Introduction to Knee Injuries

Knee injuries are among the most common musculoskeletal problems, affecting people of all ages and activity levels. The knee joint is a complex structure composed of bones, ligaments, tendons, cartilage and surrounding muscles, all working together to provide stability and movement.

Because of its essential role in walking, running, jumping and pivoting, the knee is particularly vulnerable to injury. One of the most common knee injuries is a meniscus tear, which can cause pain, swelling, mechanical symptoms and difficulty moving the knee.

Meniscus tears may result from a sudden injury or develop gradually over time due to wear and tear. Understanding the types of meniscus tears, their causes and symptoms is crucial for early diagnosis and effective treatment.

What Is the Meniscus?

Each knee contains two C-shaped pieces of cartilage called menisci (singular: meniscus). These structures sit between the femur (thigh bone) and the tibia (shin bone), positioned on the tibial surface at the periphery of the knee joint.

Key Functions of the Meniscus

The menisci play several essential roles in knee health:

• Act as shock absorbers within the knee joint
• Distribute weight evenly across the joint
• Improve joint stability
• Protect the articular cartilage from excessive wear
• Contribute to joint lubrication and proprioception

There are two menisci in each knee:

• Medial meniscus (inner side of the knee)
• Lateral meniscus (outer side of the knee)

The outer third of the meniscus has a better blood supply, which allows for some healing potential. The inner two-thirds have limited blood flow, making tears in this region less likely to heal on their own.

Because the menisci bear significant load during walking, running, squatting and pivoting, they are especially vulnerable to injury.

What Causes a Meniscus Tear?

Meniscus tears may occur due to acute trauma or gradual degeneration.

Acute (Traumatic) Meniscus Tears

Traumatic meniscal tears often occur during sports or physical activity and may happen alongside other knee injuries, such as an anterior cruciate ligament (ACL) tear.

Common mechanisms include:

• Sudden twisting or pivoting on a planted foot
• Deep squatting with rotation
• Rapid direction changes
• Direct contact or tackle
• Heavy lifting with knee flexion
• Participation in contact sports such as football, basketball and soccer

A traumatic meniscus tear commonly occurs when an athlete pivots on a planted knee while turning the upper body.

Degenerative Meniscus Tears

As we age, the meniscus becomes thinner and less flexible. Over time, normal wear and tear can weaken the cartilage, leading to a degenerative meniscus tear.

In older adults, even simple movements, such as standing up from a chair or stepping off a curb, can cause a tear. Degenerative meniscus tears are common regardless of activity level and frequently occur in patients with knee osteoarthritis.

These tears may develop without a specific injury event.

Types of Meniscus Tears

Meniscus tears vary by location and tear pattern. Common types include:

• Longitudinal (vertical) tear
• Bucket-handle tear
• Radial tear
• Flap tear
• Complex tear

The location of the tear significantly impacts healing potential. Tears in the outer “red zone” (vascular region) are more likely to be repairable. Tears in the inner “white zone” often require trimming of the damaged portion due to limited blood supply.

Symptoms of a Torn Meniscus

Common symptoms of a meniscus tear include:

• Pain along the joint line (inner or outer knee)
• Swelling that develops within 24-72 hours
• Stiffness
• Catching or locking of the knee
• Inability to fully bend or straighten the knee
• A sensation of the knee “giving way”
• Popping sensation at the time of injury

Many individuals can still walk immediately after injury but swelling and stiffness often increase over the next few days.

If a loose fragment of cartilage moves inside the joint, it may cause mechanical locking, which requires prompt evaluation.

How Meniscus Tears Are Diagnosed

Accurate diagnosis is essential to determine the most appropriate treatment plan. A meniscus tear is diagnosed through a combination of medical history, physical examination and imaging.

At OrthoTexas, evaluation includes:

Comprehensive Clinical Examination

• Review of injury history and symptoms
• Physical examination of the knee
• Joint line tenderness assessment
• Range-of-motion testing
• Specialized maneuvers to assess meniscal integrity

Imaging Studies

• X-rays to evaluate bone alignment and rule out arthritis or fractures
• MRI to confirm the meniscus tear, assess associated injuries and identify tear pattern

MRI is especially helpful in determining whether the tear is repairable and identifying coexisting injuries.

Meniscus Tear Treatment Options

Treatment depends on:

• Type and location of tear
• Patient age
• Activity level
• Presence of arthritis
• Severity of symptoms

Many meniscus tears do not require immediate surgery.

Non-Surgical Treatment

Conservative care may be appropriate for:

• Small or stable tears
• Degenerative tears
• Knees without mechanical locking
• Patients with lower activity demands

Non-surgical treatment may include:

• Rest and activity modification
• Ice and elevation
• Anti-inflammatory medications (when appropriate)
• Bracing
• Structured physical therapy
• Strengthening of quadriceps and hamstrings

Maintaining knee motion during rehabilitation is essential to prevent stiffness and further dysfunction.

Surgical Treatment

If conservative treatment fails or mechanical symptoms persist, surgery may be recommended. Arthroscopy is the standard minimally invasive approach.

Arthroscopic Meniscus Repair

When possible, preserving the meniscus is preferred. Sutures are placed to allow the tear to heal. Repair is more successful in tears located in the vascular outer portion of the meniscus.

Partial Meniscectomy

If repair is not possible, the torn portion is trimmed and smoothed while preserving as much healthy tissue as possible.

Meniscus Transplant

In select younger patients who have undergone significant meniscus removal and continue to experience symptoms, meniscal transplant using donor tissue may be considered.

Recovery After Meniscus Surgery

Recovery depends on the procedure performed.

After Partial Meniscectomy

• Early weight bearing
• Early physical therapy
• Return to many activities within 4–6 weeks

After Meniscus Repair

• Temporary limitations on weight-bearing
• Brace use when indicated
• Gradual rehabilitation progression
• Return to sports may take several months

In advanced cases of joint damage, knee replacement may eventually be considered, though this is not typical for isolated meniscus tears.

Your orthopedic surgeon will provide a personalized rehabilitation plan.

Prevention of Meniscus Tears

While not all tears can be prevented, risk reduction strategies include:

• Wearing supportive footwear
• Strengthening quadriceps and hamstrings
• Warming up before exercise
• Avoiding sudden twisting motions
• Maintaining a healthy body weight
• Reducing repetitive stress on the knee

Proper conditioning and movement mechanics help protect the knee joint.

Potential Complications

If left untreated or improperly managed, meniscus tears can lead to:

• Persistent knee pain
• Recurrent swelling
• Knee instability
• Mechanical locking
• Increased risk of knee osteoarthritis

Early diagnosis and appropriate treatment reduce long-term complications.

When to See a Knee Specialist

Schedule an evaluation if you experience:

• Persistent knee pain lasting more than a few days
• Swelling that does not improve
• Catching or locking sensations
• Knee instability
• Difficulty bending or straightening the knee
• Pain after twisting or pivoting

Prompt evaluation can help prevent worsening joint damage.

Comprehensive Knee Care at OrthoTexas

At OrthoTexas, our knee specialists treat the full spectrum of meniscus injuries, from degenerative tears to complex sports-related injuries. We offer:

• Advanced diagnostic imaging
• Conservative, evidence-based treatment plans
• Arthroscopic meniscus repair and meniscectomy
• Meniscus transplant in select cases
• Comprehensive rehabilitation planning

Our goal is to relieve pain, restore knee stability and protect your long-term joint health.