Written by: Ben Piller


What Is the Meniscus?

The meniscus is a “wedge-shaped” piece of rubbery cartilage that fits between the tibia (shin bone) and the femur (thigh bone). There are two menisci in every knee as part of the normal anatomy of the human body. These are referred to as the medial (inside) meniscus and lateral (outside) meniscus. The medial meniscus is C-shaped, while the lateral meniscus is more semicircular in shape.

Inside the knee joint, the meniscus acts as bumpers and shock absorbers, allowing the knee joint to glide smoothly and distribute forces or stresses placed on it during activities like walking, running, or jumping.

Causes and Symptoms of Meniscus Tears

Sometimes, the meniscus can become damaged and they can become torn. This can happen for several different reasons and come in all shapes and sizes. Like many other injuries, meniscus tears can result from trauma.

For example, an awkward landing from a jump can cause these tears or being tackled during a football game. Trauma is not the only thing that can tear a meniscus, though. Tearing injuries can also happen simply as a result of degeneration of the meniscus through years of them being worn out.

When a tear happens due to trauma, you may often experience a popping sensation in the knee, followed by pain and swelling. When a tear occurs because the meniscus is worn out, you may experience a slower onset of symptoms. These symptoms can present themselves as pain or swelling (like the tears caused by trauma) but could also be mechanical symptoms, like clicking, catching, and/or locking of the knee.

Diagnosis and Examination

A diagnosis of a torn meniscus can be made based on patient history, physical exam, and imaging (ex., X-ray, MRI). X-rays, however, can appear normal, so an MRI may be needed to visualize and diagnose a meniscus tear properly. Commonly, a meniscus tear is diagnosed during a physical exam.

The McMurray test is often utilized, during which an inward or outward force is placed on the knee while it is internally or externally rotated (see image for McMurray test of medial meniscus). This test may cause pain or clicking when a torn meniscus is present. Physical exam findings may also be swelling, pain with movement, or tenderness of the joint line.

Meniscus Tear Types

There are 5 common types of meniscus tears, including flap tears, vertical tears, bucket handle tears, degenerative tears, and a radial meniscal tear. These different types of meniscal tears are listed and explained below:

  1. Radial Meniscus Tear: These are the most common type of meniscus tear. Radial meniscal tears originate from the central part of the meniscus and extend outward toward the outer edge. These radial meniscus tears are in the avascular (no blood supply) part of the meniscus, making healing radial tears extremely difficult.
  2. Flap Tear: These also occur in the avascular part of the meniscus. These tears can flip in and out of position, which can cause catching and locking of the knee.
  3. Vertical Tear: Vertical tears happen along the circular curve of the meniscus tissue. When they get large enough, they can become bucket-handle tears.
  4. Bucket-Handle Tear: When a vertical tear becomes so large that it displaces to the front of the knee, it is known as a bucket-handle tear. This can cause a locked knee, where the patient cannot fully straighten their knee joint. This type of tear is more urgent and typically requires prompt surgical evaluation.
  5. Degenerative Tears: Degenerative meniscus tears of the meniscus develop due to “wear and tear” and can happen over a long period of time. These tears are often associated with knee osteoarthritis, which is the loss of the cartilage at the ends of the bones that make up the knee joint. These tears will not usually heal on their own because, as we age, the meniscus receives less adequate blood supply. These tears can, however, often be managed without surgery.

Non-Surgical Treatment for Meniscus Tears

If you have a meniscus tear, surgery may not be necessary. One option for non-surgical meniscus repair tear is a period of rest followed by physical therapy. This can allow you to build stronger muscle surrounding the knee joint, allowing your knee to function as expected.

Non-steroidal anti-inflammatory drugs (NSAIDs) can also be used to reduce the pain and swelling associated with a meniscus tear. You may also be given a corticosteroid injection into your knee joint. These are strong anti-inflammatory drugs and work well to relieve meniscus tear symptoms.

Surgical Treatment and Complications 

Due to the poor blood supply to the inner parts of the meniscus, tears often will not heal on their own, which can cause symptoms that interfere with your normal daily activities. For this reason, you may need surgery to repair a tear in your meniscus.

This type of surgery is typically performed by making several small incisions around the knee and using an arthroscope (a camera to look inside the knee joint). This is usually an outpatient procedure.

Some meniscus tears can be prepared through the use of stitches by the surgeon. Some cases, however, cannot be repaired in this way. When this is the case, the surgeon will trim away the torn portion of the meniscus to prevent further damage to the knee joint.

Whether a meniscus tear is repaired or trimmed away depends on the tear’s pattern, size, and location. Younger patients, like children and young adults, have higher repair rates than older people. Still, ultimately, the decision of whether to repair or trim the meniscus will be made at the time of surgery based on the characteristics of the tear.

Some complications could arise from meniscus surgery, just like any surgical procedure. Complications could be knee stiffness, re-tearing of the meniscus, or infection. To prevent infection, the surgeon will give you antibiotics during your surgery. You will likely begin physical therapy 1-2 weeks after surgery to avoid stiffness or re-tearing of the meniscus.

Recovery and Outcomes

To help with your recovery after surgery, you may be given a small prescription for pain medication and instructions to help with wound care for your surgical incisions.

It is possible that the surgeon may also recommend that you walk with crutches or wear a knee brace for some time after the surgery. Physical therapy will help with your recovery, and you will likely be able to return to sports 6-12 weeks after your meniscus surgery.

Outcomes for meniscus surgery are excellent! With appropriate rehabilitation, you can return to all of your pre-surgery activities with no drop in quality.

Why Choose OrthoNeuro?

If you are experiencing the symptoms of a meniscus tear or are considering meniscus surgery, see one of our Board-Certified Orthopedic Surgeons at one of our 7 Greater Columbus locations. One of our knee specialists will evaluate your lifestyle and goals to determine the best treatment option for you.

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