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Our 12-year-old daughter is highly involved in sports. This summer she tore the meniscus of her right knee and had to have surgery to repair it. What's the prognosis for an injury like this? Should she continue to play sports? Will it plague her years from now if she does jump right back in?
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Many studies in adults have proven now the importance of the meniscus (cartilage)in the knee. It used to be common to have a torn meniscus just removed surgically. But years of investigation have shown that the end result of that treatment approach is early knee joint arthritis. So now, the damaged meniscus (menisci - plural) is carefully repaired whenever possible.
Your question is a good one -- what about young athletes with the same type of (meniscal) injury? What kind of results do they get with arthroscopic meniscal repair? Several studies have been done in this area. A recent one from the University of Michigan in Ann Arbor helps answer your question.
They followed 49 cases of knee arthroscopic surgery used to repair knees with either an isolated meniscal tear or a combined meniscal and anterior cruciate ligament (ACL) tear.
They measured the results using level of knee pain, knee range-of-motion, and physical activity. The surgeons noted any physical limitations. Scores from a specific survey (Tegner and International Knee Documentation Committee or IKDC) designed to measure function were also included.
The authors also paid attention to results based on patient age at the time of injury and time between injury and surgery. MRIs were used to determine type of injury (isolated meniscus, meniscus plus ACL tear, type and extent of meniscus injury). X-rays showed if the physes (growth plates at the ends of bones) were still open or not as this could be an important factor in the outcomes of treatment.
With the exception of two athletes who reinjured their knees, healing was 100% after two years. Even tears in menisci that wouldn't normally heal in an adult were restored. Good results were obtained even for cartilage located in areas of little blood supply. The ability to heal in this age group can't be underestimated.
The status of growth plates (open versus closed) did not seem to make a difference in results. The surgeons performing this study did think that the arthroscopic technique they used (called inside-out) was a significant factor in the healing response so that's something else to consider.
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