From the Research
Management of a lateral meniscus tear in a 28-year-old patient should prioritize meniscal preservation, with meniscal repair being the preferred treatment option over partial meniscectomy, as it has been shown to have better long-term outcomes 1. The initial approach typically involves conservative treatment for 6-8 weeks, including rest, ice, compression, and elevation (RICE protocol), as well as nonsteroidal anti-inflammatory drugs like ibuprofen (400-600mg three times daily) or naproxen (500mg twice daily) to manage pain and inflammation.
- Physical therapy focusing on quadriceps and hamstring strengthening exercises should be initiated, with 2-3 sessions weekly for 4-6 weeks.
- If conservative management fails to provide relief after this period, MRI imaging should be obtained to assess the tear pattern and location.
- Surgical intervention may be necessary depending on the tear type, with meniscal repair preferred over partial meniscectomy when possible to preserve long-term knee function, as supported by recent studies 2, 3.
- Arthroscopic repair is typically followed by a rehabilitation protocol including protected weight-bearing for 4-6 weeks and gradual return to activities over 3-4 months. The decision between conservative and surgical management depends on several factors including tear location (peripheral tears have better healing potential due to better blood supply), tear pattern (vertical longitudinal tears are more amenable to repair), and patient activity level, as highlighted in the 2022 guidelines by the Chinese Society of Sports Medicine 1.
- Preserving meniscal tissue whenever possible is crucial as the meniscus serves important functions in load distribution, joint stability, and protection of articular cartilage.
- Recent research has also shown that certain types of lateral meniscal tears that were previously considered irreparable can be repaired, further emphasizing the importance of meniscal preservation 4, 1.