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Meniscus Tear-Repair or Trim Out?
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Meniscus Tear-Repair or Trim Out?

I have an MRI report that shows a horizontal cleavage tear at the inferior margin of the body portion of the medial meniscus.
I hope this can be repaired and strongly prefer not to have any portion of the meniscus removed or trimmed? I am 45, not overweight, and usually, I only have pain walking on hard surfaces and pain is only located about two inches below the bottom of the knee.  

Q1.  What kind of surgery, if any, can the Doctor repair the meniscus or must the Doctor trim out the torn portion?  

Q2. Should I get another MRI to look below the knee where the pain actually is located or is this most likely from the meniscus?  Why is there usually no pain in my knee nor anywhere around the knee itself?

Q3.  Can I have meniscus surgery while I am awake?  If yes, where in NJ, Pa, or NY can I have surgery while awake?
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The vast majority of meniscus surgery involves removal of the damaged tissue, partial menisectomy, rather than repair.  The decision to repair is made on several factors including the location and quality of the tear, the age and activity level of the patien, and other concomitant injuries.

The meniscus only has a blood supply in its outer third. Most successful repairs are in the "red on red" zone, occasionally in the "red on white" zone, almost never in the "white on white".  Horizontal cleavage tears are usually not repairable.  

Meniscus repairs are usually not done in patients in their 40's. The purpose of a repair is to prevent long term post traumatic changes. The implications here are much greater in a patient in their 20's or younger. With current arthroscopic techniques, the risk of post traumatic arthritis after partial menisectomy is quite small.  In addition, meniscal repair often requires the use of crutches for 4 to 6 weeks.  This can be quite a problem with job responsibilities etc.  Partial menisectomy allows for rapid return to activity.  

I dont think there is a need for a second MRI, many surgeons in the metropolitan area will perform surgery with local or regional anesthesia.
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