What is meniscal injury?

William N. Levine, MD
Orthopedic Surgery

The meniscus cartilage is like a shock absorber pad between the femur (thigh bone) and tibia (shin bone) in the knee. There are 2 menisci - 1 on the inside of the knee ("medial meniscus") and 1 on the outside of the knee ("lateral meniscus"). Actually many meniscal tears can and are successfully treated without surgery. Typically physical therapy (to strengthen the surrounding muscles) and anti-inflammatory medicines (i.e. Ibuprofen, to decrease inflammation and swelling) will be recommended initially for symptomatic meniscal tears.

One type of meniscal tear that will require surgery is a "bucket-handle" tear. This is a tear that usually occurs acutely and causes a "locked knee" where the knee gets stuck due to a large segment of the meniscus cartilage becoming lodged between the femur and the tibia. The 2nd type of meniscal tear that may require surgery is one in which the symptoms persist (pain and swelling and often prevention of performing activities and/or sports) despite appropriate non-operative treatment.

For those patients who require surgery, make sure you ask your doctor what the status of the surface cartilage is before the operation. The surface cartilage is also called articular cartilage and is like the white, glistening tissue on the end of a chicken bone. The loss of articular cartilage is what happens in arthritis and sometimes is damaged as well in patients with meniscal tears and can alter the treatment, rehabilitation, and ultimate outcome in patients having meniscal surgery.

Ultimately, arthroscopic treatment for isolated meniscal tears is highly successful in most patients.

Your meniscus is commonly known as your knee cartilage.  So and injury to the meniscus is one and the same as injured knee cartilage.  In the knee there are two of these tissues – one on the inside and the outside, and they're located at the knee joint, where the lower leg bone (tibia) and thigh bone (femur) meet.  Normally, these cartilage tissues collectively work together to cushion the joint surfaces and allow smooth gliding of your knee…as it flexes and extends.

Common symptoms of meniscal injury are pain, swelling, clicking, and sometimes temporary locking.  These injuries are often caused by an acute incident, but are often chronic in nature as the result of impairments in movement efficiency.  Frequently, meniscal injuries are the resultant of chronic movement dysfunction between the ankle, knee, and hip.

To envision injury of meniscal tissue consider rings of a tree.  Tears along one ring (“longitudinal”) often heal non-surgically.  Tears which span from one ring to another (“bucket handle”) are problematic and often require surgery.  However, surgical repair and quality post-operative physical therapy report very successful outocomes.  Make sure your rehabilitation program includes flexibility and strengthening for the ankle, knee, and hip.

Surgical or non-operative treatment options vary.  So report all symptoms to your physician for a comprehensive diagnostic examination.

A meniscal injury occurs when the c-shaped tissue that provides a cushion at the knee tears slightly or completely.  Each knee has two menisci – lateral and medial. Symptoms vary dependent on the severity of the injury, and can range from minor swelling to popping, locking, and/or complete immobility. The severity of meniscal injuries can vary from very minor and healable on its own, to severe, and requiring surgery. Smaller tears towards the outside of the meniscus have a better chance at healing than those larger, or further towards the middle. This is due to the available supply.


If you suspect you have a meniscal tear, practice rest, ice, compression, and elevation – and see your physician.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.