There are many things to consider
when deciding how to treat your
torn meniscus, including the extent and location of
the tear, your pain level, your age and activity level, your doctor's
preference, and when the injury occurred. Your treatment choices are:
- Nonsurgical treatment
with rest, ice, compression, elevation, and physical therapy. This may include
wearing a temporary knee brace.
- Surgical repair to sew the tear
- Partial meniscectomy, which is surgery to remove the torn
- Total meniscectomy, which is
surgery to remove the entire
meniscus. This is generally avoided, because this
option increases the risk for
osteoarthritis in the knee.
Whenever possible, meniscus surgery is done using
arthroscopy, rather than through a large cut in the
The location (zone) of the tear is one of the most
important factors in determining treatment. See a picture of the
- Tears at the outer edge of the meniscus (red
zone) tend to heal well because there is good blood supply. Minor tears may
heal on their own with a brace and a period of rest. If they do not heal or if
repair is deemed necessary, the tear can be sewn together. This repair is usually successful in the red zone.
- The inner two-thirds (white zone) of the
meniscus does not have a good blood supply, so it does not heal well
either on its own or after repair. If torn pieces float into the joint space,
which may result in a "locked" knee or cause other symptoms, the torn portion
is removed (partial meniscectomy) and the edges of the remaining meniscus are
shaved to make the meniscus smooth.
- When the tear extends from the
red zone into the white zone, there may be enough blood supply for healing. The
tear may be repaired or removed. This is something the orthopedic surgeon
decides during the surgery.
Also, the pattern of the tear may determine whether a tear
can be repaired. Longitudinal tears are often repairable. Radial tears may be
repairable depending on where they are located. Horizontal and flap (oblique)
tears are generally not repairable. See a picture of
different types of tears.
Another factor when considering treatment
is that repairs to the lateral meniscus (on the outer side of knee) typically
heal better than repairs to the medial meniscus (on the inner side of the
knee). See a picture of the
lateral and medial menisci.
It is preferable to preserve as much of
the meniscus as possible. If the meniscus can be repaired successfully, saving
the injured meniscus by doing a meniscal repair reduces the occurrence of knee
joint degeneration compared with partial or total removal (meniscectomy).
Meniscus repair is more successful in younger people (experts think people
younger than about 40 years old do best), in knees that have good stability from the
ligaments, if the tear is in the red zone, and if the repair is done within the
first few weeks after the injury (acute).1
Meniscal repair may prevent degenerative changes in the knee joint. But
it has not been proved conclusively that repairing a tear prevents more
long-term problems (such as osteoarthritis) than not repairing a tear. Many
doctors believe that a successful meniscus repair lowers the risk of
early-onset arthritis because it reduces the stress put on the knee
Orthopedists most often perform meniscus surgery with
arthroscopy, a procedure used both to examine and then
to repair the inside of a joint by inserting a thin tube (arthroscope)
containing a camera and a light through small incisions near the joint.
Surgical instruments are inserted through other small incisions near the joint.
Some tears require open knee surgery.
- Meniscus Tear: Should I Have Surgery?
Rehabilitation varies depending on the injury, the type of
surgery, your orthopedic surgeon's preference, and your age, health status, and
activities. Time periods vary, but in general meniscus
surgery is usually followed by a period of rest, walking, and selected
exercises. After you have full range of motion without pain and your knee
strength is back to normal, you can return to your previous activity
For some exercises you can do at home (with your doctor's
- Meniscus Tear: Rehabilitation Exercises.
Other knee injuries, most commonly to the anterior cruciate
ligament (ACL) and/or the medial collateral ligament, may occur
at the same time as a meniscus tear. In these cases, the treatment plan is
different. Typically, your orthopedist will repair your torn meniscus, if
needed, at the same time that ACL surgery is done. In this case, the ACL
rehabilitation plan is followed. For more information, see the topic
Anterior Cruciate Ligament (ACL) Injuries.
Meniscal transplant is an experimental treatment
for meniscal tears. It might be a good option for a meniscus that is already
weakened or scarred due to previous injury or treatment. In this surgical
procedure, a piece of meniscus cartilage from a donor (allograft) is
transplanted into the knee.
To be eligible for meniscal
transplantation, a person:
- Should be younger than age
- Must be finished growing.
- Must not be obese.
- Has knee pain and swelling that has not responded
to other treatment.
- Must have no arthritis (or minimal arthritis) in the knee
- Must have a well-aligned knee, meaning the legs are not bent outward
at the knees (bowlegged) or bent inward at the knees (knock-kneed).