Meniscus Tear
A tear in the cushioning cartilage of the knee
Quick Facts
- Type: Knee injury
- Common causes: Twisting the knee, wear with age
- Typical signs: Pain, swelling, catching or locking
- Treatment: Often rest and therapy; sometimes surgery
Overview
Each knee has two menisci, C-shaped pieces of tough, rubbery cartilage that sit between the thighbone and shinbone. They act as shock absorbers and help keep the knee stable. A meniscus tear is one of the most common knee injuries.
Tears happen in two main ways: a sudden twist or pivot of the knee, often during sports, or gradual weakening of the cartilage with age that allows it to tear with minor movements such as squatting or standing up. Treatment depends on the size, location, and type of tear, as well as the person's age and activity level. Many tears improve with non-surgical care, while others need surgery.
Symptoms
Symptoms can begin right away or develop over a day or two after the injury.
- Pain in the knee, often along the joint line on the inner or outer side
- Swelling and stiffness
- A popping sensation at the time of injury
- A feeling that the knee catches, clicks, or locks
- Difficulty fully straightening or bending the knee
- A sense that the knee may give way
With age-related (degenerative) tears, the onset may be more gradual and without a clear injury.
Causes
A meniscus tear results from forces that the cartilage cannot withstand.
- Acute injury: Forceful twisting or rotating of the knee, especially with the foot planted, such as during basketball, soccer, or skiing. Deep squatting or heavy lifting can also tear the meniscus.
- Degeneration: Over time the cartilage becomes thinner and weaker, so even ordinary movements like rising from a chair or stepping awkwardly can cause a tear in older adults.
Tears sometimes occur together with other knee injuries, such as a ligament tear.
Risk Factors
- Sports that involve pivoting, cutting, or sudden stops
- Older age, due to natural thinning of the cartilage
- Existing knee osteoarthritis
- Work that involves frequent squatting, kneeling, or heavy lifting
- A previous knee injury
Diagnosis
Diagnosis combines the history of how the knee was hurt with a physical exam. The clinician checks for tenderness along the joint line and performs maneuvers that bend and rotate the knee to reproduce symptoms. Tests may include:
- MRI: The most useful imaging test for showing the soft cartilage and confirming a tear and its location.
- X-rays: Do not show the meniscus itself but can rule out fractures and assess for arthritis.
- Arthroscopy: Occasionally used both to view and to repair the joint directly.
Treatment
Treatment depends on the type and severity of the tear and the person's needs.
- Non-surgical care: Many tears, especially smaller or degenerative ones, improve with rest, ice, compression, elevation, anti-inflammatory medication, and physical therapy to restore strength and motion.
- Physical therapy: Strengthening the muscles around the knee helps support the joint and relieve symptoms.
- Surgery: Arthroscopic surgery may be recommended when the knee locks, when symptoms persist despite therapy, or for certain tear types. The surgeon may repair the tear or trim away the damaged portion.
Recovery time varies from a few weeks for conservative care to several months after a surgical repair.
Prevention
- Keep the thigh and leg muscles strong and flexible
- Warm up before sports and use proper technique for cutting and pivoting
- Increase the intensity of activity gradually
- Use supportive, well-fitting footwear
- Use safe lifting and squatting techniques
When to See a Doctor
See a doctor if your knee is painful, swollen, or stiff, if it catches or locks, or if you cannot fully straighten or bend it. Seek prompt care if you cannot put weight on the leg, if the knee looks deformed, or if there is sudden, severe swelling, as these may indicate a more serious injury.
Frequently Asked Questions
Does a meniscus tear always need surgery?
No. Many tears, particularly smaller or age-related ones, heal or become manageable with rest, physical therapy, and anti-inflammatory measures. Surgery is generally considered when the knee locks, when symptoms persist despite non-surgical care, or for specific tear types.
How do I know if I tore my meniscus?
Common signs include knee pain along the joint line, swelling, stiffness, a popping feeling at injury, and a sense that the knee catches, clicks, or locks. A doctor confirms the diagnosis with an exam and often an MRI, which shows the cartilage clearly.
How long does a meniscus tear take to heal?
It depends on the tear and treatment. Conservative recovery may take a few weeks to a couple of months, while recovery after a surgical repair can take several months. The outer part of the meniscus has a better blood supply and tends to heal more readily than the inner part.
Can I walk on a torn meniscus?
Many people can still walk, sometimes with a limp, but a knee that locks, gives way, or will not bear weight needs prompt evaluation. Continuing strenuous activity on a torn meniscus can worsen the tear.
What is the difference between an acute and a degenerative tear?
An acute tear results from a sudden injury such as twisting the knee, often in sports. A degenerative tear happens when cartilage weakens with age and tears during ordinary movements. The type influences which treatment is most appropriate.
References
- American Academy of Orthopaedic Surgeons (OrthoInfo). Meniscus Tears.
- Mayo Clinic. Torn meniscus — Symptoms and causes.
- MedlinePlus, U.S. National Library of Medicine. Meniscus tears.
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Sports Injuries.