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Meniscus Tear: Should I Have Surgery?
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Meniscus Tear: Should I Have Surgery?
Get the facts
- Have surgery to treat a meniscus tear.
- Don't have surgery. Use home treatment and physical therapy to treat your knee.
Key points to remember
- Your decision about surgery for a torn meniscus will depend on where the tear is located, the pattern of the tear, and how big it is. Your surgeon's experience and preference, as well as your age, health, and activity level, can also affect your treatment options.
- There are two kinds of surgery for a meniscus tear. One kind repairs the tear by sewing it back together. The other kind removes part or all of the meniscus. In general, it's better to fix the meniscus than to remove it.
- Some types of tears can't be fixed. For example, radial tears sometimes can be fixed, but it depends on where they are. But most horizontal, long-standing, and degenerative tears—those caused by years of wear and tear—can't be fixed. For these kinds of tears, you may need to have part or all of the meniscus removed.
- You may want to have surgery if your knee pain is too great or if you are unable to do daily activities.
- Surgery may help you reduce the risk of other joint problems, such as osteoarthritis. There are no long-term studies to prove it, but many doctors believe that successful meniscus repair helps to evenly spread the stress placed on the knee joint. If the knee is protected from uneven force, there is a lower risk of future joint problems.
- Some kinds of tears heal on their own. Instead of surgery, you may try rest, ice, compression, and propping up your knee on a pillow when you sit or lie down.
A meniscus tear is a common knee injury. The meniscus is a rubbery, C-shaped disc that cushions your knee. Each knee has two menisci (plural of meniscus)—one at the outer edge of the knee and one at the inner edge. The menisci keep your knee steady by balancing your weight across the knee. A torn meniscus can prevent your knee from working right.
A meniscus tear is usually caused by twisting or turning, often with the foot planted while the knee is bent. These tears can occur when you lift something heavy or play sports. As you get older, your meniscus gets worn. This can make it tear more easily.
If you are older, you may not know what you did to cause the tear. Or you may only remember feeling pain after you got up from a squatting position, for example. Pain and slight swelling are often the only symptoms.
There are three types of meniscus tears, each increasing in severity. The more serious the tear, the more severe the symptoms.
With a minor tear, you may have slight pain and swelling. This usually goes away in 2 or 3 weeks.
With a moderate tear, you may feel pain at the side or center of your knee. Swelling slowly gets worse over 2 or 3 days. This may make your knee feel stiff and limit how well you can bend your knee. Usually you are still able to walk. You might feel a sharp pain when you twist your knee or squat. These symptoms go away but can come back if you twist or overuse your knee.
In severe tears, pieces of the torn meniscus can move into the joint space. This can make your knee catch, pop, or lock. You may not be able to straighten it. Your knee may feel "wobbly" or buckle without warning. It may swell and become stiff right after the injury or within 2 or 3 days.
There are two basic types of treatment for a torn meniscus—nonsurgical treatment and surgery.
- With nonsurgical treatment, you use rest, ice, compression, and elevation, and you have physical therapy. You may wear a knee brace for a short time.
surgery, you can have one of the following:
- Surgical repair to sew the tear together.
- Partial meniscectomy, which is surgery to remove the torn section of the meniscus.
- Total meniscectomy, which is surgery to remove the entire meniscus. This surgery is not usually done, because it increases the risk of osteoarthritis in the knee.
When possible, it's better to fix the meniscus than to remove it. If the meniscus can be fixed, you have a lower risk of future joint problems.1
Your doctor will likely suggest the treatment that he or she thinks will work best for you based on where the tear is, the pattern of the tear, and how big it is. Your age, your health, and your activity level may also affect your treatment options. In some cases, the surgeon makes the final decision during surgery, when he or she can see how strong the meniscus is, where the tear is, and how big the tear is.
- If you have a small tear at the outer edge of the meniscus (in what doctors call the red zone), you may want to try home treatment. These tears often heal with rest.
- If you have a moderate to large tear at the outer edge of the meniscus (red zone), you may want to think about surgery. These kinds of tears tend to heal well after surgery.
- If you have a tear that spreads from the red zone into the inner two-thirds of the meniscus (called the white zone), your decision is harder. Surgery to repair these kinds of tears may not work. You may need a partial meniscectomy instead.
- If you have a tear in the white zone of the meniscus, repair surgery usually isn't done, because the meniscus may not heal. But partial meniscectomy may be done if torn pieces of meniscus are causing pain and swelling.
Some kinds of tears can't be fixed. Radial tears sometimes can be fixed, but it depends on where they are. Most of the time, horizontal, long-standing, and degenerative tears—those caused by years of wear and tear—can't be fixed. The older you are, the less likely it is that your tear can be repaired. For these kinds of tears, you may need to have part or all of the meniscus removed.
When possible, meniscus surgery is done using arthroscopy instead of open surgery. During arthroscopy, your doctor puts a lighted tube with a tiny camera—called an arthroscope, or scope—and surgical tools through small incisions.
In a young person, surgery to fix the tear may be the first choice, because it may restore use of the knee.
Surgery has risks, including infection, a blood clot in the leg, damage to nerves or blood vessels, and the risks of anesthesia. After surgery you may still have pain and joint stiffness.
Surgery to repair tears in the meniscus relieves symptoms 85% of the time. This means that of 100 people who have this surgery, 85 have relief from pain and can use their knee normally, while 15 do not.2
Meniscus repair is most successful:
- In younger people.
- In knees that have good stability.
- In longitudinal tears or in radial tears that occur in the red zone.
- If the repair is done in the first few weeks after the injury.
Surgery to remove part of the meniscus (meniscectomy) is better at keeping your knee stable than surgery to remove all of the meniscus. Partial removal also allows a quicker and more complete recovery than total removal.
Removing the whole meniscus typically reduces some symptoms. But losing the meniscus reduces the cushioning and stability of the joint. Most people, especially if they are young or active, are not satisfied with a total meniscectomy. This is why surgeons try to remove as little of the meniscus as possible.
Studies of partial meniscectomy have shown that 78% to 88% of people have good results from partial meniscectomy. This means that 78 to 88 people out of 100 people who have this surgery have reduced symptoms and are able to return to most or all of their activities.2
Small tears found at the outer edge of the meniscus often heal with rest. Instead of surgery, you may try rest, ice, compression, and elevation. You may wear a knee brace. You can try over-the-counter medicine such as ibuprofen or naproxen to help with pain and to reduce swelling.
If your symptoms go away, your doctor may suggest exercises to build up your quadriceps and hamstring muscles and increase your flexibility. It's important to follow your doctor's guidelines so that you don't hurt yourself again.
Your doctor may recommend surgery because:
- You still have pain after trying other treatment, such as rest and physical therapy.
- Your knee "locks up" instead of working normally.
- You may be able to reduce the risk of future joint problems (osteoarthritis).
- You are an active person and your tear is in the red-to-white zone. Surgery can help return your knee to normal.
Compare your options
What is usually involved?
What are the benefits?
What are the risks and side effects?
- You have surgery to fix or remove the meniscus. In most cases, you will go home on the same day as the surgery.
- Either type of surgery is followed by rehabilitation that includes rest, walking, and doing exercises until you have full range of motion without pain.
- After surgery to fix your meniscus, you must limit movement for up to 2 weeks. It may take weeks or months before you can go back to your daily activities after surgery.
- Surgery to repair tears in the meniscus relieves symptoms 85% of the time. That means that of 100 people who have this surgery, 85 have relief from pain and can use their knee normally, while 15 do not.2
- Surgery to repair tears may reduce the risk of long-term joint problems.
- Out of 100 people who had surgery to remove part of the meniscus, 12 to 22 had relief from pain and knee problems.2
- You may still have pain and joint stiffness after surgery.
- Surgery has risks, such
- Damage to nerves or blood vessels around the knee.
- Blood clots in the leg.
- Damage to the joint.
- Risks from anesthesia.
- Your age and your health can also affect your risk.
- You try rest, ice, compression, and elevation.
- You may wear a knee brace.
- You try over-the-counter medicine such as ibuprofen or naproxen to help with pain and swelling.
- You may do exercises to build up your thigh muscles (quadriceps and hamstrings) and increase your flexibility.
- You may be able to relieve pain and return your knee to normal.
- You avoid surgery that you may not need if the tear heals on its own.
- You avoid the risks of surgery.
- You can still have surgery later if your symptoms don't get better.
- Your tear may not heal on its own, so you may still need surgery.
- You may still have pain, or your pain may get worse.
- You may not have full use of your knee.
Personal stories about meniscus tear surgery
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I've had quite a bit of pain on one side of my knee for a couple of weeks, but my symptoms have decreased. My doctor thinks that my meniscus may be healing on its own. I'm still seeing my doctor, though, and I've started rehabilitation with a physical therapist. He's got me going through range-of-motion and knee strengthening exercises at home. I don't think I'll need surgery.
Jose, age 41
A few months ago, I started having pain in my right knee when I would move it certain ways. My doctor examined my knee and asked me about my symptoms. He diagnosed a tear in my meniscus. A follow-up MRI confirmed it. I've been doing rehabilitation, but it's been 2 months and I've still got pain, particularly if I twist my knee at all. The orthopedic surgeon thinks that I may have a flap or piece of the torn meniscus moving in the knee, which is giving me a lot of problems with my knee locking. He's recommending surgical repair, and I am going to go ahead with the surgery.
Will, age 63
I injured my knee about a month ago in a tennis game. It didn't take my doctor long to diagnose a meniscus tear, and I'm going to have an arthroscopic test to see just how much I've damaged the knee. The surgeon says she can do repairs in the same procedure. My mother has severe osteoarthritis, and I believe that my knee may develop early arthritis if I don't get this tear taken care of. The arthroscopic surgery makes sense to me.
Alondra, age 32
I am a serious athlete and this isn't my first injury. But this is the first time I've had to think about surgery. I've had bad pain in my knee fairly constantly since I twisted it in the gym a few weeks ago. It's particularly bad if I bend or flex my knee. The surgeon says that the MRI shows a large tear in the inner part of my meniscus, and that's the part that doesn't heal well. He's recommending a partial meniscectomy to remove the damaged tissue. He says that he'll only have to remove a small part of the meniscus and I'll still have stability in the knee, and no more pain! I'm going to have the surgery next week.
Marlon, age 30
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have surgery
Reasons not to have surgery
I want to do whatever I can to fix my knee.
I think my meniscus tear is minor. I want to wait and see if my knee gets better before I have surgery.
I'm in a lot of pain, and I want to have surgery so I can start feeling better.
My pain isn't too bad.
I think surgery may help me avoid long-term joint problems.
I don't want to have surgery for any reason.
I accept the risks of surgery.
I feel that surgery is too risky for me.
My other important reasons:
My other important reasons:
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
NOT having surgery
What else do you need to make your decision?
Check the facts
My treatment for a torn meniscus will depend on more than just how I hurt my knee.
- TrueYou're right. Your treatment for a torn meniscus will depend on where the tear is located, the pattern of the tear, and how big it is. Your age, health, and activity level can also affect your treatment options.
- FalseSorry, that's not right. Your treatment for a torn meniscus will depend on where the tear is located, the pattern of the tear, and how big it is. Your age, health, and activity level can also affect your treatment options.
- I'm not sureIt may help to go back and read "Get the Facts." Your treatment for a torn meniscus will depend on where the tear is located, the pattern of the tear, and how big it is.
Surgery may not be able to fix every tear.
- TrueYou're right. Some kinds of tears can't be fixed. Radial tears sometimes can be fixed, but it depends on where they are. Most of the time, horizontal tears and tears caused by years of wear and tear can't be fixed.
- FalseSorry, that's not right. Some kinds of tears can't be fixed. Radial tears sometimes can be fixed, but it depends on where they are. Most of the time, horizontal tears and tears caused by years of wear and tear can't be fixed.
- I'm not sureIt may help to go back and read "Get the Facts." Some kinds of tears can't be fixed. Radial tears sometimes can be fixed, but it depends on where they are. Most of the time, horizontal tears and tears caused by years of wear and tear can't be fixed.
Surgery may help me avoid long-term joint problems.
- TrueYou're right. Surgery may be able to prevent long-term joint problems, such as osteoarthritis.
- FalseSorry, that's not right. Surgery may be able to prevent long-term joint problems, such as osteoarthritis.
- I'm not sureIt may help to go back and read "Get the Facts." Surgery may be able to prevent long-term joint problems, such as osteoarthritis.
Decide what's next
Do you understand the options available to you?
Are you clear about which benefits and side effects matter most to you?
Do you have enough support and advice from others to make a choice?
How sure do you feel right now about your decision?
Use the following space to list questions, concerns, and next steps.
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
|Primary Medical Reviewer||William H. Blahd, Jr., MD, FACEP - Emergency Medicine|
|Specialist Medical Reviewer||Patrick J. McMahon, MD - Orthopedic Surgery|
- McMahon PJ, Kaplan LD (2006). Meniscus section of Injuries section of Sports medicine. In HB Skinner, ed., Current Diagnosis and Treatment in Orthopedics, 4th ed., pp. 170–174. New York: McGraw-Hill.
- Beynnon BD, et al. (2010). Meniscal injuries on Knee. In JC DeLee et al., eds., DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice, 3rd ed., vol. 2, pp. 1596–1623. Philadelphia: Saunders Elsevier.
Last Updated:September 10, 2012