Condition · Knee

Meniscal tear

The menisci distribute load and contribute to knee stability. A traumatic tear in an otherwise healthy knee differs from the degenerative changes seen with osteoarthritis, and that distinction changes treatment.

Consultation and assessment Conservative treatment

Clinical context

What you should know

An acute tear may be longitudinal, radial, at the meniscal root or complex. Its location, fragment stability and blood supply affect whether it can be repaired.

In adults, MRI often shows meniscal changes without specific symptoms. A scan alone does not justify surgery, especially when osteoarthritis is the main source of pain.

First step

Consultation and assessment

The injury mechanism and clinical examination are considered alongside radiographs to identify osteoarthritis or other bone problems. MRI is useful when the diagnosis remains uncertain or when the result may change the treatment strategy.

A locked knee that cannot be fully straightened because of a displaced fragment requires prompt assessment. Otherwise, many cases can begin with supervised functional treatment.

Prepare for your consultation

Stepwise treatment

Options are chosen according to the diagnosis and treatment goal

1. Consultation and assessment 2. Conservative treatment 3. Meniscal repair 4. Selective partial meniscectomy

Conservative treatment

temporary load modification and control of swelling and pain
rehabilitation to restore full extension, strength and movement control
a progressive return to activity based on functional criteria
treating osteoarthritis at the same time when it is the main source of symptoms

Medication, injections and devices each have their own indications and contraindications. They are not recommended automatically and do not replace a diagnosis or monitoring of the response.

When surgery is considered

Meniscal repair aims to preserve the meniscus when the tear has healing potential. Partial meniscectomy removes only an unstable, irreparable fragment and is not a routine treatment for degenerative pain without relevant mechanical symptoms.

ArthroscopyMeniscal repairWhen a meniscus can be repaired and what rehabilitation after meniscal repair involves.Read the procedure guide ArthroscopySelective partial meniscectomyPartial meniscectomy removes only the unstable, irreparable meniscal fragment.Read the procedure guide

Do not delay

Signs that require prompt assessment

the knee remains locked and cannot be fully straightened
marked swelling immediately after injury or inability to bear weight
redness, local warmth and fever

In an emergency or if symptoms are severe, call 112 or go to the nearest emergency department.

Frequently asked questions

Concise answers, without blanket promises

Does every meniscal tear require surgery?

No. Symptoms, tear pattern and age, associated osteoarthritis and functional goals determine whether conservative treatment, repair or selective resection is appropriate.

Why is preserving the meniscus preferred?

A functioning meniscus distributes load and protects the cartilage. When a tear is repairable, preserving it may offer long-term value, although rehabilitation must be more protective.

In detail

Tear pattern changes treatment

Degenerative lesions

These develop gradually and often coexist with osteoarthritis. Exercise-based treatment and load management are first line; arthroscopic meniscectomy is not routinely indicated for an MRI finding alone.

Radial tears

These disrupt circumferential fibres. A complete peripheral radial tear can produce near-total loss of meniscal function and, when tissue permits, repair rather than broad resection should be considered.

Root tears

Root detachment, particularly of the posterior medial root, can cause extrusion and rapidly increase compartment load. Cartilage, alignment and repairability are assessed; alignment correction may also be needed.

Vertical, bucket-handle and complex tears

A displaced fragment may lock the knee. Stability, vascularity and tissue quality determine whether repair, reconstruction or strictly selective resection is appropriate.

After an irreparable meniscal defect

When autologous tendon reconstruction is discussed

A clinically important partial or segmental defect, subtotal meniscectomy or an irreparable remnant does not automatically mean that further resection is the only option. In a symptomatic patient with a stable or stabilisable knee, correctable alignment and no advanced diffuse arthritis, partial scaffold, meniscal allograft transplantation and emerging autologous tendon reconstruction can be compared.

Autograft reconstruction is not indicated for every degenerative tear and cannot guarantee cartilage regeneration. Associated alignment correction, primary or revision ACL reconstruction, or cartilage treatment may be required to protect the compartment.

Editorial responsibility

Medically reviewed content

Dr. Răzvan Anițaș
Consultant orthopaedic and trauma surgeon; PhD in medical sciences
Last editorial update: 22 August 2026

Professional background

Medical reference sources

First step

Consultation, diagnosis and a clearly explained plan

This content is educational and does not replace medical assessment. Similar symptoms can have different causes and require different treatments.

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