Knee Injuries and Meniscal Repair in London: Saving Torn Cartilage
Knee injuries and meniscal repair come down to one question: can the torn cartilage in your knee be saved? Mr Sivan Sivaloganathan, Consultant Orthopaedic Surgeon in London, assesses twisting injuries, torn menisci and ligament damage. When the tear allows it, he stitches the meniscus back in place through keyhole surgery instead of removing it.
This page is for anyone whose knee hurts, swells, catches or gives way after a sudden twist. The King’s College Hospital NHS leaflet notes that injury-related tears are typical under the age of 40. Clinics run at six London sites, including King Edward VII’s Hospital in Marylebone.
Repair does not suit every tear. A 2019 national consensus from the British Association for Surgery of the Knee (BASK) advises at least 3 months of non-surgical care for most meniscal tears. It supports repair after an acute injury when the tear can heal.
What Is a Meniscal Tear, and What Does Repair Involve?
Each knee has two menisci, an inner (medial) and an outer (lateral) one. These rubbery C-shaped pads sit between the thigh bone and shin bone. The King’s College Hospital NHS leaflet calls them shock absorbers that also keep movement smooth and steady.
The NHS guide to knee pain lists a torn meniscus, a torn ligament or cartilage damage when a knee gives way after an injury. A popping sound at the time is another sign the NHS mentions.
In a repair, the surgeon looks inside the joint with a small camera and stitches the torn edges so they can knit. The Sherwood Forest NHS leaflet warns that removing meniscus may make the remaining cartilage wear faster. So repair is discussed first whenever the tear allows it.
Knee Injury Symptoms: When to Get Help
The NHS advises calling 111 if your knee locks, gives way, clicks painfully or cannot take your weight. The table links common signs to likely causes and next steps.
| Your symptom | Possible cause | What to do |
|---|---|---|
| Pain and swelling after a twist, a pop, the knee giving way | Torn ligament or meniscus, or cartilage damage (NHS) | Get advice from NHS 111, then arrange a specialist assessment |
| Knee stuck bent and will not straighten | Displaced meniscal tear (Sherwood Forest NHS leaflet) | Same-day advice from NHS 111. BASK supports urgent surgery for a locked knee |
| Joint-line pain with twisting, squatting or stairs | Meniscal tear (King’s College Hospital NHS leaflet) | Ice, relative rest and exercises, then a specialist review if it persists |
| Hot, red, swollen knee with a high temperature | Possible joint infection (septic arthritis) (NHS) | Urgent GP appointment or NHS 111. A&E if you feel very unwell |
| Calf pain and swelling after surgery, with breathlessness or chest pain | Possible blood clot (NHS) | Call 999. Calf pain and swelling alone: NHS 111 |
| Confusion, slurred speech, blotchy skin, very fast breathing | Possible sepsis (NHS) | Call 999 or go to A&E |
The NHS sepsis page also lists uncontrollable shivering and passing very little urine in adults. Do not wait for every sign before calling 999.
Conditions Mr Sivaloganathan Treats After a Knee Injury
- Torn meniscus from a twist: the foot stays planted while the body turns. Per the King’s College Hospital NHS leaflet, these tears are typical under 40.
- Bucket-handle tear: a long split where a strip of meniscus flips into the joint and blocks it. BASK recommends urgent keyhole surgery for a knee locked this way.
- Wear-related (degenerative) tear: common over 40, often with no injury at all (Sherwood Forest NHS leaflet). Exercise comes first, and non-surgical knee pain care sets out the options.
- Cartilage damage: injury to the smooth joint lining, which the NHS groups with meniscus and ligament tears.
- Ligament injury: Versus Arthritis explains that collateral ligaments control sideways movement and cruciate ligaments control forward and backward movement. An anterior cruciate ligament (ACL) injury is examined at the same visit. Whether he reconstructs the ACL himself or refers on is [to confirm].
Treatment Options for a Torn Meniscus
Mr Sivaloganathan weighs the time since injury, your activity level and the tear pattern (his practice website). An MRI scan shows the size, type and position of the tear, according to Lancashire Teaching Hospitals NHS.
Rehabilitation Without Surgery
Ice, relative rest, painkillers and a staged exercise plan rebuild strength and control. It suits stable tears without locking, and BASK advises it for at least 3 months for most tears. There is no hospital stay. The King’s College Hospital NHS leaflet gives about 3 to 6 months to heal. The risk is ongoing symptoms, because inner tears cannot heal on their own (Lancashire NHS leaflet).
Arthroscopic Meniscal Repair
The torn edges are stitched through two or three keyhole cuts under a general or spinal anaesthetic. The Lancashire NHS leaflet says it usually takes up to an hour, with at least half a day on the ward. It suits a recent tear near the outer rim in a knee without significant arthritis. It is usually a day case (East Kent NHS leaflet). Up to a fifth (1 in 5) of repairs fail, according to the same leaflet.
Trimming the Tear When Repair Is Not Possible
If the tear lies in the inner meniscus, or the tissue is too frayed to hold stitches, only the damaged fragment is removed. The choice is often made during the operation (his practice website). It is a day case with a shorter recovery, covered on the knee arthroscopy and meniscal surgery page.
Steroid Injection Alongside Physiotherapy
The Sherwood Forest NHS leaflet uses steroid injections for some meniscal tears to ease pain for long enough to exercise. It is a short clinic procedure with no stay, given alongside physiotherapy. Limits and side effects are on the knee injections page.
Why Patients Choose Mr Sivaloganathan for Meniscal Repair
- A knee practice: his clinical work is the knee, from keyhole meniscal surgery to robotic-assisted replacement in London.
- Training: medicine at Imperial College London (degree and year [to confirm]), then orthopaedic specialist training in South West London.
- Fellowships: Montreal, Canada, in the Complex Hip and Knee unit of HMR hospital, with scholarship funding in 2021. A second fellowship at Imperial College Healthcare NHS Trust covered robot-assisted complex knee and complex trauma surgery.
- Research: a master’s degree (MSc) at UCL in Nanotechnology and Regenerative Medicine, and 18 papers in PubMed-indexed journals.
- Army service: Medical Officer (Captain) in the regular British Army, with an operational tour of Afghanistan in 2009.
- One surgeon throughout: you see Mr Sivaloganathan from assessment to follow-up in London, with physiotherapists guiding your return to sport (his practice website).
Which Meniscal Tears Can Be Repaired?
Blood supply decides most of it. Lancashire Teaching Hospitals NHS explains that the outer third, the red zone, has a good supply, so tears there usually heal. The inner two-thirds, the white zone, has a poor supply, and tears there cannot heal.
| Tear feature | Repair more likely | Repair less likely |
|---|---|---|
| Position | Outer third, the red zone (Lancashire NHS) | Inner two-thirds, the white zone (Lancashire NHS) |
| Cause | A recent injury (BASK) | Gradual wear, common over 40 (Sherwood Forest NHS) |
| Size | Small outer-edge tears may heal in 2 to 3 months (Sherwood Forest NHS) | Larger or central tears tend not to heal (Sherwood Forest NHS) |
| Rest of the knee | No significant arthritis | Severe osteoarthritis, where BASK advises against meniscal surgery except in rare cases |
BASK asks surgeons to judge healing potential from patient, anatomical, biomechanical and biological factors. The trade-off is plain: repair keeps the cushion, but recovery is longer and up to a fifth (1 in 5) fail (Lancashire NHS leaflet). Trimming is quicker, yet the Sherwood Forest NHS leaflet notes faster wear of the remaining cartilage.
Alternatives to Meniscal Repair Surgery
Many tears settle without an operation. The Sherwood Forest NHS leaflet says most people treated without surgery do as well in the longer term. It cites MRI changes in 9 out of 10 people over 50, though most with meniscal tears had no pain.
First steps on the NHS knee pain page are less weight on the knee, a wrapped ice pack for 20 minutes at a time and painkillers. Many NHS areas let you book community physiotherapy (MSK services) directly.
Waiting does not suit a locked knee. BASK recommends prompt keyhole surgery when a displaced tear blocks the joint, because a locked knee is disabling.
Your Meniscal Repair Pathway, Step by Step: Appointment, Scan and Surgery Day
- Request a visit: complete the online form with brief details of the injury and treatment so far (his practice website).
- First appointment: history and examination in London, with time for questions. Imaging is booked if it will change the plan (his practice website).
- MRI and results visit: the scan shows tear type and position (Lancashire NHS leaflet). You then receive a written report with findings and recommendations (his practice website).
- Your decision: repair, trimming or 3 months of rehabilitation first, weighed against the BASK consensus.
- Surgery day: usually a day case. A physiotherapist provides crutches and explains how much weight you may take (East Kent NHS leaflet).
- Follow-up: a consultant review usually 2 to 6 weeks after surgery, with physiotherapy starting in the same window (East Kent NHS leaflet).
Recovery and Risks After Meniscal Repair
Stitched tissue needs time to knit, so recovery is slower than after trimming. His protocol uses crutches for 2 to 6 weeks, varying with the type of repair (his practice website). The James Paget NHS protocol adds a brace that stops bending beyond 90 degrees for 6 weeks.
| When | What happens | Source |
|---|---|---|
| Weeks 0 to 2 | Repair protected, knee kept straight | Mr Sivaloganathan’s protocol |
| Weeks 2 to 6 | Bending increased by 30 degrees every 2 weeks | Mr Sivaloganathan’s protocol |
| Week 8 onwards | Full bend, including deep bending, plus strengthening | Mr Sivaloganathan’s protocol |
| Several months to a year | Return to sport, depending on your goals | James Paget University Hospitals NHS |
The Lancashire NHS leaflet lists repair failure in up to a fifth (1 in 5), blood clots, infection, stiffness and numbness at the front of the knee. The NHS arthroscopy page calls complications of keyhole joint surgery rare.
| Treatment | Hospital stay | Example risk |
|---|---|---|
| Meniscal repair | Day case (East Kent NHS) | Up to a fifth (1 in 5) of repairs fail (Lancashire NHS) |
| Meniscal repair | Day case (East Kent NHS) | Numbness at the front of the knee, sometimes long term (Lancashire NHS) |
| Trimming (partial meniscectomy) | Day case (his practice website) | Remaining cartilage may wear faster (Sherwood Forest NHS) |
| Rehabilitation without surgery | No stay | About 3 to 6 months to heal (King’s College Hospital NHS) |
Driving: the East Kent NHS leaflet suggests short trips 7 to 14 days after surgery if you are fully weight bearing, and never in a brace.
Where Mr Sivaloganathan Sees Patients in London
Clinics run at six sites across central and west London, with times taken from his practice contact page. The hospital used for meniscal repair surgery is [to confirm].
| Location | Address | Clinic times |
|---|---|---|
| King Edward VII’s Hospital | 5–10 Beaumont Street, London W1G 6AA | Wednesday, 9:30am to 12:30pm |
| Chelsea Private Care, Chelsea and Westminster Hospital | 369 Fulham Road, London SW10 9NH | Monday mornings |
| Syon Clinic | 941 Great West Road, Brentford TW8 9DU | Monday, 5:30pm to 8pm |
| Clementine Churchill Hospital | Sudbury Hill, Harrow HA1 3RX | Monday, 12pm to 2:30pm |
| Chiswick Outpatients | Bond House, 347–353 Chiswick High Road, London W4 4HS | Building open Monday to Friday, 8am to 8pm |
| The Lister Hospital | Chelsea Bridge Road, London SW1W 8RH | Building open Monday to Friday, 8am to 6pm |
Fees and Insurance for Meniscal Repair
His 2026 consultation and surgery fees are not published online, so ask the practice for an estimate once your plan is agreed.
Mr Sivaloganathan sees self-paying patients and patients insured with AXA Health, Aviva, Bupa and Healix.
If your insurer is not listed, use the contact form to check.
FAQs About Knee Injuries and Meniscal Repair
Is meniscal repair major surgery?
It is keyhole surgery, usually a day case of up to an hour (Lancashire NHS leaflet). Rehabilitation is the demanding part, with about 6 weeks of brace and crutches in NHS protocols.
How long does recovery take once the meniscus is stitched?
On his protocol, full bending starts from week 8. The James Paget NHS leaflet puts rehabilitation at several months, up to a year.
When can I drive after a meniscal repair?
The East Kent NHS leaflet suggests 7 to 14 days if you are fully weight bearing and can stop in an emergency. Never while wearing a brace.
Can the tear come back after it has been repaired?
Yes. Up to a fifth (1 in 5) of repairs fail, more often when rehabilitation advice is skipped (Lancashire NHS leaflet). A failed repair may then need trimming.
Is there an alternative to stitching the meniscus?
Yes. At least 3 months of structured rehabilitation suits most tears (BASK). Trimming suits tears that cannot heal.
How much does private meniscal repair cost?
Fees are not on his website. The practice can estimate the cost in London once the type of surgery is clear.
Will a torn meniscus heal by itself?
Sometimes. Small outer-edge tears may heal over 2 to 3 months (Sherwood Forest NHS leaflet). Inner tears cannot heal.
Do I need an MRI scan before my first appointment?
No. The King’s College Hospital NHS leaflet notes that an examination often guides the plan without one. Mr Sivaloganathan books imaging if needed.
When can I return to football or running after a repair?
The James Paget NHS leaflet puts full rehabilitation at several months to a year, depending on the sport.
How long will I be off work after a meniscal repair?
Desk workers can often return quickly, says the East Kent NHS leaflet. Manual jobs need longer because of the brace.
Why does my knee lock after a twisting injury?
A loose flap of torn meniscus can wedge in the joint (Sherwood Forest NHS leaflet). BASK recommends urgent surgery for a truly locked knee.
Book an Assessment for a Knee Injury with Mr Sivan Sivaloganathan
Arrange an appointment in London to learn whether your tear can be saved and what rehabilitation involves. Bring scan reports and a note of treatment since the injury.
- Online: the booking request form takes a few details, and the practice contact form handles general questions.
- If you prefer to phone, call the practice on [to confirm].
On his blog: healing times after a knee injury and soft tissue knee injury recovery time. For worn knees, see robotic-assisted partial and total knee replacement, or browse the full treatments page.
A knee that locks, gives way or swells badly needs your GP or NHS 111 on the same day. Breathlessness or chest pain after surgery, or sepsis signs like slurred speech or mottled skin, mean calling 999 or going straight to A&E.