Question 1

My MRI report says I have a 'posterior medial meniscus root tear' and the radiologist mentioned something called a 'ghost sign.' My GP says it's just a meniscus tear and to do physiotherapy, but I've read online that root tears are serious. Should I see a specialist?

Accepted Answer

Yes, you should absolutely see an orthopedic surgeon for second opinion. Root tears are NOT 'just meniscus tears'—they're a specific, serious type of meniscus injury with very different implications than regular meniscus tears, and many GPs are not familiar with them. Here's why this matters: WHAT IS MENISCAL ROOT TEAR: The meniscus (cartilage cushion in knee) attaches to tibia (shin bone) at front and back via 'roots' or anchors. When root detaches completely, meniscus loses its ability to function—it's biomechanically equivalent to having NO meniscus at all. Meniscus normally distributes load across knee (like shock absorber). Without functional root attachment, entire body weight concentrates on small area of cartilage causing rapid arthritis development. GHOST MENISCUS SIGN: The 'ghost sign' on MRI is highly specific for root tear—meniscus appears to float or separate from tibia on MRI images because root attachment is torn. This is a red flag finding that requires specialist evaluation. NATURAL HISTORY IF UNTREATED: Studies show root tears treated conservatively (physiotherapy, activity modification) lead to progressive medial compartment arthritis in 80-90% of patients. 30-40% need total knee replacement within 5 years. This is dramatically worse than regular meniscus tears, which can often be managed conservatively without rapid arthritis. WHY SEE SPECIALIST: Orthopedic surgeon experienced with root tears can: (1) Assess whether you're candidate for root repair—depends on: how long ago tear occurred (acute/subacute vs chronic), amount of existing cartilage damage (repair won't help if advanced arthritis already present), your age and activity level; (2) Explain realistic options: root repair (70-80% success slowing arthritis, but requires 6 weeks non-weight-bearing recovery), conservative management (accepting arthritis progression), eventual knee replacement if symptoms severe. WHO SHOULD CONSIDER REPAIR: Active patients of any age with root tear and minimal-moderate arthritis. Repair is joint-preserving surgery that can delay or prevent knee replacement for 10-15+ years in successful cases. WHO CAN DO CONSERVATIVE: Very low-demand patients (minimal walking), elderly patients already with significant arthritis, patients medically unfit for surgery. BOTTOM LINE: Don't accept 'it's just a meniscus tear, do physio' for a root tear. See orthopedic surgeon to discuss whether you're repair candidate. Even if you ultimately choose conservative management, at least you'll make informed decision understanding the consequences.

Question 2

I had meniscal root repair surgery 8 weeks ago and I'm frustrated with how slow the recovery is—I'm still using crutches and can barely bend my knee. My friend had regular meniscus surgery and was back to normal in 4 weeks. Did something go wrong with my surgery?

Accepted Answer

Nothing went wrong—root repair recovery is significantly longer and more restrictive than regular meniscus surgery (partial meniscectomy or simple meniscus repair) because of the biomechanical demands of healing the root attachment. Here's why: WHY ROOT REPAIR RECOVERY IS SLOW: When root is reattached to tibia with sutures pulled through bone tunnel, that attachment must heal before you can load it. Unlike soft tissue healing to soft tissue (regular meniscus repair), root-to-bone healing takes 8-12 weeks minimum. Early weight-bearing would pull the root off the bone (repair failure), so strict non-weight-bearing for 6-8 weeks is mandatory. Similarly, aggressive knee bending would stress the repair, so motion progression is gradual. Compare this to partial meniscectomy (removing torn meniscus tissue)—no healing required, immediate weight-bearing, back to activities in 2-4 weeks. Your friend likely had much simpler surgery than you. EXPECTED TIMELINE AT 8 WEEKS: Non-weight-bearing: should be transitioning to progressive weight-bearing at 6-8 weeks (still using crutches but starting to put some weight through leg). Knee bending: expect 60-90 degrees flexion at 8 weeks (nowhere near full bend yet—that comes at 12-16 weeks). Pain: still significant discomfort with movement and weight-bearing. Swelling: moderate swelling still present. This is NORMAL at 8 weeks post-root repair. You're on track if: you can comfortably bear weight with crutches assistance, you're gradually gaining knee bend (even if only 60-80 degrees), X-rays show healing (if surgeon ordered them). WHEN TO WORRY: If at 8 weeks you have: no improvement in pain or swelling since surgery, inability to bear ANY weight (suggests complication), severe pain out of proportion to rehab, knee locking or catching (suggests repair failed or loose body). These warrant urgent surgeon review. TYPICAL TIMELINE: Weeks 0-6: non-weight-bearing, locked brace, minimal motion. Weeks 6-12: progressive weight-bearing, wean crutches, gain motion to 90-110 degrees. Weeks 12-16: off crutches, motion improving to 120+ degrees, start strengthening. Months 4-6: return to low-impact activities (walking, cycling, swimming). Most patients not 'normal' until 6 months post-op, and some have mild residual symptoms for 9-12 months. PATIENCE REQUIRED: Root repair is major knee reconstruction. You chose this surgery (or surgeon recommended it) because it's joint-preserving and delays/prevents knee replacement. Alternative would have been partial meniscectomy (quick recovery, like your friend) but then 40-50% chance of needing knee replacement within 5 years. So while recovery is slow, you're investing time now for long-term benefit. Stay patient with the process.

Medical Disclaimer

Meniscus Anchor Tear (Meniscal Root Tear)

📖What is Meniscus Anchor Tear (Meniscal Root Tear)?

🔬What Causes It?

⚠️Risk Factors

You may be at higher risk if:

🛡️Prevention