Meniscus Tear Treatment

Each knee has two menisci, C-shaped wedges of tough fibrocartilage sitting between the thigh bone and the shin bone. They deepen the flat top of the shin so the rounded end of the thigh bone has something to sit in, and they spread load across a wide area instead of a single point. Removing one raises the pressure on the cartilage beneath it several times over.

Tears come about in two ways. In a younger knee it takes a twist on a bent, loaded joint, often during sport, and the tear is a clean split in otherwise healthy tissue. In a knee past forty the tissue has become more brittle with age, and a tear can appear after something as ordinary as standing up from a squat.

Only the outer third has a blood supply, reaching in from the joint capsule. Tears there can heal or be made to heal. Tears in the inner rim have no blood reaching them, and no amount of time or protection will knit them.

Your surgeon presses along the joint line with the knee bent, since tenderness in that exact line is the most consistent physical finding, and then rotates the bent knee under load in manoeuvres designed to trap the torn fragment between the bones.

MRI is the imaging test and it is accurate for this. It shows where the tear sits, which matters more than its size, because the zone determines whether it can be stitched. It also shows the shape of the tear, and a bucket-handle fragment displaced into the middle of the joint is the pattern that blocks movement.

Standing X-rays are usually taken alongside, particularly in anyone past middle age. A tear found on MRI in a knee that already has widespread wear is often an incidental finding, and treating it as the cause leads to disappointment.

Treated without surgery, the plan is a few weeks of reduced loading followed by a graded programme for the thigh and hip muscles, and a good number of tears settle into a knee that works normally with the tear still present. That is a legitimate endpoint.

After trimming, weight goes through the leg straight away, crutches are gone within days and desk work resumes within a week or two, with a return to sport at around four to six weeks.

After a repair the timeline is much longer, because stitched tissue has to knit across a zone with a modest blood supply. Expect crutches with weight restricted and the bend limited for around six weeks, strengthening through the following months, and no twisting sport before four to six months. That difference is worth understanding before the operation, since which one is done is often decided only once the surgeon can see the tear.