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Torn meniscus
By Mayo Clinic staffMayo Clinic Health Manager
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Definition
A torn meniscus is an injury to one or more of the two C-shaped pieces of cartilage in each of your knee joints.
Any activity that causes you to forcefully twist or rotate your knee, especially when putting the pressure of your full weight on it, can lead to a torn meniscus. In older adults, degenerative changes of the knee may contribute to a torn meniscus.
Conservative treatment — such as rest, ice and medication — is sometimes enough to relieve the pain of a torn meniscus and give the injury time to heal on its own. In other cases, however, a torn meniscus requires surgical repair.
Symptoms
If you've torn your meniscus, you may experience the following signs and symptoms in your knee:
- A popping sensation
- Swelling or stiffness
- Pain, especially when twisting or rotating your knee
- Difficulty straightening your knee fully or experiencing what feels like a block to movement of your knee, as if your knee were locked in place
Additionally, you may have pain when walking or bearing weight.
When to see a doctor
Contact your doctor if you suspect a torn meniscus — you feel a popping sensation in your knee, your knee is painful or swollen, or you can't move your knee like usual. In the meantime, apply ice to the affected knee. If you're in pain, take an over-the-counter pain reliever.
Causes
Your knee is a complicated joint consisting of various structures, including bones, tendons, cartilage and ligaments. Two C-shaped pieces of cartilage known as the menisci (plural of meniscus) curve around the inside and outside of the knee to stabilize and cushion the joint.
A torn meniscus can result from any activity that causes you to forcefully twist or rotate your knee, such as aggressive pivoting or sudden stops and turns. Even kneeling, deep squatting or lifting something heavy can sometimes lead to a torn meniscus. In older adults, degenerative changes of the knee may contribute to a torn meniscus.
In athletes, a torn meniscus may accompany other injuries, such as a torn anterior cruciate ligament — one of two ligaments that cross in the middle of your knee.
Risk factors
Anyone performing activities involving aggressive twisting and pivoting of the knee is at risk of a torn meniscus. The risk is particularly high for athletes — especially those who participate in contact sports, such as football, or activities that involve pivoting, such as tennis or basketball. The risk of a torn meniscus also increases as you get older, due to years of wear and tear on your knees.
Complications
A torn meniscus can lead to knee instability, the inability to move your knee normally, or persistent knee pain.
Tests and diagnosis
Often, a torn meniscus can be identified during a physical exam. Your doctor may bend your knee and perform physical exam maneuvers to detect a meniscal tear. Your doctor may also obtain an X-ray of the knee or magnetic resonance imaging (MRI) — a technique that uses a magnetic field and radio waves to create cross-sectional images of your knee — to confirm the diagnosis or study the extent of the tear.
In some cases, your doctor may use an instrument known as an arthroscope to study the inside of your knee. The arthroscope is inserted through a tiny incision near your knee. The device contains a light and a small camera, which projects an enlarged image of the inside of your knee onto a monitor. If necessary, surgical instruments can be inserted through the arthroscope or through additional small incisions in your knee.
Treatments and drugs
Treatment for a torn meniscus often begins conservatively. Your doctor may recommend:
- Rest. Avoid activities that aggravate your knee pain, especially any activity that might cause you to twist your knee. You might want to use crutches to take pressure off your knee and promote healing.
- Ice. Ice can reduce knee pain and swelling. Use a cold pack, a bag of frozen vegetables or a towel filled with ice cubes for about 15 minutes at a time. Do this every four to six hours the first day or two, and then as often as needed.
- Medication. Over-the-counter pain relievers also can help ease knee pain.
- Knee exercises. Physical therapy can help you strengthen and stabilize the muscles around your knee and in your legs.
- Orthotic devices. Arch supports or other shoe inserts can help to distribute force more evenly around your knee or decrease stress on certain areas of your knee.
Surgery
If your knee remains painful, stiff or locked, your doctor may recommend surgery. It's sometimes possible to repair a torn meniscus. In other cases, the meniscus is trimmed. Surgery may be done through an arthroscope.
During arthroscopic surgery, your doctor inserts an instrument called an arthroscope through a tiny incision near your knee. The arthroscope contains a light and a small camera, which projects an enlarged image of the inside of your knee onto a monitor. Surgical instruments can be inserted through the arthroscope or through additional small incisions in your knee.
Recovery time following arthroscopic surgery tends to be much faster than it is for open-knee procedures. You can often go home the same day. Full recovery may take weeks or months, however.
If the meniscus has degenerated and worn away, as would occur with severe degenerative arthritis, your doctor may recommend a knee joint replacement.
Lifestyle and home remedies
Avoid activities that aggravate your knee pain — especially sports that involve pivoting or twisting your knee — until the pain disappears. Ice and over-the-counter pain relievers can help, too.
Prevention
Regular exercise, including strength training, can help you strengthen and protect your knees. Start slowly, and increase your intensity gradually. Use proper form and protective gear for your given sport.
- Meniscal tear. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00358&return_link=0. Accessed Nov. 29, 2008.
- Anderson BC. Meniscal injury of the knee. http://www.uptodate.com/home/index.html. Accessed Nov. 25, 2008.
- Knee arthroscopy. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00299&return_link=0. Accessed Nov. 29, 2008
- Urquhart MW et al. Meniscal injuries in the adult. In: DeLee JC et al. DeLee and Drez's Orthopaedic Sports Medicine. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2003. http://www.mdconsult.com/das/book/body/114764765-3/786313327/1103/860.html#4-u1.0-B0-7216-8845-4..50030-2--subchapter5_3559. Accessed Dec. 10, 2008.
