Meniscal Injuries & Treatment

The meniscus is one of the most important structures within the knee joint. Acting as a natural shock absorber, it helps distribute weight, improve stability, protect the articular cartilage, and ensure smooth movement of the knee.

Meniscal injuries are among the most common knee problems seen in both athletes and non-athletes. Early diagnosis and appropriate treatment can help relieve pain, restore function, and reduce the risk of developing arthritis in the future.

What is the Meniscus?

Each knee contains two menisci — the Medial Meniscus (inner side) and the Lateral Meniscus (outer side). These C-shaped fibrocartilage structures act as cushions between the femur (thigh bone) and tibia (shin bone). Their functions include:

• Shock absorption
• Load distribution
• Joint stability
• Lubrication of the knee joint
• Protection of the articular cartilage

Damage to the meniscus can affect normal knee mechanics and lead to progressive joint wear if left untreated.

How Do Meniscal Tears Occur?

Sports-Related Injuries

Meniscal tears commonly occur during twisting or pivoting movements, sudden changes in direction, squatting while rotating, and contact sports injuries. These injuries are often associated with ACL tears and other ligament injuries.

Degenerative Tears

As we age, the meniscus becomes less elastic and more prone to injury. Even minor twisting movements, kneeling, or squatting may result in a tear. Degenerative meniscal tears are frequently seen in middle-aged and older adults with early arthritis.

Common Symptoms of Meniscal Tears

• Knee pain
• Swelling
• Locking of the knee
• Clicking or catching sensations
• Difficulty squatting
• Pain while climbing stairs
• Stiffness
• Feeling that the knee is giving way

The severity of symptoms often depends on the size, location, and type of tear.

Types of Meniscus Tears

The various patterns of meniscal injury include:

• Longitudinal Tears
• Bucket Handle Tears
• Radial Tears
• Horizontal Tears
• Flap Tears
• Root Tears
• Meniscal Ramp Lesions
• Complex Tears

The treatment approach depends upon the tear pattern, location, patient age, activity level, and overall knee condition.

How are Meniscal Tears Diagnosed?

Clinical Examination

A detailed assessment of pain location (generally with joint line tenderness), knee stability, range of motion (there may be a block to full extension), and mechanical symptoms such as locking and clicking.

Imaging Studies

X-rays are used to assess loose bodies, arthritis and alignment. A knee MRI scan identifies meniscal and associated ligament injuries, and is particularly useful in evaluating the size and location of the tear and planning treatment.

Treatment Options for Meniscus Tears

Non-Surgical Treatment

Many meniscal injuries can be successfully treated without surgery. Treatment options may include:

• Activity modification
• Physiotherapy
• Anti-inflammatory medications
• Weight management
• Knee bracing in selected cases
• Injection therapies when appropriate

Patients with small stable tears or degenerative tears often improve with conservative treatment.

Arthroscopic Meniscal Surgery

When symptoms persist despite conservative treatment or when mechanical locking occurs, arthroscopic surgery is recommended. This is a minimally invasive "keyhole" procedure performed through small incisions using a high-definition camera and specialised instruments.

Advantages of Meniscus Repair Surgery

Meniscus Repair is a meniscus-preserving surgery and remains the most preferred option whenever possible. Modern arthroscopic techniques allow repair of various types of meniscal tears that previously required removal, made possible by highly specialised meniscus repair devices and an improved understanding of the role of the meniscus in knee function.

• Preserves normal knee function
• Maintains shock absorption
• Protects cartilage from wear
• Reduces future arthritis risk
• Better long-term outcomes

Meniscal Root Repair

The meniscal root anchors the meniscus to the tibia. Root tears can significantly affect knee biomechanics and may accelerate the development of arthritis. Arthroscopic root repair restores the attachment and helps preserve knee function and joint health.

Partial Meniscectomy

In some cases, the damaged portion of the meniscus cannot be repaired. A partial meniscectomy involves removing only the torn and unstable fragment while preserving as much healthy meniscal tissue as possible. The aim is to relieve symptoms while maintaining knee function.

Meniscal Injuries Associated with ACL Tears

Meniscal injuries frequently occur together with ACL injuries. In these situations, meniscus repair is often performed at the same time as ACL reconstruction to maximise knee stability and improve long-term outcomes.

Recovery After Meniscal Surgery

Recovery depends on the type of injury and treatment performed. A personalised rehabilitation programme is essential for optimal recovery.

For Meniscal Repair

• Hospital stay is 1 day only
• Static quads and ankle pump exercises are started immediately as tolerated
• A walker or a pair of elbow crutches is needed for support when mobilising
• Weight-bearing may be non-weight bearing or partial weight bearing for the first 2–4 weeks based on the type of meniscal tear and surgery performed
• A range of motion (ROM) knee brace is used for protection — 0–90° flexion is allowed for the first 2 weeks and increased freely every week as tolerated; most patients are fully weight bearing with full knee ROM by 4–6 weeks
• Follow-up for wound check and suture removal is at 2 weeks
• Patients need to be under the care of an experienced physiotherapist for 2–3 months with a structured, gradual rehabilitation programme
• Office work can be resumed between 2–4 weeks based on the surgery performed
• Car driving can start at 6–8 weeks and two-wheelers by 2–3 months
• Return to sports typically after 6–9 months, or sometimes 12 months post-surgery

For Partial Meniscectomy

• Hospital stay is day-care or 1 day only
• Walking full weight bearing usually from the same day or next day
• An elbow crutch is needed for support for 1–2 weeks
• Free knee ROM allowed
• Recovery is faster
• Return to routine activities within 1–2 weeks
• Return to sports can be within 4–6 weeks

Why Choose Dr Anand Jadhav for Meniscus Surgery?

Dr Anand Jadhav has extensive experience in Arthroscopic Knee Surgery and Sports Medicine, with advanced fellowship training from leading centres in the UK, USA, Europe, Singapore, and South Korea. Thousands of patients, including sportsmen and elite athletes, have benefitted from his arthroscopic surgeries. His expertise includes:

• Meniscus Repair
• Meniscal Root Tear Repair
• Meniscus RAMP Tear Repair
• ACL Reconstruction
• Multi-Ligament Knee Injuries
• Cartilage Restoration Procedures
• Advanced Arthroscopic Knee Surgery

Dr Jadhav's treatment philosophy focuses on preserving native knee structures whenever possible and restoring long-term knee health.

Early Treatment Can Protect Your Knee