Meniscal tears
Understanding this condition
The menisci are two crescent-shaped cushions located between the femur and tibia inside the knee (one medial, one lateral). They act as shock absorbers and stabilisers: they distribute loads, protect the cartilage, and contribute to the "locking" of the knee.
A meniscal tear is a split in one of these menisci. It can occur during a trauma (sprain, forced squatting, pivoting sport) — this is the traumatic lesion in young patients. Or it can appear gradually through wear — this is the degenerative tear, common after the age of 50.
Symptoms
Pain localised at the joint line of the knee (medial or lateral), often triggered by certain movements (squatting, turning on the weight-bearing leg). A sensation of clicking or transient locking with specific movements.
In some cases, a fragment of meniscus can shift and lock the knee in flexion: inability to fully straighten the leg. Intermittent knee swelling is common.
How can it progress?
Traumatic tears in young patients, if significant and symptomatic, can progress to gradual meniscal deterioration and, in the long term, early osteoarthritis of the affected compartment. Some peripheral tears can, however, heal spontaneously.
Degenerative tears are often a reflection of already-established osteoarthritis and their management does not change the long-term prognosis of the knee.
Treatment options
For degenerative tears without locking: physiotherapy, analgesics, injections. Medical treatment is effective in the majority of cases.
For traumatic tears in young patients, and for mechanical locking, arthroscopy allows either repair (suturing) of the meniscus where possible, or removal of only the damaged fragment (partial meniscectomy) while preserving as much healthy meniscus as possible. A consultation guides the most appropriate procedure.