Each knee has two menisci: the medial meniscus on the inner side and the lateral meniscus on the outer side. These are crescent-shaped pads of fibrocartilage that sit between the thigh bone and shin bone, cushioning the joint, distributing load and contributing to stability.
The menisci play an important role in the long-term health of the knee. When the meniscus is damaged or lost, force passing through the joint is less evenly distributed, which can accelerate wear on the cartilage surfaces over time.
Meniscal tears fall into two broad categories.
Acute tears typically occur during sport or physical activity. A twisting movement over a planted foot (common in football, basketball, soccer and skiing) can cause the meniscus to tear suddenly. These injuries, particularly medial meniscus tears, often occur alongside ACL ruptures.
Degenerative tears develop gradually, most often in patients over 40, as the meniscal tissue becomes less resilient with age. These tears can occur with minimal force, sometimes with no clear incident at all, and are frequently associated with early knee osteoarthritis.
Symptoms of a meniscal tear can vary depending on the type, size and location of the injury. Common presentations include:
Some tears cause significant immediate symptoms. Others are surprisingly subtle, with discomfort that settles partially but returns with activity.
Diagnosis involves a careful history, clinical examination and imaging studies.
An MRI is often the most useful imaging investigation, providing a detailed view of the meniscus. This allows your surgeon to assess the size, pattern and location of the tear, as well as the condition of the surrounding cartilage, ligaments and joint surfaces.
X-rays may also be taken to assess bone health and look for signs of associated arthritis.
Many meniscal tears (particularly degenerative tears in older patients) can be managed without surgery. A structured physiotherapy program to improve strength, control and load management is often the first and most appropriate step. In some cases, this provides sustained relief and avoids the need for surgical intervention.
When surgery is required, it is performed arthroscopically — through small incisions using a thin camera and fine instruments. Learn more about knee arthroscopy.
There are two main surgical approaches:
Meniscal repair aims to stitch the torn tissue back together, preserving the meniscus and its function. Repair is preferred where the tear pattern and tissue quality make it feasible, as retaining the meniscus offers the best long-term protection for the joint. Recovery from repair is more involved, as the tissue needs time to heal.
Partial meniscectomy involves trimming away the damaged portion of the meniscus that cannot be repaired. It is a more straightforward procedure with a faster recovery, and is appropriate in cases where repair is not viable. Removing meniscal tissue does, however, alter load distribution in the joint, which is why preserving the meniscus is always the preferred approach where possible.
The decision between repair and meniscectomy depends on the location and pattern of the tear, the vascularity of the tissue, your age and activity level, and the condition of the rest of the knee.
As a dedicated knee practice, meniscal injuries are a core part of what we do. Our team is experienced in the full range of treatment options, from guided rehabilitation through to complex meniscal repair, and takes the time to assess each patient carefully before recommending a pathway, whether surgical or not.