An ACL tear and a meniscus tear often happen together, and the best practice is usually to treat both in one arthroscopic operation. Meniscus repairs heal better in a knee that has just been stabilised by ACL reconstruction, and the patient avoids a second operation and a second rehabilitation.
Why does the meniscus tear with the ACL?
The same twisting force that ruptures the ACL can trap and tear the meniscus. Later, every episode of the knee giving way puts the meniscus — especially the inner (medial) one — at risk again, which is why meniscus damage becomes more common the longer an unstable knee goes untreated.
How do you know you have both injuries?
- A pop, rapid swelling and later instability suggest the ACL.
- Pain on the joint line, catching or locking suggest the meniscus.
- An MRI confirms both, and the final assessment happens during arthroscopy.
How is the operation done?
- The knee is examined arthroscopically through small incisions.
- The meniscus tear is assessed and repaired with sutures whenever the tear pattern allows.
- The ACL is reconstructed with a tendon graft placed in anatomical bone tunnels.
- Rehabilitation is adjusted to protect the meniscus repair.
Repair or remove the meniscus?
| Meniscus repair (sutures) | Partial meniscectomy (trimming) | |
|---|---|---|
| Goal | Save the meniscus | Remove the torn part |
| Long-term knee protection | Better — the cushion is preserved | Less — higher load on cartilage |
| Rehabilitation | Slower, with protected bending at first | Faster |
| When chosen | Repairable tear with good blood supply | Tear that cannot be repaired |
For meniscus treatment on its own, see arthroscopic meniscus surgery.
Recovery and cost
Recovery follows the ACL programme with extra protection for the meniscus repair in the first weeks — see ACL surgery recovery and exercises after ACL surgery. In Egypt, ACL reconstruction with meniscus repair usually costs 75,000–95,000 EGP, depending on the tear and fixation devices; see ACL surgery cost in Egypt.
Video: arthroscopic meniscus repair
Frequently asked questions about ACL and meniscus surgery
Can the ACL and meniscus be fixed in the same operation?
Yes, and in most cases this is the best option: meniscus repairs heal better in a newly stabilised knee and you avoid two operations.
Can I treat only the meniscus and leave the ACL?
In an unstable knee, a meniscus repair without ACL reconstruction has a higher failure rate, because the knee keeps shifting.
What is the difference between the meniscus and the ACL?
The ACL is a ligament that stabilises the knee; the meniscus is a cartilage cushion that absorbs shock. They are often injured together.
When can I walk after ACL and meniscus surgery?
Usually straight away with crutches; weight-bearing and bending may be limited for a few weeks to protect the meniscus repair.
How much does ACL and meniscus surgery cost in Egypt?
Usually 75,000–95,000 EGP, confirmed after examination and MRI.
To have your knee assessed, book a consultation, call +20 155 240 4488 or message us on WhatsApp at +20 155 554 7181.
Medically reviewed by Prof. Dr. Ibrahim Shaarawi, Professor of Orthopaedic Surgery. This article is general medical education and does not replace an examination or the plan your surgeon sets for you. See our medical disclaimer.
Related ACL guides
This guide links our ACL reconstruction and arthroscopic meniscus surgery pages. Read also:
- ACL reconstruction surgery
- ACL treatment without surgery
- ACL surgery risks and complications
- Lateral extra-articular tenodesis (LET)
- Arthroscopic meniscus surgery
References
- Cannon WD Jr, Vittori JM. The incidence of healing in arthroscopic meniscal repairs in anterior cruciate ligament-reconstructed knees versus stable knees. Am J Sports Med. 1992;20(2):176-81.
- Kopf S, et al. Management of traumatic meniscus tears: the 2019 ESSKA meniscus consensus. Knee Surg Sports Traumatol Arthrosc. 2020;28(4):1177-1194.
- Getgood AMJ, et al. Lateral extra-articular tenodesis reduces failure of hamstring tendon autograft ACL reconstruction: 2-year outcomes from the STABILITY study randomized clinical trial. Am J Sports Med. 2020;48(2):285-297.
- American Academy of Orthopaedic Surgeons (OrthoInfo). Anterior Cruciate Ligament (ACL) Injuries.