Meniscus Tear

What a meniscus tear is

Each knee has two menisci, one on the inner side and one on the outer side. They are C-shaped pads of tough fibrocartilage, thicker at the rim and thinner toward the center, sitting like shims between the rounded end of the thigh bone and the flat top of the shin bone. They spread load, absorb shock, add stability and help the knee move smoothly. Losing meniscus tissue means more force passes directly through the articular cartilage, which is why surgeons preserve it where they can.

Tears happen in two broad ways. A sudden tear typically occurs with twisting, cutting, pivoting or being tackled, often with the foot planted, and is common in sport. A degenerative tear develops over time as the tissue becomes less resilient with age, and an ordinary movement, such as an awkward twist getting up from a chair, may be enough. Tears are described by shape and location, and location matters: the outer rim has a blood supply while the inner portion has very little, which strongly influences whether a tear can heal.

Symptoms that often bring people in

• Pain along the joint line, on the inner or outer side of the knee
• Swelling that develops over hours rather than instantly
• Catching, clicking or a sense that something is caught inside the knee
• A knee that locks or will not fully straighten
• Pain with squatting, twisting, or getting in and out of a car
• Giving way that feels different from ligament instability

How it is evaluated

Evaluation begins with how the symptoms started, since a twisting injury and a gradual onset suggest different kinds of tear. Examination includes feeling along the joint line for tenderness, checking how far the knee bends and straightens, and maneuvers in which the knee is bent and rotated. The ligaments are assessed at the same time, because meniscus tears often accompany ligament injuries. X-rays do not show the meniscus but are used to look for arthritis, loose fragments and other bony causes. MRI shows the meniscus itself, and is interpreted alongside the examination rather than on its own, since tears can appear on imaging without being the source of pain.

Treatment options in general terms

Many meniscus tears, particularly degenerative ones, are managed without surgery at first. That may involve:

• Settling the knee. Reducing swelling and irritation and modifying provocative activities.
• Physical therapy. Restoring motion and rebuilding the muscles that support and unload the knee.
• Injections. Categories that may be discussed for a painful, irritable knee, particularly where arthritis coexists.

Surgery may be raised when symptoms persist or the tear pattern calls for it:

• Arthroscopic assessment and treatment. A camera-guided look inside the knee, with the tear repaired or trimmed depending on what is found.
• Urgent consideration for a locked knee. A displaced fragment blocking movement is treated as a more pressing problem.

What to expect when you consult Dr. Wolfson

Dr. Wolfson is board certified in the United States and Canada and takes a conservative view of surgery where a conservative path is reasonable. A consultation covers how the tear happened, examination of the knee, review of imaging in the context of your symptoms, and whether therapy or an arthroscopic procedure fits your situation. Complimentary phone consultations are available for patients outside the Bay Area.

This page provides general information about meniscus tears and is not medical advice. It is not a substitute for examination, imaging and diagnosis by a qualified physician. Every case is different and requires individual evaluation. If you have severe pain, an obvious deformity, loss of function, fever, or an injury from a significant accident, seek medical care promptly.

Contact Dr. Wolfson if you would like to setup an appointment. If you are a new patient, please book all in-person appointments with Dr. Wolfson via telephone.

If you live outside of the San Francisco Bay Area, you can request a complimentary phone consultation with Dr. Wolfson to assess your case. Please call or e-mail us to set up your complimentary consultation.

Call: (415) 221-4400

E-mail: [email protected]