The meniscus is a C-shaped structure made of cartilage that acts as a shock absorber in the knee. We have two menisci in each knee, the medial (inner) and lateral (outer) meniscus. They sit between the thigh and shin bones, help transfer body weight, and contribute to the stability of the knee.

A meniscus tear occurs when this cartilage is damaged, either through:

• Trauma: a sudden twisting injury, common in sport
• Degeneration: gradual wear over time, where the meniscus tears with minimal force

Meniscus tears are among the most common knee injuries and can occur alongside other injuries such as an ACL tear.

Common signs and symptoms of a meniscus tear include:

• Pain along the knee joint line, especially when twisting or squatting
• Swelling that develops over the hours following the injury
• A sensation of the knee catching, clicking, or locking
• Difficulty fully straightening or bending the knee
• A feeling that the knee is unstable or giving way

Some degenerative tears cause only mild, intermittent symptoms, while others significantly limit movement. A specialist assessment with an MRI scan confirms the diagnosis and guides treatment.

If you suspect a meniscus tear, the first step is to stop any vigorous physical activity to avoid making the injury worse. Then care for the knee using the RICE principles:

• Rest: avoid activities that load or twist the knee
• Ice: apply ice to reduce pain and swelling
• Compression: use a compression bandage to help control swelling
• Elevation: raise the leg to reduce swelling

If pain, swelling, or locking persists, or if the knee feels unstable, arrange an assessment with an orthopaedic surgeon, who may organise an MRI scan to confirm the diagnosis and check for associated injuries such as an ACL tear.

No. Many meniscus tears can be managed successfully without surgery, particularly smaller or degenerative tears. Non-surgical treatment includes:

• Rest, ice, compression, and elevation in the early phase
• Anti-inflammatory medication for pain and swelling
• Physiotherapy to strengthen the muscles supporting the knee
• Activity modification to avoid aggravating movements

Surgery is considered when symptoms such as pain, locking, or instability persist despite these measures, or when the tear is large, displaced, or occurs alongside another injury such as an ACL tear. Your surgeon will recommend the best approach based on the tear type, its location, and your activity level.

There are two main surgical approaches to a meniscus tear, both performed arthroscopically (keyhole surgery):

• Meniscus repair: the torn edges are stitched back together so the meniscus can heal. This preserves the cartilage and is preferred where the tear is in an area with good blood supply. Recovery is longer, but it protects the knee against future arthritis.
• Partial meniscectomy: only the damaged, unstable portion of the meniscus is trimmed away, leaving healthy tissue intact. Recovery is faster, but it removes some cartilage.

Surgeons prioritise preserving the meniscus wherever possible, because retaining healthy cartilage helps protect the knee joint over the long term. The choice depends on the tear's location, pattern, and blood supply.

Recovery time depends on which procedure is performed:

• Partial meniscectomy (trimming): faster recovery, with many patients returning to daily activities within a few weeks and sport within around 4 to 6 weeks
• Meniscus repair (stitching): slower recovery, as the cartilage needs time to heal, often around 3 to 6 months before full return to sport, sometimes with a period of restricted weight-bearing or bracing

In both cases, a guided physiotherapy programme is key to restoring strength, movement, and confidence in the knee. Your surgeon will provide a timeline specific to your procedure.

Leaving a symptomatic meniscus tear untreated can lead to ongoing and potentially worsening problems, including:

• Persistent pain, swelling, and mechanical symptoms such as locking or catching
• A torn fragment moving within the joint and causing the knee to lock
• Increased stress on the knee cartilage, which can accelerate the development of arthritis over time

Not every tear requires surgery, but persistent or mechanical symptoms should be assessed promptly. Early treatment can relieve symptoms and, where the meniscus is preserved, help protect the knee against long-term joint damage.

.