Not every meniscus tear needs surgery
The menisci are two crescent-shaped structures between the femur and tibia that help with load distribution, shock absorption and knee stability.
A meniscus can tear during a twisting injury, sports activity or, in older knees, as part of degenerative change.
The correct treatment depends on the type of tear, location, symptoms, age, activity level and condition of the rest of the knee.
What are the symptoms of a meniscus tear?
Symptoms can include:
- Pain along the joint line
- Swelling
- Clicking
- Catching
- Difficulty squatting
- Pain during twisting
- Restricted knee movement
- A sensation of locking
How does a meniscus tear happen?
Traumatic tears
These often occur after:
- Twisting
- Pivoting
- Sudden squatting
- Sports injuries
- Direct trauma
Degenerative tears
As the knee ages, the meniscus can develop degenerative changes and may tear with relatively minor activity.
How is a meniscus tear diagnosed?
Assessment begins with history and examination.
Your doctor may assess:
- Joint-line tenderness
- Range of motion
- Swelling
- McMurray test
- Thessaly test
- Knee stability
- Associated ligament injury
Does every meniscus tear require surgery?
No. Many patients can initially be treated without surgery, particularly when symptoms are manageable and there is no significant mechanical locking.
Non-operative treatment may include
- Activity modification
- Physiotherapy
- Strengthening
- Anti-inflammatory medication when appropriate
- Selected injections
- Gradual return to activity
When might surgery be considered?
Surgery may be considered when:
- Symptoms persist despite appropriate conservative treatment
- There is significant mechanical locking
- A repairable traumatic tear is present
- The tear is associated with another injury requiring surgery
- The tear is causing persistent functional limitation
The goal is generally to preserve as much functional meniscal tissue as possible.
Meniscus repair versus meniscectomy
Meniscus repair
The torn meniscus is repaired to preserve tissue.
Repair is particularly important in appropriately selected tears where healing potential is reasonable.
Advantages include preservation of meniscal function, but rehabilitation can be longer and not every tear is repairable.
Partial meniscectomy
The unstable damaged portion is selectively removed when repair is not appropriate.
The aim is to remove as little healthy meniscus as possible.
Why is preserving the meniscus important?
Removing excessive amounts of meniscal tissue can increase stress on the articular cartilage.
What happens after meniscus surgery?
Recovery depends on the procedure.
After meniscus repair
Rehabilitation may involve:
- Protected weight-bearing
- Controlled knee movement
- Gradual strengthening
- Progressive return to activity
After partial meniscectomy
After selected partial meniscectomy procedures, recovery may be faster, although the rehabilitation plan still depends on the individual patient.
Frequently Asked Questions
Can a meniscus tear heal without surgery?
Some tears and many degenerative tears can be managed without surgery. Healing potential varies greatly according to the tear location and characteristics.
Does every MRI-confirmed meniscus tear need surgery?
No. MRI findings need to be interpreted alongside symptoms and examination.
What does a locked knee mean?
A true locked knee is an inability to fully move the knee because something is physically blocking movement. This is different from temporary stiffness or pain-limited movement and may require prompt assessment.
Is meniscus repair better than meniscus removal?
The appropriate procedure depends on the tear. When a tear is repairable, preserving the meniscus is generally an important objective.
Can a meniscus tear cause arthritis?
Meniscal injury and loss of meniscal tissue can contribute to degenerative changes, although the long-term risk depends on several factors.
Consultation
A meniscus tear should be treated according to the patient and the tear, not the MRI report alone.
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