Meniscal Cartilage Tears

A knee contains two menisci (cartilages). One meniscus is located on the inside part of the knee, whereas the other is on the outer side. These C-shaped, crescent-like structures cradle the femur (thigh bone) as it rests on the tibia (shin bone).

The menisci play a key role in knee function. Their primary purpose is to distribute the load across the joint surfaces; hence it helps to protect the cartilage that lines the joint. In essence, they act as the knee’s natural shock absorbers.

However, when a meniscus tears, it can no longer perform its function effectively. This may accelerate joint wear and lead to early degeneration.

Symptoms

Symptoms of a meniscal cartilage tear can vary, ranging from discomfort and clicking feelings to catching in the joint. More severe cases can lead to a locked knee, where a massive cartilage fragment gets stuck in the joint and prevents full extension.

A meniscus tear may also cause swelling and, in some cases, a feeling that the knee is giving way. However, giving away is more commonly associated with ligament damage.

Causes

In younger individuals and teenagers, a meniscal tear often results from a twisting or jarring motion. This is followed by swelling, locking, or clunking of the knee. Rapid swelling suggests bleeding within the joint. Patients may also be able to pinpoint the location of the injury by identifying pain on either side of the knee.

Meniscal tears can sometimes occur alongside other injuries, such as ligament ruptures. In younger adults, these tears generally occur due to significant force. But, in middle-aged or elderly individuals, the cartilage is weakened and is more susceptible to tearing. Over time, the meniscus becomes more fragile, so even minor movements—such as standing up from a chair, crouching, or kneeling—can cause a tear. Some patients may not recall the exact moment of injury, but recent physical activities like long walks or strenuous tasks like moving furniture might be associated.

In older adults, symptoms like pain and swelling are often milder and may not be noticeable for a few days.

Diagnosis

A physical examination, along with a review of the injury history, is key to diagnosing a meniscal cartilage tear.

X-rays are usually performed to rule out other conditions, such as arthritis, bone injuries, or loose fragments within the knee, which can mimic meniscal cartilage tear symptoms.

MRI scans may also be requested in cases where the diagnosis is unclear, although they are not always necessary.

Treatment

Once a torn meniscal tear is diagnosed, surgery is often required, as these tears rarely heal on their own. This is due to the meniscus’s limited blood supply, which is essential for healing.

Small tears may improve over time, with symptoms subsiding within approximately six weeks. However, if discomfort persists beyond this period, surgery is usually recommended. Larger tears almost always require surgical intervention.

Meniscus surgery is typically performed using an arthroscopic (keyhole) procedure. Based on the type and severity of the tear, the surgeon may repair or trim the damaged portion to create a smooth edge. This procedure is known as a partial meniscectomy.

Meniscal Repair

Only a small percentage of meniscal tears can be repaired. If the tear is identified early and is located in the outer region of the meniscus—where small blood vessels are present—it may be possible to repair it using specialised sutures or anchors. However, this procedure is generally recommended for younger patients, as the likelihood of successful healing decreases with age. Studies show that after age 30, the chances of a meniscal tear healing significantly decline.

In some cases, the meniscus may detach from its attachment point on the tibia, a condition known as meniscal root avulsion. This is a serious injury, as it completely disrupts meniscal function. Depending on the circumstances, a root avulsion may be repairable, and your surgeon will discuss the available options.

Partial Meniscectomy

In most cases, the damaged portion of the meniscus must be removed through a partial meniscectomy. This procedure is performed arthroscopically, using specialised instruments inserted through small incisions (keyhole surgery). The surgeon removes only the torn section, ensuring the remaining cartilage has a smooth, stable rim to help relieve symptoms.

Some meniscal tears, particularly cleavage tears in older individuals, may be accompanied by a meniscal cyst—a fluid-filled lump often found on the outer side of the knee. These cysts are not harmful but can be painful. They are commonly drained during the meniscectomy, though a larger incision may be needed for removal in rare cases.

Meniscal Augmentation & Replacement

When a significant portion of the meniscus is removed, it can be replaced with artificial material or donor tissue to help maintain knee function.

Meniscal Transplant

If most or the entire meniscus is missing, meniscal augmentation is not an option, as a portion of the original meniscus is needed for attachment. In such cases, a meniscal transplant may be considered.

This procedure involves transplanting donor meniscus tissue, which is sutured into place using a combination of arthroscopic and small open incisions. Unlike organ transplants, meniscal transplants do not require tissue matching. However, the procedure carries certain risks, and while it is known for alleviating pain, its long-term effectiveness in preventing arthritis remains uncertain.

Bottom Line

Meniscal cartilage tear can cause significant discomfort and impact your mobility. So, if you’re experiencing persistent knee pain, swelling, or difficulty moving your knee, don’t wait—early diagnosis is key to effective treatment.

Book an appointment with our specialist today to discuss your symptoms and explore the best treatment options.