A recurrent tear of the meniscus after prior surgery is a very challenging problem for both the athlete and the surgeon.
Though opinions may vary, regarding the preservation or removal of a torn meniscus that was previously repaired, it really comes down to what’s in the athlete’s best interest and to preserve as much meniscus as possible to prevent early degeneration of the knee.
Upon arthroscopic evaluation a surgeon can assess the meniscus for its viability and condition for repair. If the tissue is healthy, then several sutures can be placed within the meniscus to secure it back to the capsule. The knee is usually arthroscopically prepared by removing unhealthy meniscal tissue and by creating bleeding between the meniscus and the capsule; this allows for the best chance in healing.
If the meniscal tissue is fragmented, a vascular or unstable from prior injury or unsuccessful surgery, then removal is in the athlete’s best interest. Suture repair of non-viable tissue may warrant another procedure which can often cause physical and emotional delay in returning to their sport.
When considering removal it is imperative to only excise the unhealthy portion of the meniscus and to save as much meniscus as possible. This will allow for an earlier return to play and reduce the chance of arthritis.