By Dev K. Mishra, M.D.
President, Sideline Sports Doc
Clinical Assistant Professor of Orthopedic Surgery, Stanford University
• Recovery is highly variable, but generally speaking most young athletes can return to sprinting, cutting, and jumping sports at about 6 weeks after partial meniscus removal surgery
• Generally speaking, most young athletes will return to sprinting, cutting, and jumping sports at about 4 months after meniscus repair with stitches
• Beware about claims to return fully to sports at 2 weeks after surgery- this is very rare
• Success rates are very high with properly followed rehab
This weekend I watched Costa Rica defeat Uruguay in a World Cup game, with this huge upset made possible in part because star Uruguay striker Luis Suarez was unable to play due to recovery from recent knee meniscus surgery. Many sports commentators felt fairly certain Suarez would be ready to play, only about 3 weeks after his surgery. But most orthopedic surgeons would honestly tell you it would be unusual for a player that relies on speed, quickness, and the ability to turn on a dime to be fully ready that quickly.
So how long should it realistically take?
The meniscus is a shock absorber in the knee, a horseshoe shaped structure situated between the two major knee joint bones. There are two menisci in each knee, and either meniscus can be torn in patterns generally like the ones shown in the photo (from OrthoInfo, the American Academy of Orthopaedic Surgeons).
If surgery is done for a torn meniscus it will most often be a partial removal, which is somewhat like trimming a hangnail from your toe. It’s a relatively quick procedure (usually about 15-20 minutes) and weightbearing is allowed immediately after surgery. The second possible procedure is called a meniscus “repair” where stitches are placed in the meniscus to sew it back together. After a meniscus repair there is usually a period of partial weightbearing on crutches that lasts several weeks.
The type of surgery performed has a major influence on the speed of the rehabilitation. With the commonly performed partial meniscus removal there is an early emphasis on minimizing swelling and regaining motion. Comfortable walking generally takes about a week or two. The highly variable part is return of power, speed, and the ability to cut hard or pivot. This is the part that takes the longest time and will usually take 2-4 weeks. So if we add the weeks up it will be a minimum of 3 weeks and perhaps up to 6 weeks for full return to sprinting, cutting, and jumping.
With meniscus repair with stitches there could be 4-6 weeks on crutches, followed by regaining full walking ability, and finally getting the knee sport-ready with strength, power, and speed. There is some overlap in the phases but when all the time is added up you’re looking at 3 to 4 months until the player is ready for unrestricted sprinting, cutting, and jumping.
In the discussion above I’ve focused on return to sprinting, cutting, and jumping. So the timeline for return to sports will depend on whether you need to do those things in your sport. If you are a cyclist or swimmer you should expect a faster return to your sport. Distance runners will generally return to full training faster than sprinters but likely longer than cyclists.
Circling back to World Cup soccer, Mr. Suarez is now coming up on four weeks after his surgery. If I were a betting man I would expect to see him in the starting lineup for Uruguay this week. Young athletes should expect a high chance of successful return with proper rehab and time after surgery.