Quick Answer
A meniscus tear is an injury to the fibrocartilage that helps distribute load and support stability in the knee. Acute traumatic tears and age-related degenerative tears should not automatically be treated in the same way. Many tears do not require urgent surgery, but a displaced tear that blocks knee motion or a truly locked knee warrants prompt orthopaedic assessment.
Symptoms
- Pain along the inner or outer joint line
- Swelling and loss of motion
- Catching, clicking or locking sensations
- Pain with pivoting, squatting or changing direction
- In some patients, inability to fully straighten the knee
How Is It Diagnosed?
Diagnosis starts with the history and physical examination. X-rays do not show the meniscus but help assess arthritis or bone pathology. MRI is commonly used to evaluate a suspected meniscus tear and associated ligament or cartilage injury. An MRI finding alone does not determine whether surgery is needed; imaging should be interpreted alongside symptoms and examination findings.
Acute Versus Degenerative Tears
The 2024 AAOS guideline specifically addresses acute isolated meniscal injury and does not apply the same recommendations to chronic or degenerative tears. A twisting injury in a young active patient and an age-related degenerative MRI finding should therefore not be placed into one identical treatment pathway.
Treatment Approach
Nonsurgical Treatment
When there is no true locked knee, symptoms are manageable and the tear is not displaced in a way that requires repair, activity modification, control of pain and swelling, progressive exercise and physical therapy may be appropriate. In degenerative tears, associated knee osteoarthritis and overall function are particularly important. Injections may help pain in selected patients but do not anatomically repair a torn meniscus.
Surgical Treatment
Arthroscopy may be considered for displaced acute tears, tears that mechanically block motion, or selected patients with persistent significant symptoms despite appropriate nonsurgical care. When a tear is repairable, preserving functional meniscal tissue is an important goal. Rehabilitation after meniscal repair is different from rehabilitation after partial meniscectomy; treatment depends on vascularity, tear pattern, tissue quality, age and activity goals.
Recovery and Return to Sport
Return to sport depends on the procedure and the individual. Meniscal repair requires protection of biological healing and therefore generally takes longer than recovery after limited meniscectomy. AAOS notes that return to sport after surgery for acute meniscal injury may take months. Time alone should not determine clearance; swelling, motion, strength, functional testing and sport-specific demands all matter.
When Is Prompt Assessment Needed?
Seek early assessment when the knee is truly locked and cannot straighten, weight-bearing is impossible after major trauma, swelling increases rapidly or an associated ligament injury is suspected.
Frequently Asked Questions
Does an MRI tear always mean surgery?
No. Degenerative meniscal findings can be present even in people without symptoms. Management is based on symptoms, examination, activity level and imaging together.
Is the meniscus removed or repaired?
When a tear is repairable, preservation is preferred. Some tears are not suitable for repair and may require limited trimming of unstable damaged tissue. The decision depends on tear characteristics.
Are all meniscus tears sports injuries?
No. Acute tears commonly occur with twisting sports injuries, while degenerative tears may develop with age and lower-energy movements.
Sources
- AAOS — 2024 Clinical Practice Guideline for Acute Isolated Meniscal Pathology
- AAOS OrthoInfo — Meniscus Tears
This page is for general patient education and does not replace an individual medical examination or treatment plan.
Evidence sources checked: 7 August 2026.