Meniscal tears are among the most common knee injuries. Athletes, particularly those who play contact sports, are at risk for meniscal tears. However, anyone at any age can tear a meniscus. When people talk about torn cartilage in the knee, they are usually referring to a torn meniscus. Three bones meet to form your knee joint: your thighbone (femur), shinbone (tibia), and kneecap (patella). Two wedge-shaped pieces of cartilage act as "shock absorbers" between your thighbone and shinbone. These are called meniscus. They are tough and rubbery to help cushion the joint and keep it stable. Menisci tear in different ways. Tears are noted by how they look, as well as where the tear occurs in the meniscus. Common tears include longitudinal, parrot-beak, flap, bucket handle, and mixed/complex.
Sports-related meniscal tears often occur along with other knee injuries, such as anterior cruciate ligament tears.
Sudden meniscal tears often happen during sports. Players may squat and twist the knee, causing a tear. Direct contact, like a tackle, is sometimes involved. Older people are more likely to have degenerative meniscal tears. Cartilage weakens and wears thin over time. Aged, worn tissue is more prone to tears. Just an awkward twist when getting up from a chair may be enough to cause a tear, if the menisci have weakened with age.
You might feel a "pop" when you tear a meniscus. Most people can still walk on their injured knee. Many athletes keep playing with a tear. Over 2 to 3 days, your knee will gradually become more stiff and swollen.
The most common symptoms of meniscal tear are:
Stiffness and swelling
Catching or locking of your knee
The sensation of your knee "giving way"
You are not able to move your knee through its full range of motion
Without treatment, a piece of meniscus may come loose and drift into the joint.
This can cause your knee to slip, pop, or lock
How your orthopaedic surgeon treats your tear will depend on the type of tear you have, its size, and location. The outside one-third of the meniscus has a rich blood supply. A tear in this "red" zone may heal on its own, or can often be repaired with surgery. A longitudinal tear is an example of this kind of tear. In contrast, the inner two-thirds of the meniscus lacks a blood supply. Without nutrients from blood, tears in this "white" zone cannot heal. These complex tears are often in thin, worn cartilage. Because the pieces cannot grow back together, tears in this zone are usually surgically trimmed away.
Along with the type of tear you have, your age, activity level, and any related injuries will factor into your treatment plan.
If your tear is small and on the outer edge of the meniscus, it may not require surgical repair. As long as your symptoms do not persist and your knee is stable, nonsurgical treatment may be all you need. In this situation, rest, ice, and compression are recommended followed by physical therapy to restore knee range of motion, strength, and neuromascular control.