A meniscal tear is a very common injury. I’ve actually torn my own meniscus, and had it operated on, so I know what it’s like both as a patient and as an orthopedic surgeon. You may be wondering if you have a meniscus tear, and if you do then what you should do about it. Or, you may have been told that you have a meniscus tear and that you need surgery. But, do you really need surgery?

What is the meniscus, and what does it do?

In each knee, you have two menisci, and both are inside your knee joint. One is on the right side of your knee joint, and the other is on the left side of your knee joint. The meniscus is basically a ring of cartilage that acts as a shock absorber for your knee joint. It’s like each of your knees has two shock absorbers in them, and instead of looking like the shocks on your car, they look like a thick version of the letter “C”. In the mid 1900s, doctors used to think that the meniscus didn’t serve any function, so they would remove it in people who had knee pain. However, they found that over time, those people who had their meniscus removed would get early arthritis in that knee. You could imagine what it would do the frame of your car if you removed all of your shocks. 

How do I know if I have a meniscus tear?

Usually you will have pain right along the inside or outside of your knee, if your meniscus is torn. This may be associated with clicking or catching in your knee that wasn’t there before. Sometimes, you can also have swelling right after you tear it. The issue is that a lot of things in the knee can present this way, so getting a good examination by an orthopedic doctor is a great way to find out if your meniscus is indeed torn. The most definitive noninvasive way to see if your meniscus is torn, is to get an MRI of your knee joint. An MRI will show the structure of the meniscus and usually a tear can be identified. That being said, you shouldn’t jump to an MRI right away without having definitive physical exam findings. The reason for this is that some people have knee pain, and they have a torn meniscus, but the torn meniscus isn’t causing their knee pain. This then results in confusion, needless treatment, and wasted time.

What should I do if my meniscus is torn?

The answer to that question really depends on how painful it is. Some people have tears of their meniscus (usually in the posterior horn of the medial meniscus), and don’t have any pain. In this case, the best thing to do is just ignore it. If you leave it alone, it won’t make your arthritis worse. Most of the time, meniscus surgery means that they are removing part of the meniscus that is torn, because only a few specific types of tears can actually be repaired. This is because the blood supply to the meniscus just isn’t good enough. If your knee pain is really bothering you, and your doctor confirms on physical exam and on MRI that you do have a meniscus tear, then it might be worth getting surgery. If you are somewhere in between, then you might want to give your knee some time to calm down to see if it gets better on it’s own. Your meniscus tear will still be there, but there is a chance that it might stabilize and not bother you quite as much in the future. Don’t let anyone tell you that you need to have surgery to clean up your meniscus, it is completely elective in almost all cases.

If you have any questions that I didn’t answer, feel free to contact me to learn more about your knee pain and meniscus tear, and what you can do about it. 

-Written by Dr. Daniel Paull