Answer: Dear Sian,

Arthroscopic surgery is usally perform on meniscus injuries to repair them. Depending on the type of injury, a partial meniscectomy can be performed to remove only the torn segment of the meniscus. This works very well over the short and long term if the meniscus tear is relatively small but for large meniscus tears, a sufficient portion of the meniscus is removed such that problems can again creep up down the road.

The success of a meniscus repair depends on two factors. First, if the meniscus repair is attempted on a tear in the central portion of cartilage (where the blood supply is poor), it is likely to fail. Second, patients must be compliant with the post-operative rehabilitation after a meniscus repair.

If the meniscus repair fails (i.e. the repaired cartilage falls apart), which happens between 20 to 40% of the time, a second surgery may be necessary to remove the re-torn meniscus.

Rehabilitation following a meniscus repair is essential for a sucessful healing. The type of rehabilitation needed depends on several factors, and you should always check with your doctor prior to initiating or changing your post-operative rehab in any way.

A common example of rehab for a meniscus surgery is as follows:

- Upon awakening in the recovery room, patients are placed in a knee brace. The brace used may either be a knee immobilizer or a hinged knee brace. A knee immobilizer holds the knee fully extended, while a hinged knee brace can allow for controlled motion of the knee. Patients are given crutches, and instructed to walk with the crutches.

- The days after the surgery, patients can remove the knee brace or immobilizer while not walking, and bend the knee up to about 60 degrees. Patients should continue to use a brace whenever walking, and only place weight on the leg if the knee is held fully straight by the brace.

- After a month or so, more motion is allowed. Patients can walk with the knee in the brace, but no longer locked in extension. Strenuous sanctities are still restricted as the meniscus continues to heal.

- By 3 to 4 months, most surgeons will allow return to full activities and no longer protect the knee. Patients must slowly return to sports and competition, but they no longer have restrictions on motion and do not require the use of a brace.