Meniscus Tear | Symptoms & Treatments | Reno Orthopedic Center (2023)

What is the Meniscus?

The meniscus are two C-shaped pieces of rubbery cartilage in the knee that fit between the femur (thigh bone) and tibia (shine bone). The meniscus act as shock absorbers and bumpers inside the knee joint. They allow the knee joint to glide smoothly and distribute the forces within the knee during activities such as walking, running, and jumping.

Meniscus Tear Causes and Symptoms

Meniscus tears come in many different shapes and sizes, and they can occur for a variety of reasons. Often times they occur as a result of a specific trauma such as landing awkwardly from a jump or being tackled in football. Other tears occur over time as a result of degeneration (wearing out) of the cartilage. In general, there are five common types of tears –flap, radial, vertical, bucket-handle, and degenerative. Each type has its own set of causes and treatment options.

In cases of traumatic tears, the patient often experiences an acute popping sensation in the knee followed by pain and swelling. In cases of degenerative tears, patients will sometimes experience the slow onset of symptoms. When a meniscus tear is symptomatic, a patient may experience pain, swelling, and/or mechanical symptoms (clicking, catching, and/or locking of the knee).

(Video) MENISCUS INJURIES: Common Symptoms and Treatment Options for Knee Pain - Dr. Brett Franklin

It is important to understand that each patient is different and the symptoms listed above do not always mean you have a meniscus tear. A diagnosis should be made by an orthopedic surgeon to ensure the injury is treated appropriately.

Diagnosis and Examination

Diagnosis is based on the patient history, physical exam, and imaging (such as X-rays and/or MRI). A meniscus tear can often be diagnosed on physical exam. The McMurray test is used to detect a tear of the meniscus, and will often cause pain and clicking when performed. Additional exam findings include swelling, pain with range of motion, and joint line tenderness.

In most cases, x-rays of the knee will appear normal. If there is a concern about a meniscus tear or other knee injury, an MRI is usually performed. An MRI can be used to determine the size and shape of a tear as well as, look for other knee injuries such as cartilage or ligament tears.

(Video) When Surgery is Necessary for Meniscus Tears

Types of Meniscus Tears

The meniscus is a C-shaped structure that sits inside the knee joint. There are different types of meniscus tears and the type of tear can usually be determined with a knee MRI. Described here are 5 common types of meniscus tears.

  • Radial Tear: Radial tears of the meniscus are the most common. These appear as small tears in the inner part of the meniscus. These tears occur in the avascular part of the meniscus (where there is no blood supply) and, as a result, have little ability to heal on their own.
  • Flap Tear: Flap tears of the meniscus (sometimes known as a parrot beak tears) also usually occur in the avascular portion of the meniscus. They can often cause mechanical symptoms such as catching and locking since they can flip in and out of position.
  • Vertical Tear: Vertical tears of the meniscus (sometimes known as longitudinal tears) are tears that develop along the circular curve of the meniscus tissue. When these tears get large enough, they can sometimes displace into the front of the knee and are then known as bucket-handle tears.
  • Bucket-Handle Tear: When vertical tears of the meniscus become large enough, they can sometimes displace (like the handle of a bucket) into the front of knee. This can result in a “locked knee,” where the patient can’t full straighten the knee joint. Bucket-handle tears usually require an urgent surgical evaluation.
  • Degenerative Tear: Degenerative meniscus tears (sometimes known as horizontal or complex tears) tend to develop over time as a result of “wear and tear,” and is often associated with knee osteoarthritis (loss of the smooth cartilage that coats the ends of our bones). These types of tears will usually not heal on their own given the poor blood supply to the meniscus as we get older, but they can often can be managed successfully without surgery.

Non-Surgical Treatment for Meniscus Tears

Surgery is not required in all patients with a meniscus tear. Your surgeon will take into consideration the tear type, as well as your specific lifestyle needs when determine the best treatment option. Non-operative treatment often includes a period of rest followed by a course of physical therapy. This allows the patient to build strength in the muscles surrounding the knee joint, allowing for normal knee function with activities. Nonsteroidal anti-inflammatory drugs (NSAIDs) may also be helpful in reducing pain and swelling. Lastly, some patients benefit from a corticosteroid injection into the knee. Corticosteroid is a strong anti-inflammatory and can often relive knee symptoms associated with a torn meniscus.

Surgical Treatment for Meniscus Tears

The majority of meniscus tears cannot scar in and heal on their own as a result of poor blood supply to the inner parts of the meniscus tissue. As a result, some patients continue to have symptoms that interfere with their desired activities despite initial non-operative treatment. In these situations, surgery is usually recommended.

(Video) Care and Treatment of Meniscal Tears

Meniscus surgery is usually performed through several small incisions around the knee and with the use of an arthroscope (a special camera to look in and around the knee joint). Surgery is approximately 1 hour in length and is usually performed as an outpatient procedure in an ambulatory surgery center (ASC).

Some meniscus tears are able to be repaired by the surgeon with several small stitches. In some situations, the torn meniscus cannot be repaired and, as a result, the surgeon debrides and trims away the torn meniscus tissue to prevent further damage to the knee joint. Whether or not a repair is performed depends on the meniscus tear pattern, size, and location, but children and young adults have a higher rate of repair than other age groups. The decision whether to repair or debride a meniscus, is ultimately made at the time of surgery depending on the tear pattern, size, and location.

Complications

There are potential complications with any surgical procedure. With meniscus surgery, some of the potential complications include knee stiffness, re-tear of the meniscus, and infection. In order to minimize the risk of these complications, your surgeon will give you antibiotics during the procedure (to minimize risk of infection) and you will begin formal physical therapy within 1-2 weeks of surgery (to minimize the risk of stiffness and/or re-tear). Fortunately, these complications are rare, but when they do occur, additional surgery can sometimes be required.

(Video) Meniscus Tear - Andrews Sports Medicine & Orthopaedic Center

Recovery

Meniscus surgery is usually about one hour in length and is usually performed as an outpatient procedure in an ambulatory surgery center (ASC). Following surgery, patients are given specific instructions in order to ensure the best possible outcome. This includes a small prescription of pain medications and specific instructions regarding activity and wound care. Your surgeon may also have you use crutches and a knee brace for a period of time following surgery, depending on whether a repair or debridement was performed. In most cases, patients will participate in formal physical therapy to help rehabilitate the knee. Following a meniscus surgery, patients are able to return to sports between six and 12 weeks following surgery, although this may vary depending on the specific surgery performed.

Outcomes

Overall, the outcomes of meniscus surgery are excellent. With the appropriate physical therapy and rehabilitation, patients can expect to return to their normal pre-injury activity level. Unrestricted return to sports such as skiing, soccer, football, and basketball usually occurs between 6 and 12 weeks following surgery.

Why Choose ROC?

Your best chance at having an excellent outcome following a meniscus injury is to have things done right the first time. It’s important to have the correct diagnosis, receive the appropriate treatment, and rehabilitate the knee, all in a timely manner. At Reno Orthopedic Center, we have fellowship-trained sports medicine surgeons who focus on treating knee injuries. Our Sports Medicine Team has the training, experience, and expertise to treat your knee injury and get you back to the activities you love.

(Video) Meniscus Tears Explained by Dr. James Bullock of The Orthopaedic Center of South Florida

FAQs

What is the best treatment for a meniscus tear in the knee? ›

Your doctor may recommend the RICE regimen—rest, ice, compression, and elevation—to treat a meniscus tear. Resting your knee can help relieve your symptoms. Your doctor may suggest using a cane for a few weeks to keep weight off your knee and to stay away from physical activity that may have contributed to the injury.

What are 2 treatments for a meniscus tear? ›

Conservative treatment — such as rest, ice and medication — is sometimes enough to relieve the pain of a torn meniscus and give the injury time to heal on its own. In other cases, however, a torn meniscus requires surgery.

What are 3 signs of a meniscus tear in the knee? ›

Symptoms of a meniscus tear may be different for each person, but some of the most common symptoms are:
  • Pain in the knee joint: usually on the inside (medial), outside (lateral) or back of the knee.
  • Swelling.
  • Catching or locking of the knee joint.
  • Inability to fully extend or bend the knee joint.
  • Limping.

Is it worth fixing a torn meniscus? ›

When possible, it's better to fix the meniscus than to remove it. If the meniscus can be fixed, you have a lower risk of future joint problems. Your doctor will likely suggest the treatment that he or she thinks will work best for you based on where the tear is, the pattern of the tear, and how big it is.

Is walking good to rehab torn meniscus? ›

Benefits of walking after a meniscus tear

A 2015 review of studies spanning 21 years suggests that a faster rehabilitation with full weight bearing and early range of motion exercises might be a good path forward for many people.

Is walking OK with torn meniscus? ›

Unless the torn meniscus has locked the knee, many people with a torn meniscus can walk, stand, sit, and sleep without pain. Other people find that the torn meniscus prevents them from participating comfortably in their usual daily activities.

Will a knee brace help a torn meniscus? ›

Will a knee brace help a torn meniscus? Yes. Although knee braces do not heal or treat your meniscus tear directly, they can provide extra support and stability for your knee while your meniscus injury heals. A good brace will protect your knee and take the pressure off your meniscus, allowing it to rest.

What is the average recovery time for a torn meniscus? ›

Meniscus tears are the most frequently treated knee injuries. Recovery will take about 6 to 8 weeks if your meniscus tear is treated conservatively, without surgery. The time varies, depending on: the type and severity of the tear.

Do cortisone shots work for torn meniscus? ›

A cortisone injection can effectively reduce pain and inflammation in your knee, as in the case of a torn meniscus. It's only a temporary solution to your pain, though. It can't heal your meniscus and may even delay your healing. It also can't prevent you from injuring it again in the future.

What aggravates a torn meniscus? ›

Avoid activities that aggravate your knee pain, especially any activity that causes you to twist, rotate or pivot your knee. If your pain is severe, using crutches can take pressure off your knee and promote healing.

Should someone over 65 have meniscus knee surgery? ›

Research: For many patients who are over 50, arthroscopic meniscus surgery should not be offered. Instead, patients should continue with nonoperative management until total knee replacement is unavoidable.

What happens if a meniscus tear is left untreated? ›

If not treated, part of the meniscus may come loose and slip into the joint. You may need surgery to restore full knee function. Untreated meniscus tears can increase in size and lead to complications, such as arthritis.

When should you get meniscus surgery? ›

Each knee has two menisci. They are rubbery, C-shaped cushions that serve as shock absorbers in the knee joint. If your meniscus is injured or torn (often called torn cartilage), your healthcare provider may recommend surgery to remove the damaged part or repair it.

When is meniscus surgery necessary? ›

Tears on the outer one-third of your meniscus can heal independently because this area has a rich blood supply, and blood cells can regenerate the meniscus tissue. However, if the tear is located on the inner two-thirds, the tear will not repair itself and will need to be surgically removed.

How painful is meniscus repair surgery? ›

Arthroscopic meniscus repair is moderately painful. Because more soft tissue surgery is performed, it is more painful than a standard arthroscopy, but less painful than a ligament reconstruction or another procedure that requires drilling holes through the bone.

What activities should you avoid with a torn meniscus? ›

Avoid positions and activities that place excessive pressure on knee until pain and swelling resolve. Problematic positions include squatting, pivoting, repetitive bending (eg, climbing stairs, rising from seated position, operating clutch and pedals), jogging, and swimming using the frog or whip kick.

How can I speed up recovery from a torn meniscus? ›

To speed the recovery, you can:
  1. Rest the knee. ...
  2. Ice your knee to reduce pain and swelling. ...
  3. Compress your knee. ...
  4. Elevate your knee with a pillow under your heel when you're sitting or lying down.
  5. Take anti-inflammatory medications. ...
  6. Use stretching and strengthening exercises to help reduce stress to your knee.
26 Jan 2022

Will exercising with a torn meniscus make it worse? ›

Many runners get back on the road, even elite runners, with a degenerative meniscus tear. If you have a mild ache during the run, or a mildly sore knee after a run then you can often continue running. There is very little risk that running will worsen the tear.

Can you climb stairs with a torn meniscus? ›

Over time, a meniscus tear may become more severe and cause further damage if left untreated. Further, certain activities may cause symptoms to flare up. Some patients might find it difficult and painful to climb stairs, or even to get out of bed.

Can you live with a torn meniscus? ›

You can live with a meniscus tear,” Dr. Parker says. “And it may heal on its own, or just not cause you problems.” However, you'll know pretty quickly when it is a problem.

How do you sleep with a knee meniscus tear? ›

Sleep on your back with the leg slightly elevated

This is especially important during the first few days after meniscus surgery. Keeping the leg elevated (but not bent!) encourages healthy circulation, which helps keep pain and swelling in check.

Should I bend my knee with torn meniscus? ›

Rest your knee when possible. Do not squat or kneel. Take pain medicines exactly as directed.

Is heat or cold better for torn meniscus? ›

Ice Treatment: Ice is used in treating acute (new) injuries such as ankle sprains, fractures, and meniscus tears (torn cartilage in the knee). These types of injuries produce sudden, and often severe, pain and bring swelling (inflammation), tenderness, and the inability to put weight on the area.

Do they put you under for meniscus surgery? ›

Typically, the surgery can be performed under regional anesthesia with sedation, so there's minimal anesthesia risk. Occasionally, small stitches can be placed into the torn cartilage to sew it back together; this technique can successfully treat large tears in younger people. If the tear is small, it may be removed.

Do most torn meniscus need surgery? ›

Once your doctor has officially diagnosed you for a torn meniscus, they will most likely recommend non-surgical treatments first. However, if those treatments don't work or your injury is too severe, you will require surgery.

What is the downside to a cortisone shot? ›

The Downsides

According to the National Institutes of Health, the side effects from cortisone shots include: Dizziness or headaches. Skin issues, including dryness, thinness, acne, dry skin, and red or purple blotches. Fatigue and trouble sleeping.

How do you avoid meniscus surgery? ›

There are also a few exercises you can try at home, including:
  1. Heel Slides. To unlock your knee, try heel slides. ...
  2. Straight Leg Raises. Strong hips keep your knees in alignment, so it's important to maintain your hip strength. ...
  3. Single Leg Stance. ...
  4. Relearn How to Jump and Hop. ...
  5. Biking.
18 Feb 2020

Should you avoid walking with a torn meniscus? ›

For most people, it is safe to walk with a torn meniscus. Activities that involve twisting or squatting are more likely to cause pain and discomfort than walking. However, if you find that you experience pain when walking with a meniscus tear, try to rest your knee instead.

How do I know if my meniscus tear is severe? ›

A tear is usually labeled as severe if the meniscus has a big tear. Loose pieces may cause the knee joint to lock or catch. This level of injury may also keep you from bending or straightening your leg and can make walking difficult. Severe tears usually require surgery to repair.

Can a meniscus tear be seen on xray? ›

Imaging Tests

Even though x-rays do not show meniscus tears, they may indicate other knee pain causes, such as osteoarthritis. MRI (Magnetic resonance imaging). This test creates better images of the soft tissues of your knee joint, like a meniscus.

How do you treat a torn meniscus in the elderly? ›

In older adults, meniscus tears occur gradually as a result of everyday wear and tear.
...
Meniscus Tear Treatment Options
  1. Extra rest to stay off the joint.
  2. Anti-inflammatory medications and ice packs to reduce the swelling.
  3. Physical therapy or short-term rehabilitation to improve the joint's range of motion.
2 May 2020

How long do you stay in hospital for meniscus surgery? ›

Arthroscopic meniscus repair typically takes about 40 minutes to perform, and usually you will be able to leave the hospital the same day. There are three main types of meniscus repairs.

At what age should you not have knee replacement surgery? ›

Doctors do sometimes recommend that people under age 60 wait to undergo a knee replacement procedure, because these artificial joints typically last only about 15 to 20 years. If someone younger gets the procedure, it's likely that the joint will need to be replaced again down the line.

How long does a meniscus tear take to heal without surgery? ›

Meniscus tears are the most frequently treated knee injuries. Recovery will take about 6 to 8 weeks if your meniscus tear is treated conservatively, without surgery. If your symptoms persist after 3 months or your symptoms become significant, your doctor may recommend surgery to repair the tear.

How can I regenerate my meniscus naturally? ›

How to Heal a Torn Meniscus Naturally
  1. Rest: It's crucial to rest your knee after injury. ...
  2. Ice: Apply ice to your knee for 15 minutes at four-hour intervals.
  3. Compression: To help reduce swelling, you should keep something on your leg.

Can you walk immediately after meniscus surgery? ›

The meniscus is a piece of cartilage in the knee, often injured in sports. You can't walk right after surgery. How long recovery takes depends on the type of meniscus surgery and the severity of the injury, but expect two weeks down time, at minimum.

Will I need crutches after meniscus surgery? ›

Arthroscopic surgery for a torn meniscus (meniscectomy)

It may take 4-5 months for full healing. The patient should be able to bear weight on the knee while standing or walking, immediately after surgery. Crutches will be necessary for 2-7 days after surgery.

What are the 3 types of meniscus repairs? ›

Currently, there are three main methods for the surgical management of meniscus tears: meniscectomy, meniscal repair, and meniscal reconstruction.

Can you fix a torn meniscus without surgery? ›

Non-surgical treatment for tears that can heal on their own may include: Physical therapy. RICE: Rest, Ice, Compression, Elevation. Anti-inflammatory medications.

How long does it take to heal a meniscus tear without surgery? ›

Meniscus tears are the most frequently treated knee injuries. Recovery will take about 6 to 8 weeks if your meniscus tear is treated conservatively, without surgery. If your symptoms persist after 3 months or your symptoms become significant, your doctor may recommend surgery to repair the tear.

Can a knee meniscus tear heal on its own? ›

If the tear is in the outer third of the meniscus, it may be able to heal on its own because that area has a rich blood supply. Blood cells help repair tissue naturally. If the tear is in the inner two-thirds of the meniscus, surgery may be necessary.

How long should a torn meniscus take to heal? ›

Typically, mild meniscus tears heal within two to three weeks.

Does a cortisone shot help a torn meniscus? ›

A cortisone injection can effectively reduce pain and inflammation in your knee, as in the case of a torn meniscus. It's only a temporary solution to your pain, though. It can't heal your meniscus and may even delay your healing. It also can't prevent you from injuring it again in the future.

Can a torn meniscus be seen on xray? ›

Imaging Tests

Even though x-rays do not show meniscus tears, they may indicate other knee pain causes, such as osteoarthritis. MRI (Magnetic resonance imaging). This test creates better images of the soft tissues of your knee joint, like a meniscus.

What kind of brace should I wear for a torn meniscus? ›

When looking for a brace for a torn meniscus, look for one that offers compression. Braces that compress are usually made of neoprene or fabric, Dr. Walter says. Finally, look for brace types called “unloader braces.” They "can take pressure off the injured side, whether it's the medial or the lateral side.

Can I climb stairs after meniscus surgery? ›

Answer: Immediately after surgery you will learn to climb stairs safely using crutches. As recovery continues and you work on flexion and extension of the new knee, you will be able to climb without crutches. With the help of physical therapy and building up the quadriceps muscles, stair climbing will be a breeze.

How soon after meniscus surgery can I walk? ›

Arthroscopic surgery for a torn meniscus (meniscectomy)

It may take 4-5 months for full healing. The patient should be able to bear weight on the knee while standing or walking, immediately after surgery. Crutches will be necessary for 2-7 days after surgery.

How do you rehab a torn meniscus? ›

Stand with your feet 8 to 10 centimetres apart, with your hands lightly resting on a counter or chair in front of you. Slowly raise your heels off the floor while keeping your knees straight. Hold for about 6 seconds, then slowly lower your heels to the floor. Do 8 to 12 repetitions several times during the day.

Videos

1. Knee Meniscus Injuries & Treatments
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2. Dr. Fuller talks about Meniscus Tears
(Panorama Orthopedics & Spine Center)
3. How to IDENTIFY one of the WORST Meniscus Tears of the Knee: The ROOT Tear
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4. Knee Pain? It Could Be Your Meniscus
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5. I Compare Meniscus Tear Surgery vs Physical Therapy
(Jeffrey Peng MD)
6. Dr. Zoltan explains Arthroscopic Procedure to repair the Meniscus Tear
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