Knee pain is a common ailment for many of us and a meniscus tear is among the most common of knee injuries. Athletes who play contact sports are at risk for a meniscus tear, but it can happen to anyone. Let’s learn more about the meniscus itself, what a tear means and how it can be treated.
What is a meniscus tear?
The meniscus is a rubbery, C-shaped disc that cushions your knee. Each knee has two menisci—one at the outer edge of the knee and one at the inner edge. They keep your knee steady by balancing your weight across the knee. You can tear a meniscus if you plant your foot and twist. The menisci can also wear down as we age and can then tear from squatting or kneeling.
What are the symptoms of a meniscus tear?
The symptoms of a meniscus tear depend on the size and location of the tear as well as your age and the health of your knee. Typically, symptoms include:
- Knee pain
- Difficulty walking
- Feeling unstable, like it “catches” when you move
- Difficulty straightening all the way
Some people have severe pain and swelling right away when the tear happens. Or they might have less pain and swelling at first but then notice that it gets worse over a few days.
Older people sometimes don't notice when the tear happens, but then they notice symptoms later.
How is a meniscus tear diagnosed?
If you have knee pain that you suspect is a torn meniscus, you’ll want to visit your doctor for a physical exam and diagnosis. Your provider will also ask about your past injuries and what you were doing when your knee started to hurt. They will look at both of your knees and check for tenderness, range of motion and stability of the knee.
You may have tests such as X-rays to check the bones of the knee or an MRI, which can give a clear picture of where a tear is and how it might be treated. The doctor may order the MRI if the diagnosis is not clear.
Some tears may feel better on their own with home care and rehab. For others, your doctor may recommend surgery to repair it or to remove part of the meniscus. Your doctor may refer you to an orthopedic doctor who specializes in bones and/or sports injuries.
How is a meniscus tear treated?
When deciding how to treat a torn meniscus, your provider will weigh a variety of factors. These factors include:
- Where the tear is
- How serious it is
- Your pain level
- Your age
- Your activity level
- Your doctor’s treatment preference
- When the injury happened
Your doctor will suggest the treatment that they think will work best for you.
Treatment options for a torn meniscus are:
Treatment without surgery. This includes resting, using ice, wrapping the knee in an elastic bandage, propping it up on pillows, and doing physical therapy. This treatment choice may include wearing a temporary knee brace.
Treatment with surgery. These options might include:
- Surgery to sew the tear together.
- Surgery to remove the torn section of the meniscus.
- Surgery to remove the entire meniscus.
In general, the decision whether to have surgery will come down to the symptoms you have and how severe they are, rather than how big the tear itself is. Whenever possible, meniscus surgery is done using arthroscopy, rather than through a large cut in the knee.
Extent and success of meniscus repair
It's best to keep as much of the meniscus as possible. If the meniscus can be repaired successfully, repairing it reduces the chance of knee joint degeneration compared with removing all or part of the meniscus.
Meniscus repair is more successful if:
- You are younger. Experts think people younger than about age 40 do best.
- Your knee has good stability from the ligaments.
- The tear is in the outer edge of the meniscus.
- The repair is done soon after the injury.
Meniscal repair may prevent degenerative changes in the knee joint. Many doctors believe that a successful meniscus repair lowers the risk of early-onset arthritis, because it reduces the stress put on the knee joint.
Meniscal transplant is another treatment for painful meniscus problems. It's often only done if you've already had part or all of your meniscus removed and don't have arthritis in your knee.
Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.