Patients considering a Meniscus Replacement Procedure (MRP) often have one major concern: What happens if my ACL is already damaged? According to renowned orthopedic surgeon Dr. Ashwani Maichand, understanding the relationship between the meniscus and the anterior cruciate ligament (ACL) is key to understanding why early intervention can make a significant difference.
“The ACL is one of the most important stabilizing ligaments of the knee,” says Dr. Maichand. “Many people believe that once it starts degenerating, the damage is irreversible. However, in many patients, the underlying problem begins with damage to the medial meniscus.”
The medial meniscus acts as a natural shock absorber in the knee. When it is damaged or loses its function, the mechanics of the knee begin to change. Over time, the knee can gradually shift inward, a condition known as varus deformity, commonly referred to as bow-legged alignment. This altered alignment places increasing stress on the ACL, causing it to stretch.
“The extent of this stretch tells us how much the ACL has been affected,” explains Dr. Maichand.
According to him, imaging and clinical assessment help determine the severity of the ligament injury. A stretch of less than 3 millimetres typically indicates swelling or edema within the ligament. Stretching of up to 5 millimetres may suggest a partial ACL tear, while greater than 5 millimetres is generally associated with a complete tear.
This evaluation plays an important role in deciding whether a patient is a suitable candidate for MRP.
One of the most common questions Dr. Maichand hears is whether a partially damaged ACL, for example, one that is around 50% compromised will continue to deteriorate after undergoing Meniscus Replacement Procedure.
“Patients often worry about the long-term health of their knees because the ACL is already weak,” he says. “In reality, our objective is to restore the mechanics of the knee.”
According to Dr. Maichand, the meniscal bearing implant used during MRP is designed to correct the abnormal alignment created by meniscus damage. By restoring the knee’s normal biomechanics, it reduces the excessive stretch on the ACL.
“When the abnormal stress on the ligament is relieved, the ACL is no longer being continuously strained,” he explains. “Restoring a more normal mechanical environment also supports the ligament’s natural healing processes and helps preserve its function.”
Beyond relieving pain, Dr. Maichand says the procedure is intended to interrupt the cycle of knee degeneration before it progresses to more advanced arthritis.
“The real advantage of MRP is that it is both a joint-preserving and preventive procedure,” he says. “Instead of waiting until arthritis affects the entire knee and a total knee replacement becomes the only option, we aim to treat the problem early by restoring stability, preserving healthy structures and maintaining natural knee function.”
Patients who undergo the procedure often experience improved mobility, reduced pain and inflammation, and greater confidence in returning to everyday activities, including walking, exercising and other normal routines following rehabilitation.
“The beauty of Meniscus Replacement Procedure is that we’re not simply replacing damaged tissue,” Dr. Maichand concludes. “Our goal is to restore the knee’s natural biomechanics, protect important structures like the ACL and preserve the patient’s own knee for as long as possible. Early treatment gives us the best opportunity to slow degeneration and help patients remain active for years to come.”
