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WHAT IS A TORN MENISCUS?
Medial and lateral menisci, on the inner and outer side of the knee respectively, provide several vital mechanical functions in the knee joint. A torn meniscus, which occurs when pieces of menisci cartilage tear, is caused by an injury or is due to natural age-related degeneration of the meniscus.
In the US alone, over one million arthroscopic surgeries for meniscal tear are annually performed, since it is a common injury among young and middle-aged active individuals. Meniscal tears are common knee injuries because the meniscus is particularly vulnerable since it is deprived of auto-healing processes due to decreased blood flow.

WHEN IS SURGICAL INTERVENTION NECESSARY?
In cases of acute meniscal tear, where knee effusion (swelling of the joint) and severe symptoms are apparent (for instance the meniscus blocking the knee, or other simultaneous joint tears, for example anterior cruciate ligament tear), meniscal repair surgery is necessary.  Degenerative meniscal tear in elder patients, complex meniscal tear, or meniscal tear in the white-white zone (with no blood supply), are not treated according to the meniscus repair protocol, but with the removal of the torn meniscus.

HOW IS A PARTIAL MENISCECTOMY PERFORMED?
With partial meniscectomy, the peripheral rim of the meniscus that is responsible for biomechanical functions of the knee can be preserved and not removed (‘‘less is best’’)– the meniscus is a shock-absorbing cartilage between the femur and the tibia in the knee, distributing the body weight load placed on the knees and reducing friction during movement. Partial meniscectomy involves trimming the unstable flaps of the torn meniscus in order to establish a stable and healthy remnant meniscus and avoid future side effects.
A partial meniscectomy is performed arthroscopically: an arthroscope is inserted into the knee through a small incision and it is used to view the torn meniscus, whereas additional small incisions are made to allow the insertion of surgical instruments into the knee. Modern surgical procedures have abandoned total meniscectomy, since studies have proven that a total removal of the meniscus in the knee means a 1.500% higher relative risk of developing osteoarthritis in a 20-year period.
Postoperative rehabilitation programs are formulated in accordance to the patient’s torn meniscus (medial or lateral), age and level of physical activity and the preoperative functional status of the knee. Shortly after the surgery, physiotherapy sessions are recommended for attaining prior knee range of motion. In one week, patients can return to their daily activities and in 3 to 4 weeks to regular athletic activities.

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