ConditionBones, joints & muscles
Meniscus Tear (Torn Meniscus)
A meniscus tear is a tear in one of the two C-shaped cartilage pads that cushion the knee between the thigh and shin bones. In younger people it usually happens with a sudden twist on a bent knee during sport; in people over 40 it often develops from gradual wear, sometimes with a minor movement such as squatting. Symptoms include knee pain, swelling, stiffness and catching or locking. Most degenerative tears improve with physical therapy, while some traumatic tears need arthroscopic repair.
Also called: Torn meniscus, torn cartilage, meniscal tear, knee cartilage tear
At a glance
- What it is
- A tear in the C-shaped cartilage cushions (medial or lateral meniscus) of the knee.
- Types
- Traumatic (sport, twisting, often younger people) and degenerative (wear, over 40).
- Symptoms
- Pain along the joint line, swelling over 24 hours, stiffness, catching or locking.
- Diagnosis
- Examination and MRI.
- Treatment
- Rest, ice, physical therapy; arthroscopic repair or partial removal for locking or repairable tears.
When to get help
Call 911 or go to the ER
- A knee that is deformed or dislocated after an injury, or a cold, pale or numb foot
See a doctor within a day or two
- A knee that is locked and cannot fully straighten
- A pop with immediate swelling and inability to bear weight after a twisting injury (possible ACL tear)
- A hot, red, swollen knee with fever
Book a routine appointment
- Knee pain along the inner or outer joint line that has not improved after 2 to 3 weeks
- Catching, clicking with pain, or the knee giving way
- Recurring swelling after activity
Usually safe to manage at home
- Mild knee pain and swelling after a twist, with full movement and ability to walk, improving over a few days
What the meniscus does
Each knee has two menisci:
- the medial meniscus on the inner side, more often torn
- the lateral meniscus on the outer side
They act as shock absorbers, spread load across the joint, and help stabilize the knee. Only the outer third has a good blood supply (the "red zone"), which affects whether a tear can heal.
Types of meniscus tear
| Traumatic | Degenerative | |
|---|---|---|
| Who | Younger, active people | Usually over 40 |
| Cause | Sudden twist or pivot on a bent knee, deep squat with rotation | Gradual weakening; minor movement or no clear injury |
| Associated injuries | Often with an ACL tear | Often with knee osteoarthritis |
| Typical treatment | Repair if possible, especially in young people | Physical therapy first |
Tear patterns include vertical, horizontal, radial, flap, complex and bucket-handle tears. A bucket-handle tear can flip into the joint and lock the knee.
Symptoms
- a pop at the time of injury (traumatic tears)
- pain along the inner or outer side of the knee, especially with twisting or squatting
- swelling that develops over 24 to 48 hours, sometimes with a fluid-filled Baker's cyst behind the knee
- stiffness and difficulty fully bending or straightening
- catching, clicking or a feeling that something is in the way
- locking: the knee gets stuck and cannot straighten
- the knee giving way, which can also point to ligament damage and joint instability
Many degenerative tears found on MRI in older adults cause no symptoms at all.
Diagnosis
- examination: tenderness along the joint line, pain with deep bending, and special tests such as McMurray's test
- X-rays: to check for arthritis or fractures, which change treatment
- MRI: shows the tear's location and pattern and other injuries such as ligament tears
Treatment
Initial care
- relative rest from activities that hurt
- ice for 15 to 20 minutes several times a day
- compression and elevation
- ibuprofen, naproxen or acetaminophen (paracetamol), following the label dose
- crutches if needed for the first days
Physical therapy
For degenerative tears, and many stable traumatic tears, structured exercise therapy is the first-line treatment. Studies comparing physical therapy with arthroscopic partial meniscectomy for degenerative tears found similar improvement at 1 to 2 years, so surgery is not routinely recommended for these. Strengthening the quadriceps, hamstrings and hip muscles reduces load on the meniscus.
Injections
A corticosteroid injection may ease pain in people with a degenerative tear and arthritis.
Surgery
Arthroscopic (keyhole) surgery may be recommended for:
- a locked knee or a displaced bucket-handle tear
- a repairable tear in a young person, especially in the outer, well-supplied zone, or with an ACL reconstruction
- persistent mechanical symptoms despite physical therapy
Options:
- meniscus repair: stitching the tear to preserve tissue. Recovery takes about 3 to 6 months, often with restricted weight-bearing or knee bending early on
- partial meniscectomy: trimming away the torn part. Recovery is faster (a few weeks), but removing meniscus tissue increases the long-term risk of arthritis
Recovery time
| Treatment | Typical return to activity |
|---|---|
| Physical therapy for a minor or degenerative tear | Improvement over 6 to 12 weeks |
| Partial meniscectomy | Daily activities in 1 to 2 weeks; sport in about 4 to 6 weeks |
| Meniscus repair | Sport in about 4 to 6 months |
Long-term outlook
Most people return to normal activities. Meniscus tears that happen alongside several torn ligaments, as in a multi-ligament knee injury, need more complex reconstruction. Meniscus tears, especially with meniscus removal, increase the risk of knee osteoarthritis over time. Keeping thigh muscles strong and maintaining a healthy weight help protect the knee.
Frequently asked questions
What are the symptoms of a torn meniscus?
Common symptoms are pain along the inner or outer knee, swelling developing over a day or two, stiffness, and catching or locking. Many people feel a pop at the time of a twisting injury. Some degenerative tears cause few symptoms.
Can a torn meniscus heal on its own?
Tears in the outer edge, which has a good blood supply, can heal. Most tears in the inner part do not heal fully but often stop causing symptoms with rest and physical therapy. Locked knees and some tears need surgery.
How long does it take to recover from a meniscus tear?
Minor or degenerative tears often improve over 6 to 12 weeks with physical therapy. After partial meniscectomy, most people return to sport in 4 to 6 weeks. After meniscus repair, return to sport usually takes 4 to 6 months.
Do I need surgery for a meniscus tear?
Not usually for degenerative tears, where physical therapy works as well as surgery for most people. Surgery is considered for a locked knee, repairable tears in young people, tears with an ACL injury, and persistent mechanical symptoms.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Orthopaedic Surgeons (OrthoInfo): Meniscus tears
- AAOS: Management of Osteoarthritis of the Knee (Non-Arthroplasty) Clinical Practice Guideline
- BMJ Rapid Recommendations: Arthroscopic surgery for degenerative knee arthritis and meniscal tears
- MedlinePlus: Knee injuries and disorders
- NHS: Knee pain