The meniscus in your knee is the C-shaped cartilage located between your thigh and shin bones. It acts as a shock absorber, cushioning your knees when you walk, run, or jump. However, if it is damaged due to sports injuries or degenerative diseases, it can cause knee pain and limit your range of motion, making daily life difficult.
As a first aid, your doctor may recommend conservative treatments, such as resting your leg, applying ice, and physical therapy. However, if your symptoms persist or worsen, your doctor may eventually suggest a total knee replacement surgery.
Before you decide whether to take this surgery, here's what you need to know about what happens to your meniscus during the procedure.
When do doctors recommend total knee replacement?
A Total Knee Replacement (TKR), also known as total knee arthroplasty, is a surgical procedure that replaces your knee joint with a prosthetic made from metal or medical-grade plastic. This joint replacement is designed to mimic the natural movement of the knee, enabling you to move your knee naturally.
This procedure is usually not the first treatment option for treating knee pain, but your healthcare provider may recommend this surgical procedure if you experience:
Visible knee deformity
Persistent knee pain during rest or activity
Severe osteoarthritis or rheumatoid arthritis
Stiffness or limited range of motion in the knee
X-rays or MRIs of the knee shows severe meniscus cartilage damage
Chronic knee swelling and inflammation that doesn’t improve with medication
You have had a total meniscectomy due to a severe meniscus tear that has led to osteoarthritis
Other than recommending total knee replacement surgery (TKR), your surgeon may suggest a partial knee replacement to treat your joint, particularly if your knee injuries are not too severe.
Unlike TKR, which replaces the entire joint, this procedure only replaces the damaged compartment. This less invasive approach can result in a faster recovery, less postoperative pain, and more natural knee movements after surgery.
While the decision to undergo TKR surgery is completely up to you, we understand that it is not always a straightforward choice. To learn more about the procedure and its suitability for your condition, it is best to discuss with an orthopaedic specialist. Schedule an appointment with Thomson Medical today.
What happens to the meniscus during a total knee replacement?
During the knee replacement procedure, your orthopaedic surgeon will start by making a vertical incision on your knee to access the joint. Before inserting the prostheses, they will prepare the joint by removing the damaged cartilage and a small amount of bone from the ends of your thigh and shin bones.
Next, your doctor will position the metal implant on the prepared bone surfaces and insert a plastic spacer in between to replicate the function of the meniscus cartilage and ensure a smooth gliding surface for your artificial joint. Once the procedure is finished, the incision will be closed with stitches or surgical staples, and your knee will be bandaged.
What are the considerations of removing the meniscus?

During the TKR procedure, removal of the meniscus is an essential step to ensure successful treatment. Here are a few reasons why:
Removing torn or degenerated meniscal tissue will eliminate the source of pain and inflammation, providing relief.
The removal process also ensures that the prosthesis is properly placed on the joint surfaces.
Any remaining meniscus tissue could interfere with your new joint and cause pain, stiffness, or premature wear on the implant.
It enables full joint replacement, as artificial joints require the space that was previously filled by the meniscus.
Additionally, your artificial knee joint is designed to perform all the functions that your natural meniscus would have performed, providing your knee with shock absorption and maintaining joint stability. This allows for smooth movement and distributes weight evenly across your knee joint.
After your knee replacement surgery
After your knee replacement procedure, you will be moved to a recovery room where you will be closely monitored. However, you won't be lying down for too long, as there is an increased risk of blood clots after surgery. To prevent this, your healthcare provider may instruct you to:
Sit up and begin walking with crutches
Take a prescribed blood thinner, either by injection or orally
Perform breathing exercises to prevent lung complications
Gradually increase your activity level under a physical therapist guidance
Wear an elastic compression stocking to prevent blood from pooling in the leg veins
During this time, your healthcare team will closely monitor your condition. Usually, you'll stay in hospital for 3 to 4 days following a knee replacement surgery. Your surgeon will decide when you are ready to leave, depending on your recovery process.
However, with the Enhanced Recovery After Surgery (ERAS) protocol pioneered by Dr Jerry Chen, you can experience a faster, smoother recovery and reduce your hospital stay to less than a day.
For further information about knee replacement surgery and ERAS protocol, schedule an appointment with Thomson Medical.
Recovery tips
To help you recover, your surgeon will create a personalised recovery plan based on your specific needs. However, there are some steps you can take to ensure a smooth recovery. This includes:
Making sure the area around the incision is clean and dry to prevent infection
Maintain a healthy body weight to avoid straining your new knee joint
Apply an ice pack to the surgical area to help reduce swelling and post-surgery pain
Adhering to any tailored physical therapy recommended by your physical therapist
Eat a healthy diet full of protein, vitamins, and minerals to help your body heal and promote tissue repair
Keep your knee raised above the level of your heart to reduce swelling and promote proper blood flow. You can use pillows or a cushion to prop up your leg while sitting or lying down
Schedule regular check-ups with your orthopaedic surgeon to monitor your health and ensure the knee implants fit properly for everyday activities
FAQ
Is it painful to have the meniscus removed during TKR?
You will not feel any pain during a knee replacement operation, as it is performed under general or regional anaesthesia. Any discomfort you experience afterwards will be due to the overall surgical procedure, rather than the placement of the artificial joint or the removal of the meniscus.
Can the meniscus be preserved in any cases?
During a partial knee replacement, healthy meniscus tissue can be preserved if it is functional and undamaged. However, during total knee replacement surgery, the meniscus is removed to make room for the artificial components and ensure the implant functions properly.
This removal is necessary because the damaged meniscus tissue can interfere with the prosthetic components.
What are the long-term effects of living without a meniscus?
In healthy knees, loss of meniscus tissue can accelerate the development of osteoarthritis by increasing pressure on the knee joint. Without the meniscus to cushion the impact, your thigh and shin bones can rub together and experience greater wear and tear, leading to degenerative joint damage over time.
However, this concern is mitigated following a total knee replacement, as the artificial joints are designed to perform all the functions of the meniscus, including shock absorption, stability, and load distribution.
How long does it take to recover after TKR?
The initial recovery period usually lasts between 6 and 12 weeks. During this time, you will regain basic mobility and be able to resume your normal daily activities. Most people can walk without crutches after three weeks and drive after four to six weeks.
However, full recovery, including regaining your strength, balance, and range of motion, can take up to 6 or 12 months.
What should I expect after my knee replacement?
During the first six weeks, you can expect some pain, swelling and bruising, all of which are normal parts of the healing process. You will start physical therapy straight away to help restore movement and strength.
Between weeks four and six, you should notice a dramatic improvement in your knee function, with reduced swelling and increased mobility. Most people can return to work and start driving again during this period.
However, you may notice that your artificial knee feels different to your natural joint, particularly in cold weather or when kneeling.
How long does a total knee replacement last?
A total knee replacement implant usually lasts for 15 to 20 years. However, some newer implants can last even longer, particularly with proper care and adherence to low-impact activities.
This information is intended as general guidance only and should not be considered as medical advice. For personalised health screening recommendations based on your medical conditions, schedule an appointment with Thomson Medical.
For more information, contact us:
Thomson Specialists (Thomson Medical Centre) — Orthopaedic
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