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Oxford University Hospitals NHS Foundation Trust
Hip and Knee

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Meniscal tears

Mensical TearThe menisci are shock absorbers (sports cartilages) that sit in the joint between the ends of the two bones.

The menisci are a commonly injured structure within the knee. Injuries can occur in any age group. In younger patients the meniscus is tough and rubbery, but can be torn in fairly forceable twisting injuries (traumatic tear). The meniscus grows weaker and less elastic with age, and can be torn with fairly minor injuries, even sometimes a simple squat (degenerative tear).

Signs and symptoms

The most common problem caused by a torn meniscus is pain.

The pain may be felt along the line of the joint where the meniscus lies or be more vague and felt all over the knee. It is often made worse with twisting, squatting or impact activities when the meniscus can be pinched. Symptoms may settle with rest.

The joint may also become swollen. If the torn part of meniscus is large, locking may occur. This is caused by a large fragment getting caught in the hinge mechanism of the knee and acting like a wedge - preventing the knee from fully straightening.

Treatment

Initial treatment for a torn meniscus is directed towards reducing the pain and swelling in the knee. This can be achieved by resting the knee, icepacks and anti-inflammatory medications.

If the knee is locked and cannot be straightened out, surgery may be recommended as soon as reasonably possible to remove the torn portion that is caught in the knee joint. Once a meniscus is torn, it will most likely not heal on its own.

Symptoms in a large number of patients with degenerative tears will settle with appropriate treatment (anti inflammatory medication and rest). The symptoms may recur intermittently but if they can be managed relatively easily then retaining the degenerate meniscus may be better for the knee in the long term. If the symptoms continue, surgery will be required to either remove the torn portion of the meniscus or to repair the tear

Surgery

Meniscal surgery is done using the arthroscope. Small incisions are made in the knee to allow the insertion of a small TV camera into the joint. Through another small incision, special instruments are used to remove the torn portion of meniscus while the arthroscope is used to see what is happening.

In some cases the meniscus tear can be repaired (this is most likely in young people with relatively recent meniscal tears). Sutures are then placed into the torn meniscus until the tear is repaired.

Repair of the meniscus is not possible in all cases. Degenerative type tears in older people are not usually repairable.

For further information, please download the booklet below: