Meniscus tears can happen in two main ways:

1. Acute Tears: These occur suddenly, often during sports like football, soccer or basketball. They usually happen when the knee twists or rotates sharply, like when pivoting or squatting. Everyday activities like climbing stairs or getting in and out of a car can also cause tears.
2. Degenerative Tears: These develop slowly over time due to wear and tear. As people age, their meniscus can become stiff and brittle, leading to gradual tears.

• A popping sound when the injury happens
• Pain and swelling on the inner or outer side of the knee
• Stiffness and difficulty bending or straightening the knee
• Clicking or catching sensations
• Feelings of instability or the knee “locking” up
• Trouble walking, running, or climbing stairs

Sometimes, the knee might feel better after a few weeks, but pain and other symptoms can return during activities. Over time, a meniscus tear can significantly increase the risk of developing osteoarthritis or needing a knee replacement.

To diagnose a meniscus tear, doctors use a combination of:

• Physical Exam: Special tests like the McMurray Test and Apley’s Compression Test can check for pain and swelling.
• X-rays: These can show if there are any fractures or signs of arthritis, but they can’t detect meniscus tears.
• MRI: This imaging test helps confirm the tear and shows how serious it is, as well as if there are any other knee problems.

The treatment depends on the type, size, and location of the tear, as well as your age and activity level.

Meniscus Zones

The meniscus is divided into three zones:

• White Zone: The inner part with poor blood supply. Tears here often require surgery to remove the damaged part (partial meniscectomy).
• Red-White Zone: This area has a moderate blood supply. Tears here may heal with conservative treatments or can be repaired surgically.
• Red Zone: The outer part with good blood supply. Tears here often heal well with conservative treatments or can be surgically repaired.

Choosing the right treatment involves considering these factors to help you recover effectively.

Meniscus tears can vary widely in how they occur and look. Here are some common types:

Bucket Handle Tears

These are large tears that run from the front to the back of the meniscus. The torn piece often looks like a “bucket handle” and can get caught in the knee joint, making it hard to straighten your leg all the way. They usually happen during sports when you twist or pivot your knee suddenly. Bucket handle tears are often seen in younger athletes.

Flap Tears

These occur when a part of the meniscus tears and flips over, like a flap. This type of tear can make the knee feel unstable and cause pain, locking or stiffness as well.

Radial/Root Tears

• Radial Tears: These start from the center of the meniscus and extend outwards towards the edges. They disrupt the meniscus’s ability to absorb shock and are often found in the back of the medial meniscus or in the middle and front of the lateral meniscus. Radial tears can be complete (reaching the edge of the meniscus) or incomplete (not reaching the edge). These tears can be one of the most damaging and difficult to repair depending on the location.
• Root Tears: These occur where the meniscus attaches to the tibia. They can cause the meniscus to shift out of place, which can lead to significant knee problems, including faster cartilage damage and arthritis. Root tears are seen in younger athletes and older adults. These tears if caught early and repaired may slow down the degeneration of the knee.

Horizontal Tears

These occur parallel to the surface of the meniscus and are often linked to wear and tear over time. If these tears happen in areas with good blood supply, they can be repaired with surgery. However, these tears are most commonly seen in our older patient populations.

Meniscal Ramp Lesions

These occur in the back inner corner of the medial meniscus and are often associated with ACL injuries. They can be tricky to diagnose and are sometimes missed. Ramp lesions can affect the stability of the knee, especially if the ACL is also injured.