Medial Meniscus Tears Causes, Symptoms & Treatment Options

The meniscus consists of two wedge-shaped pieces of cartilage that sit between the two major bones of the knee joint: the femur (thigh bone) and the tibia (shinbone). The meniscus serves as a shock absorber and provides stability to the knee. The medial meniscus is located on the medial or inner part of the knee, where medial meniscus tears commonly occur. If left untreated, this type of inner knee cartilage tear can significantly affect knee function.

There are six different types of meniscus tears:

• Radial
  • Longitudinal (vertical)
  • Horizontal
  • Parrot beak
  • Bucket handle
  • Flap

The most common tears are radial, bucket-handle, and flap tears. These types of meniscal injuries range from small tears to larger ones that may interfere with knee movement and stability. 

Generally, medial meniscus tears occur suddenly due to an injury, like a twisting knee injury, while the foot is firmly planted on the ground. This motion places abnormal pressure on the inner knee cartilage, increasing the risk of tearing. The meniscus accumulates wear and tear as we age, making it more vulnerable to a degenerative tear. In such cases, even minimal movement, like awkwardly getting up from a chair and twisting the leg, can cause injury.

Meniscus tears are common in these sports:

• Basketball
• Football
• Rugby
• Soccer
• Tennis

You may have a tear of the meniscus if you have experienced an injury to the knee and have one or more of the following symptoms:

• Swelling of the knee
• Tenderness
• Locking or the inability to fully extend the knee

If you have an injury to the knee and experience symptoms of a meniscal injury, make an appointment to see an orthopedic specialist. During your visit, your doctor will ask you to describe your symptoms in detail. He or she will examine the knee for signs of a medial meniscus tear. Tenderness over the affected area often suggests a tear in the cartilage.

The doctor may also perform a McMurray test, which involves gently bending, extending, and twisting your knee to check for damage. If your doctor hears a clicking sound or if you feel pain during this motion, it likely indicates a meniscal tear. In some cases, larger tears may cause the knee to lock, making it difficult to straighten the leg fully.

[IMAGE: McMurray test]

In order to make a diagnosis, your doctor may prescribe the following imaging tests:

• MRI to make a precise diagnosis
• X-rays to check for arthritis or other damage to the bones of the knee

If there is degenerative damage to the meniscus, or if the tear is small, your doctor will recommend conservative, non-operative treatments, like:

• Icing the knee
• Resting the leg
• Non-steroidal anti-inflammatory medications
• Using a brace to stabilize the knee
• Physical therapy with a licensed professional to strengthen the knee

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Medial Meniscus Tear

If your symptoms do not improve using non-operative treatments, or if the tear cannot be treated using non-operative treatments, you may need surgery to repair or remove the damaged portion of the meniscus. The type of surgery performed depends on the type of tear as well as the severity of the tear. For example, if the tear is located on the peripheral (outer) rim of the meniscus and there is good blood supply to the area, it can be repaired. If the tear is not peripheral or not amenable to repair then the piece is removed. The types of surgery used to treat meniscus tears include:

• Meniscus repair surgery: During meniscus repair surgery, the torn portion of the meniscus is stitched together. Recovery from a meniscus repair requires more time than a meniscectomy procedure. However, it has the advantage of preserving the meniscus tissue.

• Meniscectomy: During a meniscectomy, the damaged tissue of the meniscus is carefully trimmed and removed. The surgeon attempts to remove only the damaged tissue, preserving as much of the meniscus as possible.

These surgeries are performed arthroscopically, meaning that they are done using a minimally invasive method. Arthroscopic surgery uses several tiny incisions to access the damaged part of the meniscus. Through one of these incisions, a tiny camera attached to the end of a thin, flexible tube, called an arthroscope, is inserted. It projects video on a screen to allow your orthopedic surgeon to locate the tear. Through the remaining incisions, special instruments are inserted that are used to repair or remove the damaged tissue.

The time it takes you to recover from a medial meniscus tear depends on the type of tear, the severity of the tear, and the treatment methods used to repair the damaged tissue.

Using non-operative treatments, recovery can take six to eight weeks. If you require surgery, recovery can take up to three months for a meniscus repair surgery and roughly three to four weeks for a meniscectomy.

You can return to play when you have regained full range of motion and strength without any pain.