerve symptoms with inside-out. - Jackson GR, Warrier AA, Wessels M, et al. A Systematic Review of Adverse Events and Complications After Isolated Posterior Medial Meniscus Root Repairs. Am J Sports Med. 2024;52(4):1109-1115. PubMed
Systematic review: repairing medial root tears is important to prevent accelerated arthritis in knees without significant pre-existing arthritis. - Chang PS, Radtke L, Ward P, et al. Midterm Outcomes of Posterior Medial Meniscus Root Tear Repair: A Systematic Review. Am J Sports Med. 2022;50(2):545-553. PubMed
Systematic review: posterior medial root repair improves function and may slow but not prevent arthritis at mid-term. - Jiang EX, Abouljoud MM, Everhart JS, et al. Clinical factors associated with successful meniscal root repairs: A systematic review. Knee. 2019;26(2):285-291. PubMed
Systematic review: high-grade cartilage damage and varus alignment over 5 degrees predict poorer outcomes after root repair. - Chung KS, Ha JK, Ra HJ, et al. A meta-analysis of clinical and radiographic outcomes of posterior horn medial meniscus root repairs. Knee Surg Sports Traumatol Arthrosc. 2016;24(5):1455-68. PubMed
Meta-analysis: medial root repair improved clinical scores, though meniscal extrusion was not reduced. - Bumberger A, Koller U, Hofbauer M, et al. Ramp lesions are frequently missed in ACL-deficient knees and should be repaired in case of instability. Knee Surg Sports Traumatol Arthrosc. 2020;28(3):840-854. PubMed
Systematic review: ramp lesions are often missed during ACL surgery without a posteromedial view; unstable ramp lesions should be repaired. - Koo B, Lee SH, Yun SJ, et al. Diagnostic Performance of Magnetic Resonance Imaging for Detecting Meniscal Ramp Lesions in Patients With Anterior Cruciate Ligament Tears: A Systematic Review and Meta-analysis. Am J Sports Med. 2020;48(8):2051-2059. PubMed
Meta-analysis: MRI has moderate sensitivity for ramp lesions, so arthroscopic assessment is recommended. - O’Donnell K, Freedman KB, Tjoumakaris FP. Rehabilitation Protocols After Isolated Meniscal Repair: A Systematic Review. Am J Sports Med. 2017;45(7):1687-1697. PubMed
Systematic review: early motion and immediate weight-bearing did not harm success after isolated meniscus repair. - VanderHave KL, Perkins C, Le M. Weightbearing Versus Nonweightbearing After Meniscus Repair. Sports Health. 2015;7(5):399-402. PubMed
Systematic review: restricted and accelerated weight-bearing protocols gave similarly good results. - Kaminski R, Kulinski K, Kozar-Kaminska K, et al. A Prospective, Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Study Evaluating Meniscal Healing, Clinical Outcomes, and Safety in Patients Undergoing Meniscal Repair of Unstable, Complete Vertical Meniscal Tears (Bucket Handle) Augmented with Platelet-Rich Plasma. Biomed Res Int. 2018;2018:9315815. PubMed
Randomized trial: PRP augmentation improved meniscus healing and function after repair. - Utrilla GS, Degano IR, D’Ambrosi R. Efficacy of platelet-rich plasma in meniscal repair surgery: a systematic review of randomized controlled trials. J Orthop Traumatol. 2024;25(1):63. PubMed
Meta-analysis: more studies are needed to confirm the effectiveness of PRP in meniscus repair. - Keller RE, O’Donnell EA, Medina GIS, et al. Biological augmentation of meniscal repair: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2022;30(6):1915-1926. PubMed
Systematic review: biologic augmentation improved scores, but benefit over standard repair is uncertain.
Medically reviewed by Andrew P. Dold, MD, FAOA, FAAOS, FACS, FRCSC. Last reviewed October 2026. This page is general information, not medical advice. Individual results vary.
