Comprehensive Guide to Meniscus Tears: Symptoms, Causes, Treatment
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The meniscus is an important structure in the knee joint that plays a key role in stability, shock absorption, and overall joint health. Meniscus tears are among the most common knee injuries, particularly in athletes, older adults, and anyone who puts frequent stress on their knees. Left untreated, a torn meniscus can cause long-term knee pain, instability, and even lead to arthritis.
In this guide, we’ll explore what a meniscus tear is, what causes it, how it feels, how it’s treated, and what recovery looks like.
By Arete Orthopaedic Centre
Medically Reviewed by Dr Wang Lushun
What Is the Meniscus?
The meniscus is a C-shaped piece of cartilage located between the femur (thighbone) and tibia (shinbone). Each
knee has two menisci, one on the inside (medial) and one on the outside (lateral). They help to distribute body
weight across the knee joint, stabilise it during movement, and protect the bones from wear and tear.
When the meniscus is torn, the knee can lose some of its natural shock-absorbing ability, which may result in
pain, swelling, and impaired function.
What are Common Types of Meniscus Tears?
Meniscus tears can vary based on their shape, location, and severity. Common types include:
Radial tear: A tear that occurs perpendicular to the tibial plateau and often affects the central part of the meniscus.
Horizontal tear: A tear that splits the meniscus into upper and lower sections.
Longitudinal (bucket handle) tear: A vertical tear along the meniscus that can cause the cartilage to displace or flip over.
Flap tear: An irregular tear that causes part of the meniscus to catch in the joint.
Complex tear: A combination of tear patterns, often seen in older patients with degenerative changes.
The type of meniscus tear will influence treatment decisions, including whether surgery is needed and which procedures may be appropriate.
What Causes Meniscus Tears?
Meniscus tears can be classified as either acute (traumatic) or degenerative in nature.
Traumatic Meniscus Tears
These are typically caused by a sudden twisting or pivoting motion of the knee. They are common in
sports like football, basketball, tennis, or skiing, especially when an athlete suddenly changes
direction or lands at an awkward angle.
Traumatic tears often affect younger, active individuals and may occur together with other injuries,
such as anterior cruciate ligament (ACL) tears.
Degenerative Meniscus Tears
Degenerative tears occur over time due to wear and tear on the cartilage. These are more common in
individuals over 40 and may not always have a clear cause or injury event. In some cases, even
simple movements like getting up from a chair can result in a tear if the meniscus is already
weakened.
Degenerative tears are often associated with osteoarthritis, and treatment may focus on managing
symptoms rather than repairing the cartilage.
Symptoms of a Meniscus Tear to Look Out For
The symptoms of a torn meniscus can vary depending on the severity and type of tear. These may include:
Pain along the inner or outer side of the knee
Swelling and stiffness, usually appearing a few hours after injury
A popping sensation at the time of injury
Difficulty bending or straightening the knee fully
Feeling like the knee is "locked" or catches during movement
Instability or the feeling that the knee may give way
In some cases, symptoms may improve temporarily before flaring up again.
How are Meniscus Tears Diagnosed?
To diagnose a meniscus tear, the orthopaedic doctor will perform a physical examination, focusing on tenderness,
swelling and range of motion.
Imaging tests are typically used to confirm the diagnosis and evaluate the extent of damage. An MRI (Magnetic
Resonance Imaging) is the gold standard as it provides detailed images of the soft tissues in the knee,
including the meniscus, ligaments, and cartilage.
In rare cases, diagnostic arthroscopy may be used. This is a minimally invasive surgical procedure that allows
direct visualisation of the knee joint.
How are Meniscus Tears Treated?
Treatment depends on several factors, including the type, size, and location of the tear, as well as the patient’s age, activity level, and overall knee health.
Conservative (Non-Surgical) Treatment
Not all meniscus tears require surgery. In fact, many small or degenerative tears can be managed without an operation. Conservative treatments include:
Rest and activity modification
Ice application to reduce swelling
Non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief
Physiotherapy to strengthen surrounding muscles and restore function
Bracing or taping
The conservative approach is usually recommended for degenerative tears, minor stable tears, or when surgery carries higher risk.
Surgical Treatment
If symptoms persist despite conservative care, or if the tear is causing mechanical problems like locking, then orthopaedic surgery may be needed.
The most common surgical options are:
Meniscectomy: This involves the partial removal of the torn portion of the meniscus. This is often used for complex or degenerative tears that cannot be repaired.
Meniscus Repair: This involves suturing the torn edges back together. This is preferred when possible, especially in younger patients, as it preserves more of the meniscus and its protective function.
Meniscus Transplantation: This is a less common procedure reserved for patients who have had their entire meniscus removed and yet continue to experience pain and instability. In these cases, a donor meniscus will be transplanted into the knee.
Meniscus repair is only feasible if the tear is located in the outer third of the meniscus, which has good blood supply to support healing.
Recovery and Rehabilitation
Recovery after a meniscus injury varies based on the treatment approach and severity of the injury in the first place.
For conservative treatment, patients may begin rehabilitation within a few days, with a gradual return to full activity over 4 to 6 weeks.
After a partial meniscectomy, most individuals can return to light activities within 2 to 3 weeks, with full recovery in about 4 to 6 weeks.
Recovery from meniscus repair is longer and more structured, often requiring crutches for 2 to 4 weeks, limited weight-bearing, and physiotherapy for several months. Return to sports typically takes 4 to 6 months, depending on individual factors.
It must be noted that adherence to physiotherapy is essential for a successful recovery. Your physiotherapist may recommend exercises focused on strengthening the quadriceps, hamstrings, and hip muscles, as well as those that aim to restore range of motion and joint stability.
Potential Complications and Long-Term Outcomes
If left untreated or improperly managed, a meniscus tear can lead to complications such as:
Chronic knee pain or instability
Increased risk of further injuries, including ligament tears
Accelerated wear and tear leading to early-onset osteoarthritis
Recurrence of tears or persistent locking symptoms
That said, most patients who receive timely and appropriate treatment experience very good outcomes.
Orthopaedic surgeons usually try to preserve as much of the meniscus as possible in order to improve
long-term knee health.
Prevention Tips for Meniscus Tears
While not all meniscus tears can be prevented, these tips can reduce the likelihood of developing them:
Warm up before exercise and sports
Strengthen the muscles around the knee and hip for better joint stability
Maintain flexibility in the hamstrings, calves, and quadriceps
Avoid sudden increases in training intensity or duration
Wear appropriate footwear with proper support
Use correct techniques when jumping, pivoting, or changing direction
Athletes and active individuals should consider periodic evaluations with a sports orthopaedic doctor to address any issues that may predispose them to injury.
When to See an Orthopaedic Specialist
You should seek medical attention if:
You experience a popping sensation followed by swelling
The knee locks, gives way, or feels unstable
You are unable to straighten or bend the knee fully
Pain persists or worsens despite rest and basic treatment
You suspect a meniscus tear based on symptoms or prior injury
An orthopaedic specialist can perform a thorough evaluation, confirm the diagnosis, and recommend the most appropriate treatment to help you recover fully and reduce future risk.
For more information, please reach out to our specialist clinic today.
With over 18 years of orthopaedic experience, Dr Wang Lushun is a dedicated Senior Consultant Orthopaedic
Surgeon who is skilled in the diagnosis and treatment of avascular necrosis. Having previously led the Hip
and Knee Division at Ng Teng Fong Hospital, patients can rest assured knowing that they will receive the
best possible orthopaedic care tailored to their needs.
Dr Wang Lushun is a pioneer in Enhanced Recovery after Surgery (ERAS), and has pioneered Minimally Invasive
Hip Surgeries such as Direct Superior and Direct Approaches. He has been recognised for superior outcomes in
Joint Replacements and is frequently invited as international faculty for his insights into the latest
treatment options.
Trusted
Leadership on Orthopaedic Advisory Boards
Skilful
Double Fellowships at Centres of Excellence
Experienced
Senior Consultant with Over 18 Years of Experience
