Meniscus Tears

The menisci are two C-shaped pads of cartilage that cushion the knee and spread load across the joint. A tear can make walking, squatting, climbing stairs, and rising from a chair painful or unpredictable. Acute tears happen when a bent, loaded knee is suddenly twisted, often in sport. Degenerative tears develop gradually as the tissue weakens with age and often coexist with arthritis. When the meniscus is torn, it distributes load less well, and the cartilage on the bone ends then absorbs more force with each step.

Common symptoms include:

• Pain along the joint line, the gap where the thighbone and shinbone meet
• Swelling that builds over the first day or two after an acute tear
• Catching, clicking, or locking, or a feeling that something moves inside the joint
• Pain with squatting, twisting, or rising from a chair
• A knee that feels unreliable on stairs or while pivoting

Diagnosis begins with a focused physical exam, where tenderness along the joint line is the most consistent finding. X-rays are taken first to rule out a fracture and check for arthritis. An MRI defines the tear pattern and any associated damage, and is ordered when the diagnosis is uncertain, surgery is being considered, or symptoms are not improving.

Not every tear needs surgery. Degenerative tears and most stable tears start with nonsurgical care:

• Relative rest and activity changes, avoiding deep squatting, twisting, and impact
• Physical therapy to strengthen the quadriceps and hip muscles
• A short course of anti-inflammatory medication, and at times a corticosteroid injection

Surgery is considered for tears with true locking, unstable patterns, or persistent mechanical symptoms after nonsurgical care. The meniscus is preserved with a repair whenever the tear pattern, tissue quality, and blood supply allow; otherwise the unstable fragment is trimmed. A knee arthroscopy is the usual approach for these procedures.

• Knee arthroscopyKnee

For a fuller explanation, including anatomy, diagnosis, and the full range of treatment:

• Meniscus Tears — AAOS OrthoInfo