Meniscal Repair Surgery Cost and Procedure Guide
1 to 3 hours
Day case or 1 to 2 nights
General or Epidural
Meniscal repair surgery is a type of orthopaedic surgery that repairs the meniscus in the knee. The menisci in the knee act as shock absorbers and can be torn or damaged, causing pain and some mobility issues. Meniscal repair surgery can greatly reduce these symptoms for patients that are a good candidate for surgery.
Why Have Meniscal Repair Surgery?
Preservation of healthy meniscal tissue is often one of the primary goals of meniscus repair surgery. This is particularly motivating for active patients who may be sidelined because of their knee pain caused by injury to their meniscus.
Generally, patients are a better fit for surgery if they are younger and very active with tears located on the outer edge of the meniscus. This is because the outer parts of the meniscus have a much better blood supply than the inner portion.
A stronger blood supply means there is a much higher likelihood the tear will heal on its own after surgery with the aid of dissolvable sutures to keep it in the correct place.
Patients may be recommended for meniscus surgery if:
- The knee becomes misaligned or feels unstable
- The knee locks up when they move
- You have strong muscles in the legs or are able to build their strength before surgery
- You are a very active person or activity is important for you
- You have a physical or active job and immobility would negatively affect your income
- The meniscus injury has not healed or responded to non-surgical treatments
- You are able to adhere to a strict physiotherapy regimen
- You have healthy meniscus tissue with a strong blood supply
How Much Does Meniscal Repair Surgery Cost?
In the UK, the price of meniscal repair with a private care provider begins around £4000. The price is based on a number of factors including pre-existing health conditions, and the location of the hospital.
After the meniscal repair consultation, patients will be given a bespoke price for their procedure. The personalised meniscal repair surgery price will include:
- All fees related to your hospital stay
- Accommodation (if needed)
- Nursing care
- Surgical theatre fees
- Imaging costs
- 7 days worth of any medications prescribed by your surgeon
- A standard mobility aid like crutches or a cane
- 10 post-operative physiotherapy sessions
- 1 post-operative X-ray
- Post-operative appointments with your surgeon
How is Meniscal Repair Surgery Performed?
While more traditional and invasive techniques are sometimes used to perform meniscus repair, arthroscopic methods are very popular currently.
Arthroscopic surgery, also called keyhole surgery, is far less invasive and associated with shorter healing times compared to more invasive methods. This article focuses only on the procedure of arthroscopic meniscus repair surgery.
Generally, arthroscopic meniscal repair takes anywhere from 30 minutes to one hour to complete. The length of the surgery varies from patient to patient because there are many different ways to correct or address a meniscus injury depending on where the injury is located.
Arthroscopy is a very versatile surgical technique that can address and/or diagnose many knee injuries or joint diseases so the length of the operation varies from patient to patient. The surgeon will walk through the exact steps they will take during the meniscal repair before the day of surgery (likely during a preoperative assessment).
Types of Meniscal Repair Incisions
Arthroscopy is a low-invasive surgery technique that requires just 3 small incisions on and surrounding the knee. Below is a photo of a patient’s knee shortly after arthroscopy surgery before the stitches were removed.
Depending on the exact techniques THE surgeon will use, the placement of the incisions can differ from the placement of the incisions in this photo.
Surgical Techniques for Meniscal Repair
After the incisions are made on the knee, surgical instruments and a camera with light are inserted into the knee as seen in the diagram below.
The joint is filled with sterile water via the instrument labelled cannula in the diagram. Filling the joint with water allows the camera to get a better view of the joint. The water also allows the surgical tools more room to move.
The surgeon then accesses the meniscus and joint via a screen showing what the camera is capturing inside the knee. After seeing the meniscus damage, there are a number of ways the surgeon can proceed.
Depending on their diagnosis, the surgeon can:
- Reshape the existing meniscus and smooth any tears to make movement easier
- Remove damaged parts of the meniscus to make movement easier
- Repair tears in the outer portion of the meniscus with dissolvable sutures to aid in healing
- Completely remove the meniscus, also called a meniscectomy
Once the surgeon is happy with their work, they remove the water and any debris from the knee with the cannula. When all the instruments are removed from the knee, the incisions are closed and the operation is complete.
After Meniscal Repair Surgery
Most patients are able to go home the same day as their meniscal repair procedure providing the surgeon is happy with their recovery and deem it safe to do so. As meniscal repair is often used to diagnose knee injury or disease, the surgeon will share results and further treatment options during a postoperative appointment.
Physiotherapy may also be prescribed to some patients after arthroscopic meniscus repair surgery. It is vital patients follow the advice and exercise or stretching plan given by the physiotherapist and surgeon. Everything they request is necessary to get the best results possible from the meniscal repair.
Potential Meniscal Repairs Risks & Complications
As with all surgical procedures, there are potential risks and complications that patients should be aware of. General risks associated with surgery include blood clots, complications related to anaesthesia, nausea, vomiting, and pain at the location of the operation.
The risks and complications associated with meniscal repair include:
- Swelling and bruising of the knee
- Excessive bleeding
- Damage to surrounding nerves, tendons or other structures surrounding the knee
It is important that patients understand the potential risks and complications before agreeing to any procedure. The surgeon will be happy to discuss these in full ahead of the operation or at any step along the way.
Meniscal Repair Preparation
How to Prepare for Meniscal Repair Surgery?
To prepare the knee for surgery and recovery, patients may be prescribed a course of physiotherapy that will help ensure the muscles in the leg are as strong as they can be. Leg strength and overall good health are a great way to give the best chance at the quickest and easiest recovery possible.
It is very important that patients do not take ibuprofen or medicines in the Nsaid category for at least 1 to 2 weeks before the operation because they are related to an increased risk of excessive bleeding during and after surgery. Patients may also need to avoid taking them for a period after surgery. The surgeon will give specific advice on this. Patients will likely be advised by their surgeon to stop smoking or using any nicotine products for at least 2 weeks before surgery and throughout recovery. This is because nicotine restricts blood flow which can delay healing and lead to less than perfect results.
Patients may also be advised not to shave the knee before surgery. Shaving causes microscopic damage to the skin which can harbour bacteria. This can put patients at a higher risk of infection.
Meniscal Repair Surgery Aftercare
What to Expect After Meniscal Repair Surgery?
Depending on the technique used during the meniscus repair surgery, patients will be advised not to bear weight on their knee for some time. This may last for several weeks. To make daily life easier, patients will be given a mobility aid like crutches to use during this period. They will also be given advice on how to gradually reduce the amount of time they use them as they recover.
The Knee Brace
Patients may be required to wear a brace on their knee for between 4 to 6 weeks after surgery, especially if other knee repairs were performed on the knee. Wearing the brace helps ensure the knee only flexes a certain amount and prevents injury. The surgeon or physiotherapist will set this brace and it is very important patients do not alter the settings yourself. Patients will be given guidance on how to perform day-to-day activities with the brace, for example, using stairs, the ideal sleeping posture, and how to bathe.
A physiotherapy programme will be individually designed for the patient and their needs after meniscus repair surgery. This will likely last between 2 and 6 months. This programme is vital to how the patient recovers and how well the knee functions in the long-term.
Patients will likely have gentle exercises to do at home before physiotherapy starts. These may include things like walking with a mobility aid. A typical physiotherapy programme begins a 1 or 2 weeks after surgery. Rehabilitation after a meniscectomy is often intensive to ensure the internal structures of the knee are not over-protected as they heal. Some programmes may also include hydrotherapy meaning exercises are performed in a pool to reduce strain on the joint.
Course contents will vary depending on your needs, but all physiotherapy programmes focus on:
- Building strength in the leg muscles
- Ensuring the knee’s range of movement as good as possible
- Keeping you and your knee active
Wound Care, Ice Packs, and Wound Dressings
Patients will have a wound dressing and a bandage on the knee when they wake up from surgery. It is important that patients keep these clean and do not get them wet or remove them themselves. Wounds are usually closed with stitches or staples. If staples or non-dissolvable stitches are used, patients will be given an appointment to see your surgeon 7 to 14 days later to have them removed. Sterilised wound tape is often used after this to support the skin as it heals completely. Patients may be advised to apply ice packs or special ice dressings to the knee after surgery to help reduce swelling. Take care not to keep ice in contact with the bare skin.
Showering and Bathing
Patients may be advised to use a special plastic cover on the leg when they shower to prevent the wounds on the knee from getting wet. Patients will likely be advised not to wash their wounds until they are healed. After this point, often gentle soap and clean water are all that is needed to clean them. Carefully pat (never rub) wounds dry with a clean towel after bathing.
Patients will likely experience some pain and discomfort after the meniscus repair surgery. This is normal after a surgical procedure and patients will be given advice on how to manage the pain. Patients may be given medication to take home or be advised on the best type of pain-relief to use as they recover.
The First 24 Hours After Surgery
It is normal to experience some pain both after surgery and during recovery, but this should ease over time. The surgeon will give you advice on what pain relievers are suitable as patients may need to avoid ibuprofen and similar drugs because of bleeding risk.
Surgery can be quite tiring emotionally and physically so it is normal to feel tired and out of sorts for some time after. Anaesthesia, especially general anaesthesia, may add to these feelings as it can take several days to ensure the effects are completely worn off.
Going Home After Surgery
Some patients are able to go home on the day of surgery, but others may need to stay a night in the hospital. As anaesthesia can affect judgement and coordination for up to 48 hours after surgery, patients must arrange for someone to take them home from the hospital and to stay with for at least the first 24 hours.
Children and Pets
After this, patients will likely need a friend or family member to help take care of any dependents such as children or pets for some time because mobility will be limited.
To help prevent blood clots patients will be advised on special exercises and be fitted for compression socks. Some people may need injections to help thin the blood. The patient or someone who is caring for them will be shown how to do this. Elevation and icing is a vital part of recovery and patients will be given an icing schedule to follow.
Time Off Work
When patients go back to work will depend largely on the kind of meniscus surgery they had and what kind of work the patient does. For a sedentary position that mainly involves sitting at a desk, patients may be able to return after 2 to 3 weeks. More strenuous jobs that involve standing or walking may require a 4 to 6-week break. Jobs involving manual work, physical labour, or a long journey to work may need to be avoided for anywhere between 3 and 6 months.
Sports and Exercise
The length of time it takes to return to sports or physical activity varies from person to person and is largely dependant on the type of meniscus surgery performed. A period of 3 to 6 months is expected for a typical patient. Elite athletes may need to take 8 to 12 months or longer to return to competitive training.