The meniscus acts as a shock absorber, protecting your joint cartilage and spreading the load during activities.
A torn meniscus it is often called 'torn cartilage' and can happen in the young and old.
The knee joint is made up of three bones – the thighbone (femur), shinbone (tibia) and kneecap (patella) – and is stabilised by four main ligaments.
It is often painful in the early stages and may cause a catching or clicking sensation.
An MRI scan will show where the tear is and if it needs surgery or can be managed through physical therapy. The scan will also show any other cartilage or ligament injuries.
The meniscus is a c-shaped, tough piece of cartilage inside the knee joint. It sits between the ends of the thigh bone (femur) and lower leg (tibia), acting as a shock absorber.
We have a medial meniscus on the inner knee and a lateral meniscus on the outer side of the knee. A meniscus is torn when it becomes trapped between the femur and tibia, usually during a twisting motion. It can happen alongside other injuries such as an ACL tear.
A torn meniscus it is often called 'torn cartilage'. It’s a common knee injury in younger people, especially in sports that involve twisting and turning (such as soccer, netball, basketball and football). This is known as an ‘acute’ tear.
As we get older, the menisci gradually lose their blood supply and become more brittle. This makes them easier to injure. It also makes them less likely to heal with or without surgery. Middle-aged and older patients often tear their meniscus with no specific injury or from a low impact activity such as walking on the beach. This is known as a ‘degenerative’ tear.
Meniscal tears can also be part of osteoarthritis. We often see patients who show meniscal tears in an MRI but have pain from knee osteoarthritis instead. This is important as meniscus repair surgery can make the pain worse in these patients.
In an acute meniscal injury, you may feel a tearing or popping sensation. It is often painful in the early stages: this pain is usually sharp, stabbing, and be pinpointed to the side of the knee where the tear has occurred. Pain comes on rapidly with twisting movements of the knee but often disappears quickly.
Any swelling is usually worst within a few hours of the injury. If the meniscal tear creates a flap of tissue, it can get trapped in the knee causing a catching or clicking sensation. Occasionally the tear can cause the knee to 'lock': this is where you can’t fully straighten your knee. Sometimes it can be ‘unlocked’ by wiggling and twisting the leg although often it needs surgery to remove or repair the jammed cartilage.
If a tear happens in a knee that also has osteoarthritis, you may have an aching pain on that side of the knee (usually the inner side). This is usually worse with exercise and can also be painful at night. The knee will often click and catch.
A GP, physiotherapist or specialist can diagnose a torn meniscus by asking about your injury, examining your knee, and performing an MRI. The MRI shows whether you have a tear, whether it’s repairable and, whether there is any other cartilage or ligament injury.
Nearly all meniscal tear patients benefit from non-operative treatments before surgery.
Firstly, we settle your knee down so it can be used for day-to-day activities. This involves anti-inflammatories such as ibuprofen, diclofenac or meloxicam for 1 to 2 weeks, which helps reduce any swelling and pain in the knee.
**Please check with your doctor or specialist that these medicines are safe for you first.
It is important to reduce the impact going through your knee during recovery – avoid running and jumping. Some compression bandaging or bracing can be useful as can ice packs.
A physiotherapist then assesses the strength and function of your legs: not just in the knees, but also your hips and core. They can then direct your exercise program which reduces the load on your knees, balances it to reduce your risk of re-injury, and strengthens you to improve your speed, endurance, or distance with the driver off the first tee.
The exercise program can take 2-3 months to make a difference but it works for most simple meniscal tears. If the meniscal tear is still causing problems despite all the above, it’s time to consider surgery.
Meniscal tear repair surgery is an arthroscopic (keyhole) procedure. Please make an appointment with the surgeon to discuss what is most appropriate for you.