Not Every Meniscus Tear Requires Surgery
By Jayesh Patel, MD
A sudden twist on the basketball court, a hard tackle on the football field, or even a simple squat can lead to a meniscus tear. But not all meniscus injuries are the same, and understanding the difference can help guide the right treatment.
The meniscus is a C-shaped piece of cartilage in the knee that acts as a shock absorber between the thighbone and shinbone. Each knee has two menisci that help provide stability, distribute weight, and protect joint cartilage.
Meniscus tears generally fall into two categories: acute and degenerative.
Acute tears usually occur during a specific injury, often in athletes or active individuals. Symptoms may include sudden pain, swelling, popping, catching or difficulty fully straightening the knee. If the knee becomes locked or physically stuck, prompt medical evaluation is important.
Degenerative tears develop gradually as the meniscus becomes less flexible with age. These tears may occur during routine activities such as kneeling, squatting or even getting out of a car. Symptoms often include intermittent pain, stiffness, swelling after activity and discomfort with stairs or prolonged walking. In older adults, meniscus tears are frequently seen alongside arthritis.
One common misconception is that every meniscus tear requires surgery. In reality, many patients improve with nonsurgical treatment, including physical therapy, activity modification, anti-inflammatory medications, ice and, in some cases, injections.
When surgery is needed, preserving the meniscus is often the goal, particularly in younger patients with traumatic tears. Repairing the meniscus helps protect the knee and may reduce the risk of future joint problems. Surgery may also be recommended for patients who experience persistent catching, locking or other mechanical symptoms despite conservative treatment.
An MRI can identify a meniscus tear, but the most important question is whether that tear is actually causing the symptoms. Treatment decisions should consider the patient’s history, physical examination, activity level, imaging findings and overall knee health.
If persistent knee pain, swelling, catching or locking is interfering with daily activities or sports, an evaluation by a sports medicine specialist can help determine the cause and the most appropriate treatment.
The goal is not simply to treat an MRI finding. It’s to treat the patient and help them return safely to the activities they enjoy.
