ACL And Meniscus Surgery – What Is The Difference?

I have a friend who is currently recovering from a broken hip bone that he got because of a motorcycle accident.

Ever since his surgery, I have been asking millions of questions and doing so much research about what exactly happened. The human body has always amazed me and so have surgeries so his case was fascinating to me.

The fitness freak that I am led me to find out what common injuries athletes have. I could not imagine being bedbound for months like my friend so I set out on a quest to learn more.

The most severe injury that required surgery I came across was ACL and Meniscus Surgery.

At first, I thought they were the same but digging deeper I found that they were similar but different.

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What Are The ACL And Meniscus?

​The first thing I had to find out was what exactly these two injuries were.

Anatomy of the knee

ACL

The ACL, I discovered stands for Anterior Cruciate Ligament and it is located in the knee. The ACL is one of the four very important ligaments that control the back and forth motion of our knees. (1)

Meniscus

The Meniscus, on the other hand, is a cartilage found in help cushion the knee joint. They are often compared to ‘shock absorbers' that absorb the impact from your thighbone and shinbone. (2

What Are ACL Tears?

ACL Tears

When your ACL ligament tears due to high demanding sports or improper landing, the degree of the tear can be categorized into three:(1)

  • Grade 1 - the ligament has been stretched but is still able to hold the joint
  • Grade 2 - the ligament has stretched to the point where it is loose
  • Grade 3 - the ligament has wholly torn into two pieces and cannot support the joint

If you have a severe tear, ACL surgery is required for you to gain full use of your joint. Unfortunately, the most common kinds of tears are the severe Grade 3 tears that require surgery.

What Are Meniscus Tears?

Meniscus Tears

Whether a meniscus tear requires surgery will depend on the shape of the tear. Different types of tears can be categorized into (3)

  • A flap tear - a layer of the cartilage pulls away and creates a loose tab that can flap
  • A longitudinal tear - this happens inside the meniscus itself similar to a buttonhole
  • A radial tear - is inside edge of the meniscus curve and extends outward
  • A bucket handle tear - similar to the longitudinal tear but the tear creates a visible hole

I was so intrigued by all this information and a little terrified at the same time. I wondered how my ACL and Meniscus looked like- was it torn? Was I running properly? What would happen if I needed surgery?

Anyway, my curiosity won my fear and I decided to finish what I started. So I went back to understanding how the surgery was conducted. The answer filled me with awe and again, fear.

How Is ACL Surgery Conducted?

How Is ACL Surgery Conducted

The basic goal of ACL surgery is to reconstruct or repair the torn ACL and restore stability in your knee. Although open surgery is an option, most orthopedics prefer to use arthroscopic surgery. Whichever type of surgery is performed, two possibilities are depending on the degree of your injury: (4)

  • Reconstruction surgery - a graft ligament was taken from your own body is used to replace the damaged ligament
  • Repair surgery - the ACL is reattached merely to the bone

Arthroscopic Surgery

The reason why many surgeons and patients opt for arthroscopic surgery is that it is safer and uses smaller incisions. 

  • First, many incisions are made around the knee and a salt solution is pumped to help wash the blood from the area.
  • Pumping a saline solution also causes the knee to expand which allows the surgeon to see more clearly. (5)
  • Then an arthroscope (a small camera) is inserted into one of the incisions. The pictures from inside your knee are then transmitted to a monitor for your surgeon to analyze.
  • The graft is pulled through the tunnels until it reaches its destination and is secured with screws or staples.
  • If there has been any other damage to your knee, the surgeon will also repair this. 
  • Finally, the incision is closed and you are off to recovery.

How Is Meniscus Surgery Conducted?

As already mentioned, surgery of the meniscus is only conducted if the tear cannot heal on its own. Since the outside one-third of the cartilage has good blood circulation, a tear in this area may heal on its own. An example is a longitudinal tear. (6)

On the other hand, the inner part of the meniscus lacks good blood supply. Tears in this area cannot heal on their own and often require surgery to trim the parts away.

  • If surgery is required, two procedures may be performed depending on the location of the tear.

1. Meniscus Repair

This is conducted if the tear can be repaired with stitches. Arthroscopic surgery is the preferred procedure. The process is similar to what we already mentioned but no grafts are used. Instead, the torn pieces of cartilage are stitched together. These stitches will be absorbed by the body once the tear heals.

2. Partial Meniscectomy

This procedure is done if the area of the tear is in the inner part of the meniscus. Since healing is not possible, the damaged tissue is cut away by the surgeon.

3. Total Meniscectomy

Although this is an extreme procedure that requires the total removal of the meniscus, it may be necessary if the damage is severe. Due to the complications that arise after such a surgery including rapid degeneration of the joint resulting in arthritis, this procedure is often the last option.

As much as possible, a partial meniscectomy is performed so that a percentage of the cartilage is retained. (7)

What Is The Expected Recovery Time After Surgery?

Expected Recovery Time After Surgery

Apparently, the amount of time it takes to recover depends on the severity of the condition. My friend, for example, had a titanium rod inserted in his bone during surgery. He was using crutches for about two months and now has graduated with a cane but it will take him a few more months to be able to walk normally again.

ACL Recovery Time

As for ACL surgery, one reference estimated about 16 weeks of strict adherence to a recovery program before one could return to running. . The partial ACL recovery time   is a little less-three month. Even after recovery, you would need to find the best knee brace for torn ACL to help support your knees.

Meniscus Recovery Time

For a meniscus tear, it is possible for an athlete to return to practice two weeks after surgery. This is provided they spend hours in rehabilitation. For the majority of patients, returning to a regular routine is possible in less than six weeks. (9)

Final Thoughts

My journey through human anatomy has been a mind-opener. Our knees are a fine piece of machinery perfectly designed. Any small tear can cost you months on the sidelines and even a lifetime of problems.

The lesson for every runner is this: take care of your knees and they will take care of you.

  • Did you find this article interesting?
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