Os menisci They are essential structures for the proper functioning of the knee. They act as shock absorbers, help distribute loads, improve stability and protect cartilage. Therefore, when an injury occurs, the decision about treatment needs to consider some variables, not just the pain at the moment, but also thinking about the future of the joint.
In the past, it was common to remove the injured part of the meniscus with relative ease. The logic was simple: if the tissue was torn and caused pain, the fragment was removed. Over time, however, it became clear that losing the meniscus increases the strain on the cartilage and can accelerate .
From “cutting” to “preserving”
Modern orthopedics has increasingly valued meniscal preservation. Not only reducing surgical indications but also prioritizing surgical repair with meniscus suture, whenever possible.
This change is especially important in young patients, athletes or people with recent illnesses. In these cases, preserving the meniscus can reduce the risk of future degeneration and better maintain knee function.
This does not mean that every injury can be sutured. The type, location, evolution time and quality of the tissue directly influence the choice.
Not every injury needs surgery
Another important advance was understanding that many degenerative meniscus injuries, common with aging and natural wear and tear of the knee, do not always benefit from surgery.
Recent studies show that, in several cases, conservative treatment – with physiotherapy, weight control and adjustment of activities – can be sufficient in more than half of patients and offer results similar to those of surgery, especially when there is no locking of the knee.
The pain, in these cases, often does not come only from the meniscus, but from a set of factors, such as overload, inflammation, muscle weakness and the beginning of osteoarthritis.
Therefore, operating an MRI is a more common mistake and can be avoided with a good conversation and examining the patient.
The long-term impact
Removing part of the meniscus can alleviate symptoms in appropriate situations, but it also reduces the knee’s ability to absorb impact. With less meniscus, the cartilage receives more load, which increases the risk of osteoarthritis over the years.
Therefore, the decision must be individualized. In traumatic, unstable injuries or joint blockage, surgery may be necessary. In degenerative lesions, the initial approach must often be conservative.
The current objective is not simply to “resolve the injury”, but to preserve the joint for as long as possible.
Treating the meniscus requires a balance between relieving today’s pain and protecting tomorrow’s knee. And this is perhaps the main change in modern orthopedics: understanding that surgery is not always necessary and when it comes to the meniscus, less removal often means better health in the future.
*Text written by Camila Cohen Kaleka, orthopedist and member of Brazil Health (CRM/SP 127.292 | RQE 57.765)
