Medial Meniscus Tears Causes, Symptoms & Treatment Options

Overview

The meniscus consists of two wedge-shaped pieces of cartilage located between the two main bones of the knee joint: the femur (thigh bone) and the tibia (shinbone). The meniscus acts as a shock absorber and provides stability to the knee.

The medial meniscus is on the inner (medial) side of the knee, where meniscus tears most commonly occur. If left untreated, tears in this inner cartilage can significantly affect knee function.

There are six main types of meniscus tears:

• Radial: Extends from the inner edge toward the outer edge of the meniscus, often causing pain with twisting motions.
• Longitudinal (vertical): Runs along the length of the meniscus and may create a flap that catches during knee movement.
• Horizontal: Splits the meniscus into top and bottom sections, sometimes leading to swelling and knee locking.
• Parrot beak: A curved tear resembling a bird’s beak, which can cause instability and discomfort when bending.
• Bucket handle: A large tear in which a portion of the meniscus flips into the joint, often causing the knee to lock.
• Flap: A small piece of cartilage becomes loose, catching or locking the knee during motion.

The most common tears are radial, bucket-handle, and flap tears. Meniscal injuries can range from small tears to larger ones that interfere with knee movement and stability.

What causes Medial Meniscus Tears?

Medial meniscus tears most often happen suddenly from an injury, such as twisting the knee while the foot is firmly planted. This motion puts extra stress on the inner knee cartilage and can cause it to tear. 

In older adults, the meniscus also weakens over time from normal wear and tear. This makes it more likely to develop degenerative tears, which can happen during everyday movements, such as standing up from a chair and twisting the leg.

• How the Injury Occurs: Medial meniscus tears typically happen when the knee twists while bearing weight, forcing the cartilage to stretch or tear. Degenerative tears may occur gradually over time as the cartilage weakens with age.
• Common Everyday Causes: Outside sports, meniscus tears can happen during activities like climbing stairs, squatting, or twisting awkwardly while standing or lifting objects. Even minor movements can trigger injury in a worn or weakened meniscus.

Meniscus tears are common in these sports:

• Basketball: Sudden jumps, pivots, and direction changes can twist the knee and cause tears.
• Football: Quick cuts, tackles, and collisions place high stress on the medial meniscus.
• Rugby: Frequent heavy contact and sudden movements increase the risk of inner knee injury.
• Soccer: Rapid turning, pivoting, and awkward landings can strain the meniscus.
• Tennis: Sharp lateral movements and sudden stops can lead to tears in the inner knee cartilage

Symptoms

A meniscus tear may be suspected if you have injured your knee and notice one or more of the following:

• Swelling of the knee, which can develop gradually or immediately after the injury
• Tenderness, especially along the inner edge of the knee joint
• Locking or an inability to fully extend the knee, often caused by a fragment of cartilage catching in the joint

Non-operative treatment

If the meniscus tear is small or caused by degenerative changes, your doctor may recommend conservative, non-surgical treatments, including:

• Icing the knee to reduce swelling and relieve pain
• Resting the leg to prevent further stress on the injured cartilage
• Taking non-steroidal anti-inflammatory medications (NSAIDs) to ease pain and inflammation
• Using a knee brace to stabilize the joint and support healing
• Participating in physical therapy with a licensed professional to strengthen surrounding muscles and improve knee function

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Medial Meniscus Tear

Surgical Treatment

If symptoms do not improve with non-operative treatments or if the tear cannot be managed conservatively, surgery may be necessary to repair or remove the damaged portion of the meniscus. The type of surgery depends on the location and severity of the tear.

For example, if the tear is on the peripheral (outer) rim of the meniscus, where the blood supply is good, it may be repaired. If the tear is not peripheral or cannot be repaired, the damaged section is removed. Common surgical procedures include:

• Meniscus Repair Surgery: The torn portion of the meniscus is stitched together. Recovery takes longer than after a meniscectomy, but this procedure preserves the meniscus tissue.
• Meniscectomy: The damaged tissue is trimmed and removed while preserving as much of the meniscus as possible.

These procedures are typically performed arthroscopically, using a minimally invasive approach. Small incisions allow access to the damaged area. A tiny camera called an arthroscope is inserted through one incision, projecting video to a screen so the surgeon can locate the tear. Specialized instruments are inserted through the other incisions to repair or remove the damaged tissue.