Meniscal Tear

The meniscus is a c-shaped piece of cartilage found in the knee. There are 2 of them in each knee. The meniscus, along with the cartilage that covers the ends of the bones in the knee, serves as a shock absorber. Tears of the meniscus can occur in teenagers, but are more common in adults. Meniscus tears in children are uncommon.

Causes & Risk Factors

A meniscus tear usually happens with a twisting injury of the knee, or sometimes when a person falls on a bent knee. In children, a meniscus tear can happen because the meniscus is abnormal from birth.  

Symptoms 

A patient with a meniscus tear typically experiences a twisting injury of the knee. They often report hearing or feeling a “pop,” and generally is unable to continue any activity. The knee may swell, but not usually fast or a very much. The patient usually has pain when moving the knee, more pain with walking or trying to run, and often describes a clicking or popping sensation with moving the knee. Some patients with large meniscus tears may experience locking of the knee (the knee gets stuck and is very painful to move).

Diagnosis & Tests

A meniscus can be torn in several different ways. Doctors usually cannot tell how a meniscus is torn just by examining the patient. Cartilage tears also cannot be seen on regular X-rays. Doctors usually order an MRI scan to see the torn meniscus.

Treatment & Care

Some meniscus tears can heal with rest. Children and teenagers with small tears in an otherwise normal meniscus may heal with a month or more of rest – no running or jumping allowed. 

Meniscus tears in older teenagers and adults are less likely to heal with rest. For these patients, doctors usually recommend surgery. The surgeon may be able to repair the torn cartilage. In patients with large cartilage tears, repair may not be possible. The torn meniscus may need to be partially or totally removed.

Living & Managing

Whether the meniscus heals with rest or surgery is needed, most patients will require some physical therapy during or after healing to build-up the muscles around the knee and getting the knee working normally. It is important for patients to remember that even though their pain and swelling may be gone, their meniscus will never be as good as new, so they need to be careful with their knees if they return to sports.