SPECIAL FOCUS
Meniscal Sutures
Francesco Benazzo, MD and Giacomo Zanon, MD
Abstract: Even though partial arthroscopic meniscectomy is one of
the safest and most effective orthopedic procedures, the possibility of
suturing some meniscal tears is particularly important especially in the
case of young and active patients. One of the most important aspects of
the diagnosis and treatment of meniscal tears is the distinction between
stable and unstable meniscal tissue. The decision to suture a meniscal
tear essentially depends on the location of the lesion, the association of
an anterior cruciate ligament lesion, the tear age, and patient age. The
technically simplest and most successful sutures regard longitudinal
tears in the peripheral zone of the meniscus (red-red zone). The
majority of authors recommend this approach especially when in
conjunction with anterior cruciate ligament reconstruction. There are
different techniques to suture a meniscal tears: all-inside, outside-in,
inside-out. In this paper all the possibilities for meniscal sutures are
considered to evaluate indications, advantages, and disadvantages of
every single technique.
Key Words: meniscus, suture technique, tear classification
(Tech Knee Surg 2010;9: 159--164)
HISTORICAL PERSPECTIVE
Meniscal tears mainly cause mechanical symptomatology
and surgery on the meniscus to restore joint function, alleviate
pain and also, where possible, reinstate functional anatomy of
the knee to protect it from arthritic degeneration.
To treat meniscal tears appropriately, it is essential to
understand the anatomy and biomechanics of the meniscus and
the pathologic anatomy of the tear.
The inevitable arthritic degeneration associated with a
total meniscectomy has led to the study of new ways to treat
tears which aim to preserve the healthy meniscal tissue and, in
selected cases, restore it. Even though partial arthroscopic
meniscectomy is one of the safest and most effective of
orthopedic procedures, the possibility of suturing some
meniscal tears is particularly important especially in the case
of young and active patients.
To correctly frame meniscal tears, it is vital to precisely
define certain facts regarding the functional anatomy of the
meniscal tissue.
ANATOMY OF THE MENISCI
General Anatomy
The menisci cover the peripheral two-thirds of the tibial
articular surface, with the lateral meniscus occupying a small
part of the external tibial plateau.
From the Clinica Ortopedica e Traumatological dellUniversita, Fonda-
zione Policlinico San Matteo, University of Pavia, Pavia, Italy.
Address correspondence and reprint requests to Giacomo Zanon, MD, Via
Valtanturla 127020 Torre dIsola, Pavia, Italy. E-mail:
zanon.g@libero.it.
Copyright r 2010 by Lippincott Williams & Wilkins
Techniques in Knee Surgery  Volume 9, Number 3, September 2010
The lateral meniscus is more or less circular whereas the
medial meniscus is semilunar (C-shaped). Longitudinally,
menisci are thicker in the attachment zone at the capsule,
tapering as they extend into the joint where they end in a free
edge. The medial meniscus is thicker posteriorly. The superior
surfaces of the 2 menisci are concave to align with the femoral
condyles whereas the inferior surfaces are flat to conform to
the tibial plateau.1
The menisci have capsular attachments which hold them
in position.
The medial meniscus is firmly attached to the posterior
portion of the tibia whereas its anterior attachment can prove
less stable. Because the meniscus is attached to the tibia, the
coronary ligament, is only a few millimeters from the joint
surface, a synovial recess on the surface beneath the meniscus is
created.
The lateral meniscus attachment is lateral and posterior to
the anterior cruciate ligament (ACL); the Humphry and
Wrisberg meniscal ligaments run from the lateral meniscus
to the femur in proximity to the posterior cruciate ligament.
Whereas the medial meniscus has a continuous peripheral
attachment, the lateral meniscus is not attached in the region of
popliteal hiatus or to the collateral ligament.
Despite their attachments, the menisci display a certain
degree of mobility. Less capsular attachment renders the lateral
meniscus more mobile than the medial meniscus. On average,
medial meniscus shifting is around 5 mm whereas lateral
meniscus mobility can exceed 10 mm; the anterior horn of the
menisci is more mobile than posterior.2 This mobility permits
greater congruence to the tibio-femoral articulation during
movement offering, furthermore, greater stability. The relative
greater mobility of the lateral meniscus can reduce the risk of
breakage.3
Microscopic Anatomy
The microscopic anatomy of the menisci explains both
their resistance to tears and certain characteristics of the tears
themselves.
The menisci are composed of collagen fibrils (mainly
type 1), proteoglycans, glycoproteins, and elastin. Most of the
meniscal structure is conditioned by a primary structure
composed of longitudinally positioned collagen fibrils interposed
with others of radial, vertical, and oblique orientation. This
collagen fiber structure is made up of extracellular proteins and
water.4
The longitudinal collagen fibers are predominant in the
meniscal periphery and are stabilized by radial, vertical, and
oblique fibers. Acting as casing, the radial fibers resist longi-
tudinal forces. This radial fiber structure covers the longitudinal
fibers and prevails in the posterior half of the meniscus, that which
is subject to the most load. Owing to the higher concentration
of peripheral longitudinal fibers, longitudinal tears occur mainly in
the peripheral portion of the meniscus. There are less longitudinal
fibers in the free margin which leave space for certain zones of
tissue with radial oriented fibers.4
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Benazzo and Zanon
The central part of the meniscus is characterized by radial
fibers defined as penetrating.5 It has been shown that there is
a predisposition for radial tears in the external meniscus due
to the elevated concentration of radial fibers. Further-
more, due to the differing degrees of mobility of the upper
and lower portions, horizontal tears are equally frequent.
Although the meniscus is principally made up of the previously
mentioned collagen fiber structure, the superficial layers in
direct contact with the joint surfaces are composed of a thin
layer of randomly arranged type II collagen fibrils which are
practically friction-free and resistant to cutting forces.
Vascularization/Innervation
Most of the meniscal structures are vascularized during
embryonic development. Meniscal vascularization during
adulthood is purely peripheral.6 Perforating vessels account
for 10% to 30% of the medial meniscus and 10% to 25% of the
external meniscus. The two-thirds of meniscal tissue which jut
out toward the free margin are unvascularized. The character-
istics of meniscal vascularization influence the prognosis and
possibility of healing.
The simplest way to classify meniscal tears according to
their vascularization is by applying the Zone criteria proposed
by Arnoczky and Warren7:
1. The red/red peripheral zone, running for 3 mm, is highly
vascularized (Fig. 1),
2. The red/white central zone, from 3 to 5 mm, is of variable
vascularization,
3. The white/white zone, which extends from 5 mm to the free
margin is basically avascular.
Tears in highly vascularized areas have a better chance of
healing. The nutrient vessels which carry the arterial exudates
to the avascular area of the meniscus and the diffusion of
nutrients from the synovial liquid are not sufficient for repair.8
Meniscal innervation is limited to the periphery and does
not involve the free margin. This explains why the more
peripheral tears are symptomatic whereas those more central
can be asymptomatic. As central tears in the free margin can
provoke traction in the more peripheral portion of the
meniscus, symptomology can also result when the tear does
not extend as far as the periphery itself. Meniscal innervation
could play a proprioceptive role even though such a hypothesis
has not been demonstrated as it has for the ligaments of the
knee.9
BIOMECHANICS OF THE MENISCUS
The mechanical functions of the meniscus are:
1. Transmission of load to the underlying cartilaginous layer with
dispersion of contact forces.
2. Shock absorption.
3. Joint stability.
4. Joint lubrication.
Load Transmission
The meniscus converts axial loads into tensile forces.10
Although axial load is perpendicular to the meniscus, the
crescent shape of the meniscus determines dispersion of forces
to its peripheral extrusion. This is counterbalanced by the
longitudinal collagen fibers which are stabilized by radial
nodular fasciae. It is this structure which allows the meniscus
to absorb the radial forces.
The menisci transmit load both in flexion and extension,
transmission being greater in the former: when the leg is
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Techniques in Knee Surgery  Volume 9, Number 3, September 2010
outstretched, 50% of the compressive load is transmitted
through the meniscus; when the knee is flexed at 90 degrees, a
good 85% of the load is transmitted through the meniscus,
acting therefore as a shock absorber of compressive loads.11
Most of the load is discharged onto the posterior horn of the
meniscus, which is far more rigid under tension than the
anterior horn.
Shock Absorption
The meniscus acts as a shock absorber.12
After compression, the meniscus can easily change form
due to the discharge of interstitial fluid. When a compressive
force is exerted, this biomechanical characteristic of the
meniscus permits the dispersion of a great deal of energy hence
protecting the joint cartilage.13
Joint Stability
Stability is mainly down to the medial meniscus which
restrains anterior shifting of the tibia on the femur. Since the
lateral meniscus does not have the peripheral attachments of
the medial meniscus, it subsequently does not affect joint
stability in the same way. However, this stabilizing function is
secondary and without the ACL, the stabilizing effect of the
medial meniscus is easily compromised.14
Due to the elasticity and surface friction, the meniscus is
able to return to its original form. Furthermore, the meniscal
surfaces are roughly 5 times more rigid than those of joint
cartilage; the posterior and circumferential zones, which are 20
times more rigid than the cartilage, enable the meniscus to
withstand impact.15
TEAR CLASSIFICATION
Arthroscopy has allowed us to classify meniscal tears and
diagnose the types of tears in detail.
There are 2 classification methods:
1. That based on the position in reference to blood flow (vascular
zones).7
2. That based on the orientation and appearance of the type of
lesion.16
Arnoczky has proposed 3 meniscal vascularization
zones7:
1. red/red,
2. red/white,
3. white/white.
The classification is useful for determining if a tear is
reparable or if resection would be a better option. In the red/red
vascularized peripheral zone, healing is more likely; in the red/
white zone healing potential is varied whereas in the white/
white zone it is decidedly less probable. Besides ascertaining
if a meniscal tear can be repaired or not, this classification
scheme is also useful for defining the tears position with
respect to the meniscus dimensions.
The most commonly used classification scheme is based
on different types of tear which are generally divided as
follows16:
1. vertical,
2. horizontal,
3. complex.
Vertical tears are then divided into longitudinal and
transversal/radial whereas those horizontal can be partial, with
or without flap. Although complex tears can occur in healthy
tissue, they are usually associated with degeneration consonant
with aging.
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Techniques in Knee Surgery  Volume 9, Number 3, September 2010
Vertical Tears
Vertical tears of the meniscus can be either longitudinal or
transversal (radial). On occasion there can be a combination of
tears, hence referred to as complex. Generally, the transversal
component of a combined tear represents an extension of a
more important longitudinal component.
Longitudinal Tears
Longitudinal tears generally occur in the peripheral area of
the meniscus due to the higher concentration of circumferential
collagen fibers adjacent to the peripheral attachment. These
tears occur at the posterior horn (Fig. 1) of the meniscus and run
longitudinally along the collagen fiber plane.
Longitudinal tears usually occur in young and active
patients. This type of tear is often correlated with lesions of the
ACL as the meniscus is trapped between the femoral
condyle and the tibial plateau.
When a longitudinal tear extends anterior from posterior,
most of the lesioned free margin can subluxate between the
femoral condyle and the tibial plateau or even in the throat:
such a tear is referred to as bucket handle and can cause
articular blockage.
Transversal (Radial) Tears
Transversal tears like longitudinal tears occur on a
vertical plane but their orientation is radial. They can be
primary or secondary, representing the extension of other types
of tear becoming, as such, complex. Although they can occur
in different parts of the meniscus, radial tears usually arise at
specific points, the most common site being the free margin of
the lateral meniscus.
If the tear remains contained, it tends to result asympto-
matic even though, more often than not, the peripheral nerve
endings are put under tension giving rise to pain.
Another type of radial tear of the lateral meniscus is
typical of the posterior area of the lateral meniscus and is
known as root tear. This tear is frequently associated with
ACL deficiency and results from the avulsion of external
meniscus from its posterior insertion or root.
Horizontal Tear
The horizontal tear is the most common.
FIGURE 1. Lesion in the red zone of the posterior horn of the
medial meniscus. This sight is suitable for a suture.
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Special Focus: Meniscal Sutures
Simple tears are horizontal in the superior and inferior
portions of the meniscal tissue. Partial tears originate like
simple tears but exhibit superior and inferior extension,
creating a preternatural mobility zone called flap. Although
it is possible for the flap to originate from a vertical tear, it is
more common for it to develop as a primary tear.
The most common position for a flap is the posterior part
of the medial meniscus. Anomalous mobility results between
the superior and inferior portions of the meniscal tissue
creating cutting forces which transform a horizontal tear into a
flap. Arthroscopic evaluation and palpation of the meniscal
tissue is fundamental as the fragments are often displaced,
especially in the part underlying the meniscus.
Complex Degenerative Tears
Complex tears originate from a combination of different
primary tears. Complex tears result from degenerative patholo-
gies but often simple chronic small tears can become complex
and can be instigated by a minor trauma.
Stable and Unstable Meniscal Tissue
One of the most important aspects of the diagnosis and
treatment of meniscal tears is the distinction between stable
and unstable meniscal tissue.
Some tears are typically stable and require neither
excision nor even suture.
Longitudinal peripheral tears the whole thickness of
which is less than 5 mm or tears with a partial thickness less
than 10 mm are to be considered stable (Fig. 2).17 These are
general guidelines which must, however, be adapted to the
case in question. Each meniscal tear must be carefully
examined arthroscopically before deciding upon which
strategy to adopt.
A further extremely important guideline is the potential
mobility of the meniscal tissue: each tear cannot give rise to
tissular mobility exceeding 3 mm. If the lesioned meniscus
tissue is or could become unstable, carrying out a partial
meniscectomy to reinstate a stable configuration is indicated.
Furthermore, although the meniscus has a physiological
FIGURE 2. Unstable peripheral lesion of the posterior horn of the
medial meniscus (more than 10 mm) in a young patient is the
correct indication for a meniscal suture.
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Benazzo and Zanon
undulation, it is however necessary to thoroughly inspect the
tissue to ensure there are no hidden deep partial tears.
SURGICAL TECHNIQUES
Introduction
The function of meniscus biomechanics has been clearly
established.
It is a well known fact that articular degeneration resulting
from medial meniscectomy is correlated with the amount of
meniscal tissue exported. If the tear extends to the vascular
zone of the meniscus, cicatrization can result.
Indications for Meniscal Suture
Faced with a meniscal tear, it is necessary to ascertain if it
is amenable to repair or not. There is often the tendency to
resort to the simplest and quickest technique, the partial
meniscectomy, instead of seeking to repair the meniscus. The
latter option involves more surgery and rehabilitation but,
without doubt, can protect the joint long term, especially in
young patients.
The decision to suture a meniscal tear essentially depends
on:
 location
 the association of an ACL lesion
 tear age
 can be abraded using a small rasp or a motorized instrument. It
patient age
 any associated injuries
The technically simplest and most successful sutures
regard longitudinal tears in the peripheral zone of the meniscus
(red-red zone). The majority of authors recommend this
approach especially when in conjunction with ACL recon-
struction. Tears <1 cm in length (Fig. 2) and/or incomplete
with minimum mobility on palpation (<3 mm) can be treated
conservatively.18 It is equally well known that stable lateral
meniscus tears, during ACL reconstruction, if not treated,
cause no damage even in the long run.
Results regarding sutures in the white-red zone and the
avascular zone (white-white) are more complicated and open
to debate.
Flap tears are not susceptible to repair. It is sometimes
possible to treat those in the posterior portion of the lateral
meniscus where vascularity is high and repair can be
successful. In this zone, most tears, whether vertical or
horizontal, have an extremely high repair rate. Repair is also
favored by the low mobility of the meniscal tissue in this site.18
In contrast, successful repair of radial tears in the medial
third of the lateral meniscus is generally unlikely.
Suture of meniscal tears has a higher success rate if
carried out within 6 weeks of trauma. Beyond 6 weeks,
cicatricial processes in the red or white-red zone cause scarring
which impedes the healing process of the suture itself. If the
suture is carried out after this point, needling or abrading the
tear margin is necessary to instigate bleeding thus benefitting
from both the biological potential of bleeding and the
mechanical stability provided by the suture.19
Another very important prognostic factor is patient age.
Meniscal suture is obligatory under 16 years. Saving the
meniscal tissue of patients in this age group has a high success
rate. Even at this age, in cases of discoid meniscus, suture is
fiercely contraindicated whereas suture of a bucket-handle
tear gives controversial results.
In patients over 16 years it would seem that bucket-handle
tears cannot heal whereas tears in the red or white-red zone
have a very good chance.
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In patients under 30 years, peripheral tears of both the
medial and lateral meniscus in conjunction with ACL
reconstruction must be sutured.
Meniscal Repair Techniques
There are 3 arthroscopically assisted meniscal repair
techniques and 1 without arthroscopy:
 inside-out technique: Henning technique
 outside-in technique: Warren technique
 all-inside technique
 tissue regeneration technique (growth factors)
Inside-out Technique (Henning Method)
The most recent technique involves vertical sutures which
are easier to pass than the horizontal sutures used in the old
technique. Literature presents differing points of view regard-
ing the resistance of these 2 types of suture; some studies
demonstrate that a vertical suture is twice as resistant as a
horizontal suture,20 others report little difference between the
two.21
Literature categorically supports the choice of vertical
sutures. The fact being that a vertically oriented suture
involves more collagen fasciae in circumferential orientation
than a horizontal suture.
Preparation of the tear zone is very important. The zone
can also be advantageous to abrade the adjacent synovial tissue
to promote neovascularization, especially in the case of lesions
over 6 weeks old and/or inveterate.
Although using a fibrin clot can aid tear zone healing,
recent studies have used (platelet rich plasma) PRP derived
growth factors as a compliment to a stable knee isolated lesion
repair technique in cases when the incidence of satisfying
results is significantly lower than that of meniscal lesion repair
in conjunction with ACL reconstruction.
Inside-out Repairs: Zone-specific Repair
This technique uses zone-specific cannulas.22,23 The
curvature of the cannulas is of similar anatomy such that it
complies with the tibial plateau and condylar surfaces and
permits correct visibility and perforation of the meniscal
surface.
The patient lies in the supine position on the operating
table such that he/she can flex the knee. The leg is positioned
in flexion, abduction, and external rotation.
Meniscal repair is approached from the contralateral
portal, whereas the homolateral portal is used for joint
visualization.
This technique uses a small contraincision (medial for
medial suture, lateral for lateral suture) as needles cannot be
removed blindly due to potential neurovascular complica-
tions.
In the case of medial suture, incision should be posterior
and parallel to the medial collateral ligament. The space
between the medial collateral ligament posterior margin and
the medial twin is then to be individuated: this space represents
the correct exit point for the medial suture needles. The
arthroscope is positioned in the intercondyle opening in the
posteromedial section so that the light helps the surgeon to
identify the suitable incision site. With the knee flexed at
around 90 degrees, the hamstring insertion and the saphenous
nerve branch lie posterior to the incision.
However, when the tear to suture is in the external portion,
the incision is made along the posterior profile of the ileotibial
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Techniques in Knee Surgery  Volume 9, Number 3, September 2010
band, retracting the biceps, anterior to the gastrocnemius tendon
lateral head. Generally, the medial meniscus is repaired with the
knee flexed at around 5 to 15 degrees whereas for lateral meniscus
repair, knee flexion exceeds 45 degrees.
The next step is arthroscopic abrading of the tears
capsular margin to revive perfusion of the peripheral tissue.
The technique involves introducing the cannula (single or
double), positioning it in the free margin of the tear. Even
though it is more difficult to position, a double cannula is
easier. The needles and sutures/threads are introduced via the
cannula, 3 to 4 mm apart, starting from the most posterior point
of the tear. The needles are then retrieved via the accessory
portal and the 2 sutured wires create a U suture at capsule level.
Outside-in Technique (Warren Technique) according to the site of the tear to treat:
This is a relatively simple technique requiring no special
instruments, just an 18 spinal needle and a single-wire suture.24
This technique also calls for a contraincision but it is much
smaller than needed in inside-out cases.
Positioning the needle can be facilitated using arthro-
scopic illumination along the joint line which identifies the
meniscus position and helps to avoid nerves and superficial
vessels. There are 2 types of suture.
As the first needle passes through the meniscus and tear
zone, its correct path and that of the wire is ascertained
arthroscopically. A second needle then passes a wire with wire
snare and retrieved externally creating a mattress type right number of arrows will therefore keep the suture in place.
horizontal suture, preferably vertically oriented.
All-inside Repair Technique
The advantage of all-inside repair is that there is no
contraincision and therefore no risk of neurovascular damage
(Fig. 3). The procedure is also quicker. Besides the Morgan
technique which uses just a needle and suture hook, various
techniques using different devices are now available which
demonstrates the growing popularity of the all-inside technique.
Morgan Technique
This difficult technique is used only to repair posterior
horn tears less than 2.5 mm in length.25 Using an intramuscular
needle a posteromedial or posterolateral portal is made. A
FIGURE 3. Meniscal suture of the posterior horn of the medial
meniscus: the stability of the tissue is restored.
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Special Focus: Meniscal Sutures
special hook or pigs tail needle is introduced via the
portal usually at 45 degrees and enters the tear at its medial
one-third. Under constant ampliscopic guidance, the wire is
retrieved with forceps always via the posteromedial portal. A
knot is then tied completing a vertical suture. Sutures are
passed using this method until the number is sufficient to
ensure posterior horn tear stability.
Meniscal Screw Fixation Technique
This technique developed by Albrecht-Olsen uses biode-
gradable poly-lactic acid screws.26 It is quick, simple, easy to
reproduce and substantially complication free. It can take more
than a year for the screws to hydrolyze and be absorbed. They
are T-shaped with protruding tabs and come in 3 different sizes
1. 10 mm: anterior horn
2. 13 mm: body, occasionally the posterior horn
3. 16 mm: generally for the posterior horn
They are introduced using special cannulas and the
meniscal tear is transfixed in the suitable place by a guide wire
which solidarizes and controls tear mobility. The arrow is
introduced through the contralateral portal, crosses the meniscal
tissue free margin and penetrates the meniscus-capsule junction
and beds itself in the capsular margin. The T handle sits at the
free edge with the free end at the external edge: the tabs stop the
arrows from moving and so the suture is well stabilized. The
Suture With T-fix Anchor Technique
This technique uses anchoring nonabsorbable mono-wire
suture mounted on a 3-mm-wide bar.27 The bar is preloaded
into a needle, passed through the tear and positioned at the
menisco-capsular junction. The procedure is repeated to
position a second wire 7 to 8 mm from the first. The wires
attached to the 2 bars are retrieved and knotted externally. A
knot pusher helps to push the suture inwards and ensure it stays
in place. In the case of posterior horn tears, the needle is
introduced through the homolateral portal which permits radial
oriented repair. For the tears extending to the medial third of
the meniscus, the needle is introduced through the contralateral
portal.
Suture With Fast-fix Technique
For reasons of simplicity and reliability, this device has
become one of the most commonly used.
This technique involves a needle loaded with 2 staples,
3 to 4 mm apart. Rotating the introductory needle cannula by
a few degrees, the staple is positioned and anchors itself
beyond the meniscal tear. The second staple is then positioned
and the tear is stabilized via the integrated running knot which
is then tightened using the knot pusher.
Tissue Regeneration Technique
This technique is not actually arthroscopic but involves
the use of PRP-derived growth factors.
Indications for use include:
 minor displacement of the meniscal body in the red-red zone
(<1 cm)
 small meniscal cysts of recent onset
 meniscectomy results (medial or lateral with painful
consequences)
The activated PRP is injected into the tear site guided by
computed tomography. The introduced needle can be used to
abrade the tear zone. Abstention from load and immobilization
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Benazzo and Zanon
for 48 to 72 hours following treatment is stipulated. The newly
formed tissue is left to mature and isometric muscle
rehabilitation is carried out, avoiding full extension, full
flexion and joint torsion for 2 weeks.
Meniscal Suture Results
Results published regarding meniscal repair have been
varied for different reasons.
Tear repair concomitant with ACL repair has given the
best results. Once the ACL has been reconstructed, the
posterior horn in the repair zone is subject to less stress as
the tibia is more anteriorly subluxated. In the case of isolated
repair of the meniscus, abundant hemarthrosis associated with
ACL reconstruction could be another important factor regard-
ing meniscal tissue repair. The incidence of unsuccessful cases
is low, around 10%.
Method presents an evaluation drawback. From a clinical
point of view, case histories in literature report satisfying
results for 87% to 98% of cases but this does not mean that the
tear is repaired.28 Arthroscopic studies published in second
look report a success rate of 75%.
Although not feasible for all patients, arthro-magnetic
resonance imaging is the most useful technique for evaluating
the extent of repair as it can identify the degree of tissue
cicatrization.29
Patient age and the age and location of tear under-
standably influence healing. Longitudinal lesions less than
6 weeks old and located in the red zone are the perfect
candidates for repair.
Postoperative Treatment
Meniscal suture approaches described to date differ in
technique, suture orientation and instruments used. Post-
operative treatment does not vary particularly from 1 technique
to another.30
Immediately after intervention, exercises for articulation
recovery are begun. Flexion is not to exceed 90 degrees for 2 to
3 weeks, especially in cases of posterior horn tear as excessive
flexion can stress the meniscus. In cases of isolated meniscal
suture, load is to be avoided for 4 to 6 weeks depending on the
location and suture endurance. When ACL reconstruction is
involved, rehabilitative approach is that specific for ligament
rehabilitation. Crouching movements must be avoided for
around 4 to 6 months.
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