Meniscus tears

A meniscal tear is one of the most common knee injuries and a frequent cause of knee pain and swelling. The meniscus plays a key role in stabilising and protecting the knee joint, and damage to it can affect movement, comfort and long-term knee health.

What is the meniscus?

The knee contains two menisci, the medial meniscus on the inner side of the knee and the lateral meniscus on the outer side. These are crescent-shaped pieces of cartilage that sit between the thigh bone (femur) and the shin bone (tibia).

The meniscus acts as a shock absorber, helps distribute weight evenly across the joint and contributes to knee stability.

What causes a meniscal tear?

Meniscal tears can occur suddenly or develop gradually over time. They can also occur due to progression of arthritis and structural collapse of the knee.

Common causes include:

  • Twisting or pivoting the knee, especially during sports
  • Sudden stops or changes in direction
  • Squatting or lifting heavy objects
  • Direct impact to the knee
  • Age-related degeneration, where the meniscus becomes weaker and more prone to tearing

In older adults, a meniscal tear may occur with minimal trauma. It is important to distinguish whether a meniscal tear has occurred in otherwise healthy tissue due to an injury, or whether it is degenerative and associated with cartilage wear or structural damage. This often guides decision making for treatment.

Symptoms of a meniscal tear

Symptoms may vary depending on the size and location of the tear, but often include:

  • Knee pain, particularly along the joint line
  • Swelling or stiffness
  • A clicking, catching or locking sensation
  • Difficulty fully straightening or bending the knee
  • A feeling that the knee may give way

Symptoms may appear immediately after injury or develop over several days.

Types of meniscal tears

Meniscal tears are classified based on their pattern and location, such as:

  • Longitudinal or vertical tears
  • Radial tears
  • Horizontal tears
  • Flap tears
  • Degenerative tears

The type of tear can influence treatment options and recovery. Some tears may be repairable and some may not.

How meniscal tears are diagnosed

Diagnosis typically involves:

  • A physical examination and movement tests
  • Review of symptoms and injury history
  • Imaging studies, most commonly MRI scans
  • X-rays to rule out bone-related issues

Treatment options

Treatment depends on the type of tear, age, activity level and severity of symptoms.

Non-surgical treatments may include:

  • Rest and activity modification
  • Physical therapy
  • Anti-inflammatory medications
  • Bracing or support

Surgical treatment may be considered if symptoms persist or the knee locks or remains unstable.

The British Association for Knee Surgery has published evidence-based guidance on recommended treatment for meniscal tears, which helps guide the best course of treatment depending on the scenario and presence of other structural cartilage damage. Mr Pavlou would advise the most appropriate course of action based on individual circumstances.

Recovery and long-term outlook

Many people recover well from a meniscal tear, especially with early diagnosis and appropriate treatment. Strengthening the muscles around the knee and improving flexibility can help protect the joint and reduce the risk of future injury.

When to seek medical advice

You should consult a healthcare professional if knee pain, swelling, locking or instability continues or worsens, particularly after an injury.