Table of ContentsView AllTable of ContentsDefinitionSymptomsCausesDiagnosisTreatmentPrognosis
Table of ContentsView All
View All
Table of Contents
Definition
Symptoms
Causes
Diagnosis
Treatment
Prognosis
A meniscus tear is common sports injury that affects the C-shaped cartilage in the knee. Pain from a torn meniscus is felt at the front or sides of your knee. You may be able to bear weight on the injured leg at first. However, the knee will swell and become increasingly painful over the course of a few days.
Initial treatments for meniscal tears include rest, ice, compression, and elevation (R.I.C.E.), pain-relieving medications, steroid injections, andphysical therapy. In some cases, surgery may be needed.
This article discusses the symptoms, diagnosis and treatment for meniscal tears. It explains the anatomy of the knee, sports where meniscal tears are more likely to occur, and how meniscus tears are treated.
What Is a Meniscus Tear?
The meniscus is a type of C-shaped cartilage that sits within your knee joint between your thigh bone and shin bone. Each knee joint has two menisci—one on the outside of the knee (called the lateral menisci) and one on the inside of the knee (called the medial menisci).
The medial and lateral menisci act as shock-absorbers and also provide cushioning and stability to the knee, which is why any tear or damage to a meniscus results in pain, swelling, and sometimes, a feeling that the knee is giving out.
While knee meniscus tears are common in athletes, older people are particularly at risk too.
Torn Cartilage in the Knee Symptoms and Treatment
Symptoms of a Meniscal Tear
A meniscus tear results in pain in the front of the knee, either in the middle of the knee (from a medial meniscus tear, which is more common) or the side of the knee (from a lateral meniscus tear).
Often with a torn meniscus, a person can still walk and even continue to play their sport right after the injury. However, within a day or two, the knee becomes uncomfortably swollen and stiff.
Along with pain, swelling, and stiffness, depending onthe type and severity of the injury, other symptoms may include:
Meniscus Tear Causes
Most commonly, a meniscus tear results from an acute injury to the knee, often from a sudden twist of the knee while squatting during a sports activity.
Examples of sports that increase a person’s risk for a menisci tear include:
But meniscus tears can also occur due to age-related degenerative (wear-and-tear) changes (knee osteoarthritis).As people age, their menisci weaken and become more brittle and prone to damage.
Everyday movements like getting up improperly from a chair can be enough to cause a meniscus tear.
Diagnosing Meniscal Tears
The diagnosis of a meniscal tear requires a medical history, physical examination, and imaging.
Medical History
During your healthcare provider’s appointment, they will ask you several questions about your knee pain. Examples of such questions include:
Physical Examination
After taking a medical history, your healthcare provider will perform a physical exam in which they will inspect, press on, and move your knee joint to evaluate for swelling, tenderness, itsrange of motion, and clicking within the joint.
They will also check your leg muscle strength and assess your gait and ability to fully extend or bend your knee on your own.
The McMurray test is one classic test used to assess for meniscus damage.
How the McMurray Test Is Performed
Imaging
Even if your healthcare provider suspects a meniscus tear, they may first order anX-rayof your knee to assess for any bone breaks or other signs of knee pain, like osteoarthritis.
In general, though,magnetic resonance imaging (MRI)is the gold standard for diagnosing and evaluating a meniscus tear.
Conditions With Similar Symptoms
Other knee-related diagnoses may cause pain and symptoms that mimic that of a meniscus tear. Injury to the anterior cruciate, medial collateral, or lateral collateral ligaments are often suspected.
These can occur with a meniscus tear or independent of one.
Anterior Cruciate Ligament Injury
Ananterior cruciate ligament (ACL) tearmay occur when an athlete suddenly changes direction or lands from a jump incorrectly.Sometimes an ACL tear occurs along with a medial meniscal tear.
Such injuries can often be distinguished with a good history. An ACL tear may cause a “popping” sound or sensation and will often cause immediate swelling. In contrast, the swelling of an isolated medial meniscus tear tends to develop gradually over the course of one to two days.
An MRI can confirm one or both diagnoses.
Collateral Ligament injury
Collateral ligament injuries may also cause knee pain and swelling, like meniscus tears.These may involve themedial collateral ligament(located on the inside of the knee) or thelateral collateral ligament(located on the outside of the knee).
Ligament injuries tend to occur as a result of a direct blow to the knee (like during a football tackle). And similar to an ACL tear, they may occur in combination with a meniscus tear.
A detailed physical exam can help distinguish between knee ligament and meniscus injuries.
As with an ACL tear, an MRI can sort out a collateral ligament versus a meniscus injury, or determine if you have both.
Possible Causes of Knee Pain
Meniscus Tear Treatment
While you may presume that surgery is needed for thetreatment of a meniscus tear, this is not usually the case. Most of the time, non-surgical therapies are all that is needed to heal the meniscus.
Non-Surgical Options
The initial treatment of a meniscus tear is theR.I.C.E. protocol:
In order to further reduce pain and swelling, your healthcare provider may also advise you to take an oralnonsteroidal anti-inflammatory drug (NSAID).
Sometimes, asteroid (cortisone) injectioninto the knee joint is given to reduce inflammation and ease pain.
PT for a Torn Meniscus
If you are still in pain after four to six weeks of modified activity and physical therapy and/or you are still not able to return to your pre-injury activities, surgery may be recommended.
Note, though, that non-surgical treatments are nearly always the ideal choice for treating meniscus tears that occur as a result of degenerative changes. This is because studies have found that long-term results are not improved with surgery for people with a degenerative meniscus tear.
For instance, one study found that there was no clinically relevant difference between those who underwent a supervised 12-weekexercisetherapy program versus those who underwent surgery for degenerative medial menisci tears.
In fact, the participants in the exercise therapy program had an improvement in thigh muscle strength compared to those who had surgery—a positive outcome.
Surgery
Surgery has the best results when the primary symptoms of the meniscus tear are mechanical.This means that the meniscus tear is causing acatching or locking sensationof the knee.
When the meniscus tear is only causing pain, the results of surgery may not be as reliable.
There are three types of surgery used to treat a meniscus tear:
Arthroscopic Meniscectomy
A meniscectomy is a procedure to remove the torn portion of the meniscus. This is the most commonly done surgery for a meniscus injury.
The meniscectomy is done toremove the damaged portion of the meniscuswhile leaving as much healthy meniscus as possible.
This surgery usually has a quick recovery and allows for the rapid resumption of activities.
Meniscus Repair
Ameniscus repairis a surgical procedure done to repair the damaged meniscus. The meniscus repair can restore the normal anatomy of the knee and, when successful, has a better long-term prognosis than meniscectomy.
However, meniscus repair is a more significant surgery with a longer recovery. And because of limited blood supply to the meniscus, it is not always possible.
Meniscus Transplant
Meniscus transplantation consists of placing the meniscus from a deceased donor patient into an individual who has had their meniscus removed.
The ideal patient for a meniscus transplant is someone who had their meniscus removed and subsequently begins to develop knee pain.
Meniscus transplant is not performed for an acute meniscus tear, but rather when removal of the entire meniscus has caused persistent pain in the knee.
Long-Term Prognosis
When you tear the meniscus of your knee, the shock absorbing ability of the joint is threatened. Because of this, there is an increased risk of developing damage to the cartilage surface of the knee joint.
Loss of the meniscus places more of a burden on the cartilage surfaces of the joint, and they are more likely to developwear-and-tear arthritis.
The upside is that you can make lifestyle changes to decrease your risk of developing arthritis after having sustained a meniscus tear. Some of these lifestyle preventive strategies include:
17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Stanford University Medicine.What are the symptoms of a meniscus tear?American Academy of Orthopaedic Surgeons.Meniscus Tears.Miller MD, Thompson SR.DeLee, Drez, & Miller’s Orthopaedic Sports Medicine: Principles and Practice (5th Edition). Elsevier Health Sciences, 2020.Howell R, Kumar NS, Patel N, Tom J.Degenerative meniscus: Pathogenesis, diagnosis, and treatment options.World J Orthop. 2014;5(5):597-602. doi:10.5312/wjo.v5.i5.597Gupta Y, Mahara D, Lamichhane A.McMurray’s Test and Joint Line Tenderness for Medial Meniscus Tear: Are They Accurate?Ethiop J Health Sci., 2016 Nov;26(6):567-572. doi:10.4314/ejhs.v26i6.10US National Library of Medicine.Meniscus tears - aftercare.American Academy of Pediatrics.ACL Injuries in Young Athletes.American Academy Of Orthopaedic Surgeons.Common knee injuries.American Academy of Orthopaedic Surgeons.Anterior Cruciate Ligament (ACL) Injuries.Wilderman I, Berkovich R, Meaney C, Kleiner O, Perelman V.Meniscus-Targeted Injections for Chronic Knee Pain Due to Meniscal Tears or Degenerative Fraying: A Retrospective Study.J Ultrasound Med. 2019 Nov;38(11):2853-2859. doi:10.1002/jum.14987Kise NJ, Risberg MA, Stensrud S, Ranstam J, Engebretsen L, Roos EM.Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up.BMJ. 2016;354:i3740. doi:10.1136/bmj.i3740Miller MD, Thompson SR.DeLee, Drez, & Miller’s Orthopaedic Sports Medicine: Principles and Practice (5th Edition). Elsevier; 2020.Kim SG, Nagao M, Kamata K, Maeda K, Nozawa M.Return to sport after arthroscopic meniscectomy on stable knees.BMC Sports Sci Med Rehabil. 2013;5(1):23. doi:10.1186/2052-1847-5-23University of Washington Orthopaedics and Sports Medicine.Arthroscopic Meniscus Repair.University of Iowa Hospitals & Clinics.Meniscus transplant.Patil SS, Shekhar A, Tapasvi SR.Meniscal Preservation is Important for the Knee Joint.Indian J Orthop. 2017;51(5):576-587. doi:10.4103/ortho.IJOrtho_247_17Gersing AS, Schwaiger BJ, Nevitt MC, et al.Is Weight Loss Associated with Less Progression of Changes in Knee Articular Cartilage among Obese and Overweight Patients as Assessed with MR Imaging over 48 Months? Data from the Osteoarthritis Initiative.Radiology. 2017;284(2):508-520. doi:10.1148/radiol.2017161005Additional ReadingMaher SA, Rodeo SA, Warren RF.The Meniscus.J Am Acad Orthop Surg. 2017 Jan;25(1):e18-e19. doi: 10.5435/JAAOS-D-16-00689American Academy of Orthopedic Surgeons. (n.d.).Meniscus Tears.Jones BQ, Covey CJ, Sineath MH.Nonsurgical Management of Knee Pain in Adults.Am Fam Physician. 2015 Nov 15;92(10):875-83.Kise NJ, Risberg MA, Stensrud S, Ranstam J, Engebretsen L, Roos EM.Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up.BMJ.2016 Jul 20;354:j3740. doi:10.1136/bmj.i3740
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Stanford University Medicine.What are the symptoms of a meniscus tear?American Academy of Orthopaedic Surgeons.Meniscus Tears.Miller MD, Thompson SR.DeLee, Drez, & Miller’s Orthopaedic Sports Medicine: Principles and Practice (5th Edition). Elsevier Health Sciences, 2020.Howell R, Kumar NS, Patel N, Tom J.Degenerative meniscus: Pathogenesis, diagnosis, and treatment options.World J Orthop. 2014;5(5):597-602. doi:10.5312/wjo.v5.i5.597Gupta Y, Mahara D, Lamichhane A.McMurray’s Test and Joint Line Tenderness for Medial Meniscus Tear: Are They Accurate?Ethiop J Health Sci., 2016 Nov;26(6):567-572. doi:10.4314/ejhs.v26i6.10US National Library of Medicine.Meniscus tears - aftercare.American Academy of Pediatrics.ACL Injuries in Young Athletes.American Academy Of Orthopaedic Surgeons.Common knee injuries.American Academy of Orthopaedic Surgeons.Anterior Cruciate Ligament (ACL) Injuries.Wilderman I, Berkovich R, Meaney C, Kleiner O, Perelman V.Meniscus-Targeted Injections for Chronic Knee Pain Due to Meniscal Tears or Degenerative Fraying: A Retrospective Study.J Ultrasound Med. 2019 Nov;38(11):2853-2859. doi:10.1002/jum.14987Kise NJ, Risberg MA, Stensrud S, Ranstam J, Engebretsen L, Roos EM.Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up.BMJ. 2016;354:i3740. doi:10.1136/bmj.i3740Miller MD, Thompson SR.DeLee, Drez, & Miller’s Orthopaedic Sports Medicine: Principles and Practice (5th Edition). Elsevier; 2020.Kim SG, Nagao M, Kamata K, Maeda K, Nozawa M.Return to sport after arthroscopic meniscectomy on stable knees.BMC Sports Sci Med Rehabil. 2013;5(1):23. doi:10.1186/2052-1847-5-23University of Washington Orthopaedics and Sports Medicine.Arthroscopic Meniscus Repair.University of Iowa Hospitals & Clinics.Meniscus transplant.Patil SS, Shekhar A, Tapasvi SR.Meniscal Preservation is Important for the Knee Joint.Indian J Orthop. 2017;51(5):576-587. doi:10.4103/ortho.IJOrtho_247_17Gersing AS, Schwaiger BJ, Nevitt MC, et al.Is Weight Loss Associated with Less Progression of Changes in Knee Articular Cartilage among Obese and Overweight Patients as Assessed with MR Imaging over 48 Months? Data from the Osteoarthritis Initiative.Radiology. 2017;284(2):508-520. doi:10.1148/radiol.2017161005Additional ReadingMaher SA, Rodeo SA, Warren RF.The Meniscus.J Am Acad Orthop Surg. 2017 Jan;25(1):e18-e19. doi: 10.5435/JAAOS-D-16-00689American Academy of Orthopedic Surgeons. (n.d.).Meniscus Tears.Jones BQ, Covey CJ, Sineath MH.Nonsurgical Management of Knee Pain in Adults.Am Fam Physician. 2015 Nov 15;92(10):875-83.Kise NJ, Risberg MA, Stensrud S, Ranstam J, Engebretsen L, Roos EM.Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up.BMJ.2016 Jul 20;354:j3740. doi:10.1136/bmj.i3740
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Stanford University Medicine.What are the symptoms of a meniscus tear?American Academy of Orthopaedic Surgeons.Meniscus Tears.Miller MD, Thompson SR.DeLee, Drez, & Miller’s Orthopaedic Sports Medicine: Principles and Practice (5th Edition). Elsevier Health Sciences, 2020.Howell R, Kumar NS, Patel N, Tom J.Degenerative meniscus: Pathogenesis, diagnosis, and treatment options.World J Orthop. 2014;5(5):597-602. doi:10.5312/wjo.v5.i5.597Gupta Y, Mahara D, Lamichhane A.McMurray’s Test and Joint Line Tenderness for Medial Meniscus Tear: Are They Accurate?Ethiop J Health Sci., 2016 Nov;26(6):567-572. doi:10.4314/ejhs.v26i6.10US National Library of Medicine.Meniscus tears - aftercare.American Academy of Pediatrics.ACL Injuries in Young Athletes.American Academy Of Orthopaedic Surgeons.Common knee injuries.American Academy of Orthopaedic Surgeons.Anterior Cruciate Ligament (ACL) Injuries.Wilderman I, Berkovich R, Meaney C, Kleiner O, Perelman V.Meniscus-Targeted Injections for Chronic Knee Pain Due to Meniscal Tears or Degenerative Fraying: A Retrospective Study.J Ultrasound Med. 2019 Nov;38(11):2853-2859. doi:10.1002/jum.14987Kise NJ, Risberg MA, Stensrud S, Ranstam J, Engebretsen L, Roos EM.Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up.BMJ. 2016;354:i3740. doi:10.1136/bmj.i3740Miller MD, Thompson SR.DeLee, Drez, & Miller’s Orthopaedic Sports Medicine: Principles and Practice (5th Edition). Elsevier; 2020.Kim SG, Nagao M, Kamata K, Maeda K, Nozawa M.Return to sport after arthroscopic meniscectomy on stable knees.BMC Sports Sci Med Rehabil. 2013;5(1):23. doi:10.1186/2052-1847-5-23University of Washington Orthopaedics and Sports Medicine.Arthroscopic Meniscus Repair.University of Iowa Hospitals & Clinics.Meniscus transplant.Patil SS, Shekhar A, Tapasvi SR.Meniscal Preservation is Important for the Knee Joint.Indian J Orthop. 2017;51(5):576-587. doi:10.4103/ortho.IJOrtho_247_17Gersing AS, Schwaiger BJ, Nevitt MC, et al.Is Weight Loss Associated with Less Progression of Changes in Knee Articular Cartilage among Obese and Overweight Patients as Assessed with MR Imaging over 48 Months? Data from the Osteoarthritis Initiative.Radiology. 2017;284(2):508-520. doi:10.1148/radiol.2017161005
Stanford University Medicine.What are the symptoms of a meniscus tear?
American Academy of Orthopaedic Surgeons.Meniscus Tears.
Miller MD, Thompson SR.DeLee, Drez, & Miller’s Orthopaedic Sports Medicine: Principles and Practice (5th Edition). Elsevier Health Sciences, 2020.
Howell R, Kumar NS, Patel N, Tom J.Degenerative meniscus: Pathogenesis, diagnosis, and treatment options.World J Orthop. 2014;5(5):597-602. doi:10.5312/wjo.v5.i5.597
Gupta Y, Mahara D, Lamichhane A.McMurray’s Test and Joint Line Tenderness for Medial Meniscus Tear: Are They Accurate?Ethiop J Health Sci., 2016 Nov;26(6):567-572. doi:10.4314/ejhs.v26i6.10
US National Library of Medicine.Meniscus tears - aftercare.
American Academy of Pediatrics.ACL Injuries in Young Athletes.
American Academy Of Orthopaedic Surgeons.Common knee injuries.
American Academy of Orthopaedic Surgeons.Anterior Cruciate Ligament (ACL) Injuries.
Wilderman I, Berkovich R, Meaney C, Kleiner O, Perelman V.Meniscus-Targeted Injections for Chronic Knee Pain Due to Meniscal Tears or Degenerative Fraying: A Retrospective Study.J Ultrasound Med. 2019 Nov;38(11):2853-2859. doi:10.1002/jum.14987
Kise NJ, Risberg MA, Stensrud S, Ranstam J, Engebretsen L, Roos EM.Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up.BMJ. 2016;354:i3740. doi:10.1136/bmj.i3740
Miller MD, Thompson SR.DeLee, Drez, & Miller’s Orthopaedic Sports Medicine: Principles and Practice (5th Edition). Elsevier; 2020.
Kim SG, Nagao M, Kamata K, Maeda K, Nozawa M.Return to sport after arthroscopic meniscectomy on stable knees.BMC Sports Sci Med Rehabil. 2013;5(1):23. doi:10.1186/2052-1847-5-23
University of Washington Orthopaedics and Sports Medicine.Arthroscopic Meniscus Repair.
University of Iowa Hospitals & Clinics.Meniscus transplant.
Patil SS, Shekhar A, Tapasvi SR.Meniscal Preservation is Important for the Knee Joint.Indian J Orthop. 2017;51(5):576-587. doi:10.4103/ortho.IJOrtho_247_17
Gersing AS, Schwaiger BJ, Nevitt MC, et al.Is Weight Loss Associated with Less Progression of Changes in Knee Articular Cartilage among Obese and Overweight Patients as Assessed with MR Imaging over 48 Months? Data from the Osteoarthritis Initiative.Radiology. 2017;284(2):508-520. doi:10.1148/radiol.2017161005
Maher SA, Rodeo SA, Warren RF.The Meniscus.J Am Acad Orthop Surg. 2017 Jan;25(1):e18-e19. doi: 10.5435/JAAOS-D-16-00689American Academy of Orthopedic Surgeons. (n.d.).Meniscus Tears.Jones BQ, Covey CJ, Sineath MH.Nonsurgical Management of Knee Pain in Adults.Am Fam Physician. 2015 Nov 15;92(10):875-83.Kise NJ, Risberg MA, Stensrud S, Ranstam J, Engebretsen L, Roos EM.Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up.BMJ.2016 Jul 20;354:j3740. doi:10.1136/bmj.i3740
Maher SA, Rodeo SA, Warren RF.The Meniscus.J Am Acad Orthop Surg. 2017 Jan;25(1):e18-e19. doi: 10.5435/JAAOS-D-16-00689
American Academy of Orthopedic Surgeons. (n.d.).Meniscus Tears.
Jones BQ, Covey CJ, Sineath MH.Nonsurgical Management of Knee Pain in Adults.Am Fam Physician. 2015 Nov 15;92(10):875-83.
Kise NJ, Risberg MA, Stensrud S, Ranstam J, Engebretsen L, Roos EM.Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up.BMJ.2016 Jul 20;354:j3740. doi:10.1136/bmj.i3740
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