The meniscus is a C-shaped piece of cartilage that serves as the shock absorber in your knee. It is important to keep your knee stable and to protect the health of your knee. The meniscus can be torn during a twisting or impact injury to your knee, or it can develop a tear over time from overuse.
Signs and Symptoms of a Meniscus Tear
A torn meniscus can result in either sudden or gradual onset of pain. There is often swelling of the knee and severe pain with walking, running, twisting, or moving the knee. The pain is usually located one the sides or front of the knee, although it can occasionally be located in the back of the knee. Some patients may experience catching, clicking, or locking of their knee.
Treatment of a Meniscus Tear
Many meniscus tears can be treated successfully without surgery. The RICE (rest, ice, compression, elevation) principle can be useful in the first several days after a meniscus tear to help reduce inflammation, swelling, and pain. Physical therapy exercises can help to improve muscle strength, knee range of motion, and decrease sensitivity to the pain.
Some patients will ultimately need surgical treatment of their meniscus tear. Most of the time these patients have a specific injury that caused the meniscus tear, and may often have reduced range of motion of mechanical symptoms such as catching or locking. Some types of tears, such as meniscal root tear or a bucket-handle tear, almost always need surgery. In general we use an MRI or ultrasound to look more closely at the meniscus and determine if it is something that needs surgical treatment, although this decision is also made based on how the patient responds to nonsurgical treatment.
Many meniscal repairs can be repaired surgically. Although the meniscus has traditionally been considered a difficult structure to heal, newer techniques and biologic augmentation such as PRP, stem cells, fibrin clots, and cartilage scaffolds have led to an improved rate of healing. Current literature suggests that meniscal repair is successful between 75-95% of the time, depending on the type and location of the tear.
Occasionally, the meniscus must be trimmed back. This is necessary in irreparable tears or in situations with poor healing potential. The least amount of meniscus possible should be removed, since over resection can lead to knee instability, cartilage damage, and premature arthritis.
What Should You Do if You Think You Have a Torn Meniscus?
If you think you may have a meniscus tear, it is recommended that you see a sports medicine physician as soon as possible. Many tears have better outcomes if they are treated early. A sports medicine specialist will examine your knee and any relevant imaging to determine which treatment you should start with first. Identifying and properly treating meniscus tears (with or without surgery) will lead to the most rapid reduction in your symptoms and is crucial to optimize the long term health of your knee.
Additional Resources About Meniscus Tears
- Meniscal Ramp Lesions. Arner, J.W., Herbst, E., Burnham, J.M. et al. Knee Surg Sports Traumatol Arthrosc (2017) 25: 3955. https://doi.org/10.1007/s00167-017-4523
Meniscal Root Repair Article. Malempati C, Burnham JM, Johnson DL. 2017