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What do the menisci do?
Each knee has two menisci, one on the inner side and one on the outer side. These flexible structures lie between the thigh bone and shin bone. They help distribute loads and contribute to joint stability. Their shape accommodates movement; they are not simply spare pieces that can be removed without consequences.
Tears vary in shape and location. Blood supply differs between areas. This affects healing and repair possibilities, together with tissue quality and other injuries. An internet description cannot determine whether your tear can be repaired.
Understand the picture
The menisci distribute loads
Thigh bone
The upper bone rests on the joint.
Menisci
Two structures help distribute loads.
Shin bone
This bone forms the lower part of the knee.
Traumatic or degenerative tear: why distinguish them?
A traumatic tear follows an identifiable event, such as twisting with the foot planted. It may occur alone or alongside a ligament injury. A degenerative tear develops in gradually changing tissue, sometimes with osteoarthritis, without a major accident.
Both can cause pain, but some tears visible on MRI cause no symptoms. Images need to be related to your history and examination. Treatment studied in adults with a degenerative tear does not automatically apply to a young person whose knee is locked after an accident.
Pain, catching and locking: what should you describe?
Pain may occur along the inner or outer side of the joint, with swelling and difficulty pivoting or bending. A click or catching sensation alone does not prove that a fragment is blocking the knee. Several structures can cause these sensations.
True locking means the knee remains unable to straighten or bend normally. A limitation caused by pain can feel similar, but you should not try to distinguish them by forcing movement. Describe what happened and seek prompt assessment of a lasting limitation, especially after a twist.
When is prompt medical help needed?
After an accident, inability to bear weight, deformity, severe pain or marked swelling requires urgent assessment. Do not continue sport to test the knee. A hot, red joint with fever needs advice the same day, even if a meniscus tear is already known.
After surgery, contact your team for wound leakage, spreading redness or unusual worsening. A suddenly swollen or painful calf also needs prompt assessment. Breathlessness or chest pain with these signs warrants a call to 112 in Luxembourg.
What can examination and MRI show?
The professional checks movement, swelling, stability and tender areas. Meniscus tests form part of a wider assessment: no single movement repeated at home confirms the diagnosis. An X-ray may look for bone injury or osteoarthritis; it does not directly show a meniscus tear.
MRI can clarify a tear when the result will influence care. It is particularly useful in some acute injuries and before discussing surgery. It must be interpreted alongside the examination, because an image of a tear does not prove that it explains all the pain.
When is rehabilitation an option?
For many degenerative tears without locking, exercise-based care is a first option. The ESCAPE study found comparable functional results at five years between this approach and partial meniscectomy in the participants studied. Locked knees were excluded, so that conclusion must not be applied to them.
A study of certain traumatic tears in young adults did not show early meniscectomy to be superior to rehabilitation with the option of later surgery. It excluded, among others, tears judged repairable and locked knees. Assessment remains essential: a “damaged meniscus” does not describe just one situation.
What does the physiotherapist work on?
The programme may aim to reduce movement limitations, make walking easier, strengthen the thigh and prepare activities. It starts at a level compatible with swelling and current abilities. Movement control and confidence matter too, especially when returning to changes of direction.
The Exercises page provides general movements with precautions. It does not authorise deep bending or pivots after a recent injury. Ask for suitable doses and limits. If your knee regularly swells after the programme or locks, the plan and sometimes medical referral need review.
In everyday life
Prepare an appointment after a twist
Describe the event
Explain the movement, any noise and when swelling appeared.
Specify the limitation
Explain whether the knee stays locked or pain limits movement.
Clarify the plan
Ask which movements are allowed and when to review progress.
When might surgery be discussed?
A displaced tear limiting movement, certain repairable tears or persistent symptoms may lead to surgical advice. Preserving meniscus tissue is important where possible. A repair aims to mend the tear; a partial meniscectomy removes a damaged portion. These operations are not equivalent.
Ask why surgery is proposed, what alternatives exist, and about risks and consequences for your activity. Surgery does not guarantee freedom from future pain. The decision also depends on other injured structures and your goals, not only the wording of an MRI report.
Which instructions should you check after an operation?
After repair, protecting the healing tissue may limit weight-bearing, bending or some exercises for a period. After partial meniscectomy, progression is often different. The repair type, location and associated procedures change the instructions: no timetable applies to everyone.
Bring the operation report and written instructions to your physiotherapist. Clarify crutch use, permitted movements and the review date. Do not copy a relative’s programme after surgery on the “same meniscus”. Low pain is not enough to permit a prohibited load during healing.
Chapter sources [9]
Work, sport and recovery: which markers matter?
For desk work, changing position may help. A job involving squatting, lifting or pivots needs different preparation. At home, a sufficiently high chair and arrangements that reduce stairs may simplify the first days, depending on weight-bearing instructions.
Return to sport depends on mobility, swelling, strength, control and the sport’s movements. Comfortable walking does not yet clear you for fast pivots. Review progress with your professional. If progress stalls, the knee gives way or locks, seek another assessment rather than following only a number of weeks.
Your questions
Can a meniscus problem improve without surgery?
Yes. Symptoms and function can improve with suitable care in several situations. This does not mean every tear heals in the same way. A displaced tear, true locking or a potentially repairable tear needs a specific discussion.
Do clicks mean I need arthroscopy?
No. An isolated noise or catching sensation is not enough to choose surgery. Also describe swelling, pain and movements that are actually impossible. Lasting locking needs prompt assessment.
Can I cycle?
This depends on available bending, symptoms and any restrictions after surgery. A suitable saddle position and resistance can be discussed. Do not force a full pedal turn if it exceeds a prescribed limit or causes locking.
Chapter sources [9]
When can I run again after surgery?
It depends on the procedure and progress. Repair often needs different protection from partial removal. Your team checks useful criteria and surgical restrictions before introducing running and then changes of direction.
Chapter sources [9]
Sources and references
- [1] IQWiG — Wie wird ein Meniskusriss behandelt?
- [2] AAOS — Acute Isolated Meniscal Pathology (2024)
- [3] ESCAPE — Five-Year Follow-up of the Randomized Clinical Trial (2022)
- [4] Van der Graaff et al. — Traumatic meniscal tears randomized trial (2022)
- [5] Assurance Maladie — Douleurs du genou : que faire et quand consulter ?
- [6] NHS — Recovering from a knee replacement
- [7] NHS — Baker’s cyst
- [8] HAS — Pertinence de l’imagerie en cas de gonalgie chez l’adulte
- [9] Assurance Maladie — Traitement des lésions méniscales du genou
- [10] CGDIS — 112 Luxembourg
Text updated on
Medical review: awaiting Hasib Selimovic.