Arthroscopic Meniscus Surgery in Egypt
Arthroscopic meniscus surgery — repair before removal
Treating meniscal tears arthroscopically through small portals, favouring repair of the meniscus over removing it wherever the tear allows, because extensive removal accelerates knee arthritis later.
When does a meniscal tear need arthroscopy?
Not every meniscal tear needs surgery; many small and degenerate tears improve with physiotherapy. Surgery is considered when there is:
- Locking of the knee, or inability to fully straighten it
- Clicking or a sensation of something moving inside the joint
- Localised pain on one side of the knee, worse with twisting and squatting
- Recurrent swelling after activity
- A tear pattern prone to locking, such as a bucket-handle tear
- Failure of an adequate course of conservative treatment
Try conservative treatment first: in degenerate tears in patients over forty, studies have shown non-surgical treatment gives results comparable to arthroscopy in many cases. Arthroscopy is of most benefit in mechanical tears that lock the knee.
Types of meniscal intervention
The intervention is determined by the shape and site of the tear and its blood supply — the outer part of the meniscus heals, while the inner part usually does not.
Meniscal repair (suture)
The preferred option wherever possible, especially peripheral tears with good blood supply in younger patients, because it preserves the meniscus as a shock absorber.
Meniscus tear care →Limited partial meniscectomy
Removing only the torn fragment while preserving as much healthy meniscus as possible, when the tear lies in a zone that will not heal.
Bucket-handle tear
A large tear that displaces into the joint and locks the knee — close to an urgent problem, since early repair improves the chance of successful suturing.
Tear with ACL rupture
Repairing the meniscus and reconstructing the ligament in one session, the commonest pattern in sports injuries.
ACL reconstruction →Degenerate tear
Common after forty and associated with early arthritis; usually managed with physiotherapy and injections rather than arthroscopy.
Non-surgical treatment →Discoid meniscus
A congenital variation in meniscal shape that makes it more prone to tearing, usually presenting in children and adolescents.
Key numbers and treatment options
- In an analysis of 51 studies (3,931 menisci), meniscal repair failed in 14.8% at 2–5 years, falling to 8.5% when done with ACL reconstruction; lateral repairs failed in 6.1% versus 10.8% medial (Schweizer et al., AJSM 2024).
- Over the long term, 20.7% needed reoperation after isolated repair versus 3.9% after partial meniscectomy, yet repair was linked to better function and less arthritis long term (Paxton et al., 2011).
- In middle-aged patients with degenerative tears, exercise therapy matched arthroscopic partial meniscectomy at two years, and only 19% of the exercise group crossed over to surgery (Kise et al., BMJ 2016).
- In the METEOR trial of meniscal tears with arthritis, improvement at 6 months did not differ between surgery and physiotherapy, while 30% of the physiotherapy group later had surgery (Katz et al., NEJM 2013).
- The European ESSKA consensus advises that arthroscopic partial meniscectomy should not be first-line for degenerative tears, and that non-operative care is tried first (ESSKA, 2017).
At Prof. Dr. Ibrahim Shaarawi’s clinics in Nasr City, Mohandeseen and New Cairo (5th Settlement) we examine the knee and review your MRI at the same visit, deciding whether the tear suits conservative care, repair or partial meniscectomy according to its type and site, your age and activity.
Treating meniscal tears
| Treatment | When we use it | What to expect |
|---|---|---|
| Conservative care: physiotherapy, strengthening, pain relief | Degenerative tears in middle age, or small stable tears | Gradual improvement for many patients without surgery |
| Intra-articular injection | Persistent pain with associated arthritis | Temporary relief that supports rehabilitation |
| Arthroscopic meniscal repair | Peripheral longitudinal tears, or tears with an ACL injury, especially in younger patients | Preserves the meniscus, with a longer recovery |
| Meniscal root repair | A tear of the meniscal root | Prevents rapid deterioration of the knee |
| Arthroscopic partial meniscectomy | An unrepairable tear with locking or persistent mechanical symptoms | Faster recovery and earlier return to activity |
Your treatment pathway, step by step
Examination and diagnosis
Clinical examination including meniscal provocation tests, with an MRI establishing the shape and site of the tear — the two factors that determine whether repair is possible (see meniscus tear grades and meniscus tear symptoms).
Conservative treatment
For non-mechanical tears: relative rest, anti-inflammatory medication, and a physiotherapy programme strengthening the quadriceps and hamstrings.
Deciding on arthroscopy
Taken when conservative treatment fails or there is mechanical locking. Repair versus resection is discussed before surgery, because it changes the rehabilitation that follows.
The arthroscopy
Performed through two small portals with a fine camera, inspecting the whole joint first, then repairing the tear with sutures or trimming it as the tear allows. Read more about arthroscopic meniscus repair.
Rehabilitation
After resection, weight-bearing starts early and recovery is quicker. After a suture repair, knee flexion and weight-bearing are restricted for weeks to protect the repair while it heals. See our guide to exercises after meniscus surgery.
Return to activity
This differs substantially by intervention: weeks after a partial meniscectomy, months after a repair — a distinction to understand before surgery, not after. If you are weighing surgery at all, read living with a meniscal tear and does a torn meniscus heal on its own?
Partial meniscectomy (meniscus trimming): when is it the right choice?
Arthroscopic partial meniscectomy, also called meniscus trimming, removes only the torn part of the meniscus that cannot heal and smooths its edges, leaving the healthy meniscus in place. We use it when the tear sits in the inner zone with poor blood supply, where stitching rarely heals, or when the tear pattern is too complex to repair.
When we choose partial meniscectomy
- A tear in the inner third of the meniscus, where blood supply is too poor for healing.
- A complex or frayed tear that cannot be stitched with a reliable result.
- A torn fragment that locks or catches the knee, or causes painful clicking.
- A degenerate tear with clear mechanical symptoms after conservative treatment has failed.
When we do not recommend it
- A peripheral, well-vascularised tear in a young patient: repair preserves the meniscus.
- A simple degenerate tear without locking: physiotherapy and exercise come first.
- Pain caused mainly by advanced knee arthritis: arthroscopy does not treat arthritis.
Meniscal repair vs partial meniscectomy
| Repair (suture) | Partial meniscectomy (trimming) | |
|---|---|---|
| What happens to the meniscus? | The torn part is stitched and the whole meniscus is kept | Only the torn part is removed |
| Suitable tear | Peripheral and well vascularised, often acute, younger patients | Inner zone with poor blood supply, or too complex to repair |
| Walking after surgery | Protected, with limits on knee bending for a period | Usually within a few days, guided by pain |
| Return to activity | Months | Weeks |
| Long-term effect | Keeps shock absorption and protects the joint | The smaller the removed part, the less extra load on the joint |
The final choice between repair and trimming is sometimes made during the arthroscopy itself, once the tear can be seen directly, so we discuss both possibilities with you before surgery. Read more about arthroscopic meniscus repair.
Why we favour repair over removal
The meniscus is not a redundant structure but a shock absorber that distributes load across the joint surface. Removing much of it raises pressure on the articular cartilage and accelerates arthritis.
- Preserving shock absorptionRetaining the meniscus protects the joint surface from excess pressure and can delay arthritis by years.
- Tear location decides feasibilityThe outer third has good blood supply and heals; the inner third is poorly vascularised and rarely heals when sutured.
- Patient age and tear typeAcute tears in young patients are the best candidates for repair, while degenerate tears in older patients are usually not sutured.
- TimingEarly repair after injury gives a higher healing rate than repair delayed by months.
- Longer rehabilitation, better jointRepair requires longer post-operative restrictions, but it is an investment in long-term joint health.
- Addressing associated instabilityA meniscal repair in a knee made unstable by an ACL tear is at risk of failing unless the ligament is treated as well.
Risks and complications of arthroscopic meniscus surgery
Meniscus arthroscopy is one of the safest operations in orthopaedics, and serious complications are rare, below 1% in large studies. You should still know what can happen and how we reduce the risk:
- Swelling and fluid in the kneeThe most common issue in the first weeks. It settles with ice, elevation and exercise and rarely needs draining.
- Temporary pain and stiffnessWound pain usually settles within days to two weeks after trimming and can last some weeks after a repair. Starting straightening and bending early prevents stiffness.
- Deep vein thrombosisUncommon. Ankle pumps and early walking lower the risk, with blood thinners for higher-risk patients.
- InfectionVery rare with sterile technique and preventive antibiotics. Signs are fever, redness and wound discharge.
- Repair failure or re-tearHappens in a proportion of repairs, roughly one in four to five over the long term, and is usually managed with a simple second arthroscopy.
- Long-term osteoarthritisLinked to how much meniscus is removed, which is why we preserve as much as possible and favour repair whenever we can.
- Numbness near the woundsMild skin numbness near the portals or repair sutures from a small skin nerve branch can occur and usually improves with time.
Contact your doctor straight away if you notice:
- pain or swelling in the calf, or sudden breathlessness
- a temperature above 38 °C, or redness and discharge from the wound
- large swelling that keeps increasing despite rest and ice
- sudden locking of the knee, especially after a repair
Why Prof. Dr. Ibrahim Shaarawi
✅ Last medically reviewed by Prof. Dr. Ibrahim Shaarawi, Professor of Orthopaedic Surgery, on 5 October 2026
- Assessment before any decision to operateSurgery is offered only after appropriate conservative treatment has been exhausted, because many patients improve without an operation.
- Academic backgroundMD and MSc in Orthopedic Surgery from Ain Shams University, with training in the Ain Shams University hospitals.
- International trainingVisiting professor and training at Ohio State University Hospital in the United States, applying the protocols used there.
- One plan from diagnosis to rehabilitationDiagnosis, surgery, physiotherapy and follow-up handled as a single pathway rather than split across separate providers.
Read patient success stories or review the full profile and credentials.
Cost and booking
The cost of meniscal arthroscopy varies with the intervention performed (suture repair versus partial resection), the fixation devices used for a repair, whether ACL reconstruction is carried out in the same session, and the hospital and anaesthesia.
Arthroscopic meniscus surgery with Prof. Dr. Ibrahim Shaarawi starts from EGP 35,000 for a partial meniscectomy, and varies with the procedure:
| Procedure | Approximate price |
|---|---|
| Arthroscopic partial meniscectomy (trimming) | EGP 35,000–50,000 |
| Meniscal repair (suture) | EGP 60,000–70,000 |
| Meniscal root repair | EGP 70,000–80,000 |
| Meniscal repair with ACL reconstruction | EGP 75,000–95,000 |
See knee arthroscopy cost for a breakdown.
A final figure is given after the MRI, because the shape of the tear is what determines the scope of the operation.
Important: bring all previous imaging and reports to your first visit, along with a list of your current medications, so an accurate plan can be made from the outset.
Video: Knee pain from arthritis, ligament and cartilage injuries: diagnosis and treatment
Prof. Dr. Ibrahim Shaarawi, Professor of Orthopaedic Surgery, explains (in Arabic).
Frequently asked questions
Does a meniscal tear heal on its own?
It depends on where the tear lies. The outer third has a good blood supply and may heal or be successfully sutured, while the inner third is very poorly vascularised and usually will not heal, which is why it is trimmed rather than repaired.
Can a meniscal tear be treated without surgery?
Yes in many cases, particularly degenerate tears in patients over forty and small tears that do not lock the knee. A consistent physiotherapy programme strengthening the thigh muscles, combined with activity modification, gives good results in these cases.
How does recovery differ between repair and resection?
Substantially. After a partial meniscectomy, weight-bearing starts early and normal daily activity returns within weeks. After a suture repair, flexion and weight-bearing are restricted for weeks to protect the repair, and full return to sport may take months.
Does removing the meniscus cause arthritis?
Extensive removal raises pressure on the articular cartilage and increases the long-term likelihood of arthritis, which is why as little as possible is removed and the outer rim is preserved. Limited trimming has a much smaller effect.
What does a locked knee mean?
It is the inability to fully straighten or bend the knee because a torn fragment of meniscus has displaced into the joint and is blocking movement. This is a strong indication for arthroscopy, and early intervention is preferred.
Is arthroscopy major surgery?
It is performed through two small portals without a large incision, and most patients go home the same day or the following day. It remains a surgical procedure with its own risks, and is not performed without clear indications.
How long does arthroscopic meniscus surgery take?
A partial meniscectomy usually takes 30 to 45 minutes and a repair one to one and a half hours depending on the number of sutures, longer when combined with an ACL reconstruction. Add time for anaesthesia and recovery; most patients go home the same day or the next day.
Book a knee assessment
If you have an MRI showing a meniscal tear, an assessment establishes whether your tear is the kind that should be sutured, trimmed, or treated without surgery at all.
Related reading
References
- American Academy of Orthopaedic Surgeons (AAOS) — Patient guidelines
- Mayo Clinic — Orthopedic procedures
- NICE — Joint replacement and arthroscopy guidance
- Cochrane Musculoskeletal reviews
- Schweizer C, et al. Meniscal Repair Outcome in 3829 Patients With a Minimum Follow-up From 2 Years Up to 5 Years: A Meta-analysis on the Overall Failure Rate and Factors Influencing Failure. Am J Sports Med. 2024;52(3):822-831.
- Paxton ES, et al. Meniscal repair versus partial meniscectomy: a systematic review comparing reoperation rates and clinical outcomes. Arthroscopy. 2011;27(9):1275-88.
- Kise NJ, et al. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up. BMJ. 2016;354:i3740.
- Katz JN, et al. Surgery versus physical therapy for a meniscal tear and osteoarthritis. N Engl J Med. 2013;368(18):1675-84.
- Beaufils P, et al. Surgical management of degenerative meniscus lesions: the 2016 ESSKA meniscus consensus. Knee Surg Sports Traumatol Arthrosc. 2017;25(2):335-346.
Medical disclaimer: the content on this page is provided for medical education only. It is not a substitute for consultation and clinical examination, and must not be used as a basis for self-diagnosis or self-treatment. Read the full medical disclaimer.