Specialist

Meniscal Tears in Adults

Meniscal tears are common in adults and may occur after even a minor twisting injury.

Symptoms

• Pain localised to one side of the knee
• Catching, locking or giving-way sensation
• In acute cases, the knee may become locked and unable to fully straighten

A locked knee is urgent, as it may indicate a displaced tear. Forcing the knee straight can worsen the injury.

Investigations

• Plain X-rays: assess underlying arthritis
• MRI scan: identifies the location, size and type of tear and guides treatment

Treatment

Acute locked knee

Urgent surgery is usually required, depending on age and the presence of arthritis.

Traumatic tear without arthritis

• Surgery performed on the next available list
• Aim is to repair the meniscus where possible based on MRI findings

Degenerative tear with arthritis

• Physiotherapy
• Steroid with local anaesthetic injection

Surgery is considered only if symptoms persist despite non-operative treatment.

Surgical procedure

Arthroscopy (keyhole surgery) is performed to assess and treat the tear.

• Small unstable flap tears may be trimmed (partial meniscectomy)
• Tears at the base or within the main substance of the meniscus are repaired whenever possible

Preserving the meniscus is important, as removal increases the long-term risk of knee arthritis, particularly with lateral meniscal tears.