Understanding meniscus tears and their treatment
The meniscus is a vital piece of cartilage in your knee that acts as a shock absorber and stabiliser during movement. Injuries to the meniscus are common and can occur from sudden twisting motions, sports injuries, or gradual wear and tear over time. Depending on the severity and type of tear, treatment options range from physiotherapy to surgical repair.
Dr George Awwad offers personalised care for meniscal injuries, helping patients recover function and return to their daily activities or sporting goals with the right treatment plan.
What is the meniscus?
Each knee has two C-shaped cartilage structures called the medial and lateral meniscus. These sit between the thighbone (femur) and shinbone (tibia), cushioning the joint and supporting smooth movement.
The meniscus:
- Distributes load across the knee joint
- Absorbs shock during impact activities
- Supports joint stability by guiding knee motion
- Protects the articular cartilage, which lines the bones
Damage to the meniscus can reduce its ability to perform these functions, leading to pain, swelling, and mechanical symptoms such as catching or locking.
Common causes of meniscal injuries
Meniscal tears can occur in two primary ways:
1. Traumatic meniscus tears
These often happen in younger, active individuals during sport or activity that involves twisting or pivoting movements. Common mechanisms include:
- Sudden turns while the foot is planted
- Direct impact to the knee
- Deep squatting or heavy lifting
2. Degenerative meniscus tears
These occur over time due to age-related wear and weakening of the cartilage. Degenerative tears are more common in middle-aged and older adults and may be associated with underlying osteoarthritis.
Types of meniscus tears
Tears vary in shape, location, and severity. Common tear patterns include:
- Longitudinal (vertical)
- Radial (across the meniscus)
- Horizontal (cleaving the meniscus)
- Bucket-handle tears (a large flap that may cause the knee to lock)
- Complex tears (combination of multiple patterns)
Tears located near the outer edge (the “red zone”) have better blood supply and greater healing potential, while tears in the inner region (the “white zone”) may not heal even with surgery.
Symptoms of a meniscal tear
Meniscal injuries may cause:
- Sharp or localised knee pain, often on one side
- Swelling, either immediate or delayed
- A clicking, catching, or locking sensation
- Feeling of the knee giving way
- Limited range of motion
- Pain with twisting, squatting, or pivoting
In some cases, a torn meniscus may go unnoticed initially and only cause symptoms with activity over time.
Diagnosing meniscal injuries
Dr Awwad will assess your knee through:
- A detailed history of your symptoms and injury
- A physical examination to test for meniscal signs
- MRI scans to confirm the location, type, and extent of the tear
- X-rays may be used to assess for arthritis or bony changes
Accurate diagnosis helps determine whether conservative or surgical treatment is more appropriate.
Treatment options for meniscal tears
Treatment depends on the tear type, location, patient age, activity level, and the presence of any associated injuries (e.g. ACL tear).
Non-surgical treatments
Some tears, particularly stable or degenerative ones, may be managed with:
- Rest and activity modification
- Anti-inflammatory medications
- Physiotherapy to strengthen supporting muscles and restore motion
- Injections (e.g. corticosteroids) in selected cases
Dr Awwad will monitor your progress and recommend further treatment if symptoms persist.
Surgical options
If symptoms continue or the tear is unlikely to heal without intervention, surgery may be recommended. Dr Awwad performs:
- Suitable for repairable tears, especially in younger or active patients
- Small sutures are used to repair the meniscus via keyhole surgery
- Recovery includes a period of restricted weight-bearing
- In cases where repair is not possible
- Involves trimming and smoothing of the damaged meniscus
- May support pain relief and function but can increase long-term risk of osteoarthritis if too much meniscus is remove
Dr Awwad always aims to preserve as much of the meniscus as possible, especially in younger patients.
Non-surgical treatments
Some tears, particularly stable or degenerative ones, may be managed with:
- Rest and activity modification
- Anti-inflammatory medications
- Physiotherapy to strengthen supporting muscles and restore motion
- Injections (e.g. corticosteroids) in selected cases
Dr Awwad will monitor your progress and recommend further treatment if symptoms persist.
Surgical options
If symptoms continue or the tear is unlikely to heal without intervention, surgery may be recommended. Dr Awwad performs:
- Suitable for repairable tears, especially in younger or active patients
- Small sutures are used to repair the meniscus via keyhole surgery
- Recovery includes a period of restricted weight-bearing
- In cases where repair is not possible
- Involves trimming and smoothing of the damaged meniscus
- May support pain relief and function but can increase long-term risk of osteoarthritis if too much meniscus is remove
Dr Awwad always aims to preserve as much of the meniscus as possible, especially in younger patients.
When to seek treatment
If you are experiencing knee pain, swelling, or instability, especially following a twisting injury, it’s important to have your knee assessed. Early diagnosis and tailored treatment may help prevent further joint damage and support a faster return to activity. Dr George Awwad offers comprehensive care for meniscal injuries, from diagnosis and non-operative management to surgical repair when needed. He works closely with physiotherapists to ensure optimal recovery and return to movement.