Can Meniscus Root Repair Be Done During ACL Surgery?

Yes. Meniscus root repair may be performed during ACL reconstruction when a root tear is found and repair is clinically suitable. An ACL injury can occur with damage to the meniscus, especially during twisting, pivoting, landing or contact movements in sport.

For active people in Brisbane dealing with knee instability, swelling or difficulty returning to sports or exercise, specialist assessment of both injuries can assist treatment planning and rehabilitation.

At Ortho ARC, our Orthopaedic Specialists provide assessment, treatment and surgery for knee injuries, including ACL reconstruction in Brisbane.

What does the meniscus do?

Each knee has two menisci. These curved pieces of cartilage sit between the thigh bone and shin bone, helping to:

  • Distribute force through the knee
  • Absorb impact during running, landing and turning
  • Contribute to knee stability
  • Reduce concentrated pressure on cartilage surfaces
  • Support smooth movement of the joint

This is especially important for people involved in football, rugby, netball, basketball, skiing, running or physical work.

What is a meniscus root tear?

The meniscus attaches to the shin bone at small areas called roots. A meniscus root tear occurs when the cartilage tears close to, or detaches from, one of these attachment points.

A root tear can change the way force passes through the knee, increasing cartilage contact pressure and changes in joint loading.

In selected patients, meniscus root repair can help reattach the torn root and preserve as much functioning meniscal tissue as possible.

Symptoms of meniscus root tear can include:

  • Pain along the inner or outer side of the knee joint
  • Swelling after exercise
  • Catching or locking sensations
  • Pain with squatting, twisting or stairs
  • Reduced confidence in the knee during sport or movement

These symptoms can also be linked to other knee conditions, so specialist examination and imaging assist a more accurate diagnosis and effective treatment decisions.

Can a meniscus root tear occur with an ACL injury?

An ACL rupture commonly happens when the knee twists during a sudden direction change, awkward landing or sporting collision. These movements are seen in sports such as soccer, AFL, rugby, netball, basketball and skiing.

The same force can also damage the meniscus. Lateral meniscus posterior root tears are recognised in association with ACL injuries.

A person may first notice instability from the ACL tear. Pain, swelling, catching or limited movement can point to an associated meniscus injury that also needs assessment.

Why we examine the meniscus during ACL surgery

ACL reconstruction is performed to address instability caused by a torn anterior cruciate ligament. During surgery, your Ortho ARC surgeon will also inspect the menisci, cartilage and other structures inside the knee.

This Knee Arthroscopy assessment can identify a meniscus tear that may require treatment during the same procedure.

When a root tear is repairable, surgery reattaches the meniscus close to its original attachment site. Where possible, any viable meniscal tissue is preserved to help support the meniscus in sharing load across the knee.

Research into meniscus root repair performed with ACL reconstruction has reported overall functional improvement, though individual results may vary.

How a repair can support longer-term knee health

The meniscus has an important role in spreading force through the knee. When a root tear disrupts this function, increased pressure on the cartilage may contribute to degenerative change over time.

For selected tears, repair may help preserve meniscal function and assist in limiting some of the mechanical changes that happen with cartilage wear. Meniscus root repair may also lower rates of osteoarthritis progression when compared to partial meniscectomy.

Repair cannot, however, remove the possibility of future arthritis. It also cannot promise a return to a specific level of sport or activity.

For active patients, treatment discussions consider present symptoms, sporting goals, work demands, rehabilitation requirements and the longer-term effects of meniscal damage.

Is meniscus root repair suitable for every tear?

Meniscus root repair is not suitable for every injury. The recommendation depends on clinical considerations such as:

  • Tear location and pattern
  • Condition of the meniscal tissue
  • Cartilage changes within the knee
  • Associated ligament injuries
  • Age, health history and activity goals
  • Adherence to rehabilitation plan

Where indicated, Ortho ARC specialists may discuss root repair during ACL reconstruction.

A consultation provides an opportunity to review imaging findings, discuss treatment choices, consider possible benefits and risks, as well as discussing the rehabilitation involved.

What recovery involves after combined surgery

Rehabilitation after ACL reconstruction with meniscus root repair can differ from rehabilitation after ACL reconstruction alone. A repaired meniscus may need early protection during the healing period. Recovery can include:

  • Crutches and a period of restricted weight bearing
  • A knee brace in selected cases
  • Physiotherapy-led movement and strength exercises
  • Progressive running, jumping and change-of-direction training
  • Functional assessment before a return to training or competition

The timing of return to sport varies according to the injury, surgery, rehabilitation progress and the demands of the activity. Your Ortho ARC surgeon and partnering physiotherapist can discuss a plan based on your clinical progress.

When should you seek specialist assessment?

Specialist medical assessment should be considered or referred after a knee injury if you are experiencing:

  • Repeated giving way of the knee
  • Swelling that continues after sport or exercise
  • Locking or catching sensations
  • Pain with twisting, squatting or loading
  • An MRI report describing an ACL tear or meniscus tear
  • Difficulty resuming exercise, sport or physical work

ACL and meniscus assessment in Brisbane

Ortho ARC provides assessment and management for sports knee injuries in Brisbane, including ACL reconstruction and meniscus surgery.

Ortho ARC Specialists consult at the Brisbane Radiology Consulting Suites in Fortitude Valley, and perform operations at the Greenslopes Private Hospital, Brisbane Private Hospital and North West Private Hospital in Everton Park.

FAQ section

Yes. In selected cases, meniscus root repair may be performed during ACL reconstruction when a root tear is identified and the injury is suitable for repair.

A meniscus root tear can affect how the knee distributes load. This may increase pressure on cartilage surfaces and contribute to joint degeneration over time.

Meniscus root repair cannot prevent arthritis in every patient. For lateral root tears treated during ACL reconstruction, research supports improved knee mechanics and function, with evidence of longer-term arthritis continuing to emerge.

Recovery can involve crutches, weight-bearing limits, physiotherapy, and a staged return to sport or demanding activity. The rehabilitation plan depends on the injury and procedure.

Ortho ARC consultations are in Fortitude Valley, with operating locations at Greenslopes Private Hospital, Brisbane Private Hospital and North West Private Hospital.

Book your ACL or meniscus injury consultation in with Ortho ARC, Brisbane

An ACL tear with an associated meniscus root tear may affect knee function, rehabilitation planning and longer-term joint health. Assessment with an orthopaedic surgeon at Ortho ARC Brisbane can review your diagnosis and discuss personalised management options, including meniscus preservation or repair.

To request an appointment with one of our Specialists, contact the Ortho ARC practice or speak with your GP about a referral for an ACL injury, meniscus tear or sports knee condition.

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References:

Choi, N.-H., Yang, B.-S., Shin, Y.-C., & Victoroff, B. N. (2026). Lateral Meniscus Posterior Root Tear Repair With Anterior Cruciate Ligament Reconstruction: High Healing Rate and Significant Clinical Improvement at a Mean 8-Year Follow-up. Orthopaedic Journal of Sports Medicine, 14(1). https://doi.org/10.1177/23259671251400773

Perry, A. K., Knapik, D. M., Maheshwer, B., Polce, E. M., Hodakowski, A. J., Jackson, G., Gursoy, S., & Chahla, J. (2023). Lateral meniscus posterior root repair in the setting of anterior cruciate ligament reconstruction restores joint mechanics to the intact state and improves clinical function: a systematic review of biomechanical and clinical outcomes. Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA, 31(10), 4474–4484. https://doi.org/10.1007/s00167-023-07461-5

Ro, K.-H., Kim, J.-H., Heo, J.-W., & Lee, D.-H. (2020). Clinical and Radiological Outcomes of Meniscal Repair Versus Partial Meniscectomy for Medial Meniscus Root Tears: A Systematic Review and Meta-analysis. Orthopaedic Journal of Sports Medicine, 8(11), 232596712096207. https://doi.org/10.1177/2325967120962078

Dr Blake Fidock (MED0001788650) MBBS (Hons. 1), MTrauma (Ortho), FRACS (Ortho), FAOrthA is a Specialist Orthopaedic Surgeon in Brisbane. This information is general in nature and is not a substitute for medical advice, diagnosis or treatment and does not establish a doctor-patient relationship. All surgery carries risk and individual results may vary. Please consult your GP regarding your individual circumstances and for referral if required.