What is the best treatment for a meniscus tear?
The meniscuses are two C-shaped cartilage discs in the knee joint that provide cushioning and stability. Meniscal tears are among the most frequent knee injuries. This article outlines the best-evidenced treatment options for meniscus tears available to patients in the UK.
Common causes
Meniscus tears often happen when the knee is forcibly rotated. Causes include:
- Twisting knee during sports like football, tennis, skiing
- Deep squatting, then suddenly standing
- Pivoting when walking, running or dancing
- Knee hyperextending
In older adults, tears occur through the wearing down of cartilage with age.
Symptoms
Signs of a meniscal tear include:
- A popping sound when a tear happens
- Swelling over hours post-injury
- Catching, locking sensation in the knee
- Difficulty fully straightening knee
- Tenderness along the joint line
- Pain when twisting or bending the knee
Seek medical assessment if new pain persists over 48 hours after knee injury.
Diagnosis
To confirm a meniscus tear, the NHS provides:
- Physical examination of knee movement and areas of tenderness
- Review of symptoms and medical history
- Imaging like X-rays, MRI scans
- Occasionally exploratory arthroscopy
This determines suitable treatments.
Treatment options
1. Rest, ice, elevation
- Cease sports/activities causing pain
- Ice pack on knee for 15 mins every 3 hours
- Keep the leg elevated on pillows to reduce swelling
- Use crutches if unable to bear weight
Allows self-healing of minor tears.
2. Physiotherapy
- Gentle range of motion exercises
- Progressive strength training avoid lifting heavy weights
- Braces to support knee temporarily
Improves stability and aids recovery.
3. Anti-inflammatories
- Ibuprofen gels or tablets
- Anti-inflammation injections
- Reduces swelling and pain of tears
Provides symptom relief only.
4. Surgery
If above treatments fail after 3-6 months, key UK surgeries include:
- Meniscectomy – Removing damaged portion of meniscus
- Meniscal repair – Stitching torn edges together
Surgery reduces pain and instability long-term but risks later arthritis.
Case studies
Below are examples of suitable UK meniscus tear treatments based on two patient scenarios:
Kate, a 16-year-old hockey player, suffered a minor inner meniscus tear after twisting her knee tackling an opponent. As an early injury with no cartilage fraying, her NHS orthopaedic surgeon prescribed 6 weeks of rest and physiotherapy, enabling her successful return to sport by the season finals.
Liam, a 42-year-old builder, had an outer meniscus tear causing catching for over 8 months. Three months of physio provided temporary relief only. Arthroscopic partial meniscectomy was advised by his specialist due to worsening disability preventing work. After surgery and more rehab, he regained functional use of his knee.
While individualised, these demonstrate typical care pathways for patients presenting with meniscal tears under the NHS based on factors like age, symptoms, and tear type.
Conclusion
In summary, minor meniscal tears can heal well with conservative measures – rest, icing, physiotherapy and anti-inflammatories. If knee function remains impaired beyond 6 months, arthroscopic surgery produces low-risk, reliable results by either stitching or removing damaged sections. This usually restores stability and activity, allowing patients to return to sports and other occupations. You can discuss your options tailored to your lifestyle with me.
References
- NHS (2024). Torn meniscus. https://www.nhs.uk/conditions/meniscus-tear/
- Patient.info. (2024). Meniscal Tears. https://patient.info/bones-joints-muscles/sports-injuries/meniscal-tears-knee-cartilage-injuries
