Meniscus Injuries

What is a meniscus?

The menisci are two crescent-shaped pieces of cartilage between the thighbone (femur) and shinbone (tibia). They help distribute load, absorb shock and contribute to knee stability.

A meniscus can tear after twisting the knee, particularly during sports. With increasing age, the meniscus may also become more vulnerable to tearing during relatively minor movements.

What are the symptoms of meniscus tear?

You may experience:

• Pain, particularly along the joint line

• Swelling

• Clicking or catching

• Difficulty squatting

• Restricted movement

• A sensation of locking in some tears

How is a meniscus tear diagnosed?

Your history and examination are important. Clinical tests can suggest a meniscal injury, while MRI provides detailed information about the tear and other structures of the knee.

Does every meniscus tear require surgery?

No.

Many tears can initially be treated with activity modification, medication when appropriate and physiotherapy, particularly when symptoms are manageable and there is no significant mechanical locking.

When might surgery be considered?

Surgery may be considered when symptoms persist despite appropriate non-operative treatment or when a tear is causing significant mechanical symptoms.

Whenever possible, the aim is to preserve and repair healthy meniscal tissue rather than remove it, because the meniscus has an important role in protecting the knee.

What happens if surgery is not done?

Some tears become comfortable with rehabilitation and do not require surgery.

However, persistent pain, recurrent swelling, catching or true locking may indicate that further treatment is necessary. The location, pattern, age of the tear and condition of the meniscal tissue all influence the decision.

Can every meniscus tear be repaired?

No. Not every meniscus tear is suitable for repair. The decision depends on the type, location and age of the tear, the quality of the meniscal tissue, blood supply and whether the tissue can be restored to a stable position.

Some tears are difficult to repair successfully because the damaged part of the meniscus has a poor ability to heal, the tissue has become too damaged or the tear has been present for a long time. In such cases, trying to repair the meniscus may not provide a reliable result. If repair is unlikely to heal, removing only the damaged and unstable portion (partial meniscectomy) may be the better option while preserving as much healthy meniscus as possible.

Does removing part of the meniscus damage the knee permanently?

Not necessarily. Whenever possible, preserving and repairing healthy meniscal tissue is preferred because the meniscus helps protect the knee. However, when a portion of the meniscus is irreparably damaged and is causing persistent symptoms or mechanical problems, removing only the unstable or damaged portion (partial meniscectomy) may be the appropriate treatment.

The goal is to preserve as much healthy, functional meniscus as possible, rather than choosing repair or removal based simply on the name of the tear.

Why not repair every meniscus tear?

A repair is useful only when the torn tissue has a reasonable chance of healing and can be restored to a stable position. A repair that is unlikely to heal may leave the patient with persistent symptoms and can sometimes require another operation. Treatment therefore involves balancing the potential benefits of preservation against the likelihood that the repair will actually heal.

The decision is based on the individual tear, tissue quality, patient factors and associated knee problems, rather than the MRI diagnosis alone.

When can I return to normal activity?

Recovery depends considerably on whether the torn portion of the meniscus is removed (partial meniscectomy) or the meniscus is repaired. Recovery is generally faster after partial meniscectomy, while a repair requires more time because the meniscus needs to heal.

After a partial meniscectomy, many patients can return to routine daily activities within 1–2 weeks and to regular work in approximately 3–6 weeks, depending on the nature of their job. Physically demanding work may require longer.

After meniscal repair, return to regular activities is slower. Patients should generally plan for approximately 6–8 weeks before returning to regular work, with physically demanding work potentially requiring longer. Rehabilitation continues for several months as strength, movement and function recover.

These are approximate timelines for planning purposes and may vary depending on the type and location of the tear, the repair performed, associated injuries and individual recovery.

When can I return to sports?

Return to sports is generally faster after partial meniscectomy than after meniscal repair. After a partial meniscectomy, some patients may begin progressive running and sport-specific activity within several weeks, with return to sports often possible around 6–12 weeks if pain, swelling, movement and strength have recovered.

After meniscal repair, the return is more gradual because the repaired tissue needs time to heal. Running and sport-specific training are generally introduced after several months, and return to unrestricted sports is commonly around 4–6 months, depending on the type of repair and rehabilitation progress.

Return to sport should be based on adequate movement, strength, knee control and sport-specific function rather than time alone.

When should I see an orthopaedic surgeon?

You should consider an orthopaedic assessment if knee pain, swelling, clicking or catching persists after an injury, particularly if these symptoms interfere with your daily activities, work or sports. Specialist assessment is especially important if your knee becomes locked or you are unable to fully straighten or bend it, as some types of meniscal tear can cause mechanical blockage.

An orthopaedic assessment is also appropriate when symptoms continue despite an initial period of rest, activity modification and rehabilitation, or when an MRI has shown a meniscal tear. Not every meniscal tear requires surgery, but a specialist can assess the type, location and condition of the tear and determine whether continued non-operative treatment, meniscal repair or partial meniscectomy is most appropriate.