The Centers for Advanced Orthopaedics
Maryland Orthopedic Specialists
A Division of The Centers for Advanced Orthopaedics
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Knee

Meniscus Tear

A meniscus tear is one of the most common knee injuries we treat — and with the right care, the vast majority of patients return to full activity, including sport. At Maryland Orthopedic Specialists, our fellowship-trained sports medicine surgeons and orthopedic surgeons have extensive experience managing the full spectrum of meniscal pathology, from straightforward partial tears to complex bucket-handle tears and meniscal root avulsions, and are committed to preserving your meniscus whenever surgically possible. Whether your path forward is physical therapy, an injection, or arthroscopic surgery, you will leave your first appointment with a clear diagnosis and a personalized plan.

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What is meniscus tear?

Each knee contains two C-shaped wedges of fibrocartilage called the menisci — the medial meniscus on the inner side of the joint and the lateral meniscus on the outer side. Tears of the meniscus are one of the most common orthopedic problems.

Each knee contains two C-shaped wedges of fibrocartilage called the menisci — the medial meniscus on the inner side of the joint and the lateral meniscus on the outer side. These structures sit between the femur (thighbone) and tibia (shinbone) and serve several critical functions: distributing load across the joint surface, absorbing shock, providing secondary rotational stability, and facilitating joint lubrication. The menisci transmit approximately 50–70% of the compressive load across the knee in full extension and up to 85–90% in flexion. This load-sharing function depends on intact circumferential collagen fibers that convert axial compressive forces into outward "hoop stresses" along the meniscal body. When any component of this architecture is disrupted — by tear, extrusion, or root avulsion — contact pressures on the underlying articular cartilage rise sharply.

Meniscal tears fall broadly into two categories based on mechanism. Acute traumatic tears occur most commonly in younger, active patients during sports involving pivoting, cutting, or deep knee loading — the same mechanisms responsible for ACL injuries, with which meniscal tears are frequently concurrent. Common acute patterns include vertical longitudinal tears, bucket-handle tears, and radial tears. Degenerative tears arise in middle-aged and older adults through cumulative wear of progressively less resilient meniscal tissue; an awkward twist rising from a chair can be sufficient to propagate a tear through aged fibrocartilage. Degenerative tears most often affect the posterior horn of the medial meniscus and frequently present as horizontal cleavage or complex (multiplanar) patterns. Epidemiological data confirm meniscal tears are among the most common musculoskeletal injuries, with an estimated incidence of approximately 60 per 100,000 person-years in the United States.

The anatomic location of the tear determines its healing potential and guides surgical decision-making. The outer third of the meniscus (the "red zone") has a blood supply from the peripheral capillary plexus and can heal following repair. The inner two-thirds (the "white zone") is avascular and relies on synovial fluid diffusion; tears in this region have limited intrinsic healing capacity. The medial meniscus is less mobile than the lateral, bears greater load in the medial compartment, and is the more commonly injured of the two. The lateral meniscus covers a larger proportion of the tibial plateau and is more mobile, making it less frequently torn in isolation but more commonly involved in ACL-associated injuries. A distinct and clinically important subtype — the meniscal root tear — involves avulsion or tear at the posterior bony attachment and functionally converts the meniscus into an unanchored structure, dramatically increasing articular contact pressures and accelerating cartilage loss.

Treatment options

Treatment is individualized based on your age, activity level, tear pattern, tear location, associated injuries, and long-term goals. Meniscal tissue is a precious, load-bearing structure — our default is always preservation over resection.

Non-Operative Management

Non-operative treatment is appropriate for stable, partial-thickness tears in the avascular zone, degenerative tears without mechanical symptoms in middle-aged or older lower-demand patients, and acute tears in individuals who are not candidates for surgery. The non-operative program typically includes:

Surgical Procedure

Meniscus Repair

Arthroscopic suture repair that reattaches a torn meniscus to the vascular periphery, preserving native tissue and long-term joint health. Repair requires a longer recovery than meniscectomy but protects the knee from early arthritis.

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Partial Meniscectomy

Arthroscopic removal of the unstable, irreparable portion of a torn meniscus while preserving every millimeter of healthy tissue. Provides reliable symptom relief for tears that cannot be repaired due to location, pattern, or tissue quality.

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Frequently Asked Questions

Do I need surgery for a meniscus tear?
Not necessarily. Many meniscal tears — particularly stable, partial, or degenerative tears in lower-demand patients — respond well to structured physical therapy and activity modification. Surgery is indicated when you have significant mechanical symptoms (locking, persistent catching), when the knee fails to improve with adequate non-operative treatment, or when the tear pattern is one that will not heal on its own and is causing ongoing joint damage. We will review your MRI findings, your symptoms, and your activity goals together and make a recommendation tailored to you.
Can a meniscus tear heal on its own?
Tears in the well-vascularized outer (peripheral) zone of the meniscus have some intrinsic healing capacity with appropriate activity restriction. However, most symptomatic tears — especially those in the avascular inner zone — will not heal without intervention. Non-operative treatment can reduce symptoms and improve function even in tears that do not fully heal, but a structural tear in the avascular zone will not close on its own.
What is the difference between a meniscus repair and a partial meniscectomy?
A repair stitches the torn edges of the meniscus back together, preserving the tissue and restoring its load-distributing function. It requires a longer recovery (4–6 months to sport) and is only feasible when the tear is in a location with adequate blood supply and the right geometry. A partial meniscectomy removes the torn fragment — recovery is faster (4–6 weeks), but the lost tissue does not grow back. Because meniscal tissue is protective against cartilage wear and osteoarthritis, we preserve and repair whenever it is surgically possible to do so.
What happens if a meniscus tear goes untreated?
The consequences depend heavily on the tear pattern. A small, stable degenerative tear in an older, lower-demand patient may be managed long-term without surgery. However, an unstable tear, a bucket-handle tear, or a root tear that goes untreated exposes the articular cartilage to abnormal stress and can accelerate the development of knee osteoarthritis. Longitudinal data confirm that significant meniscal loss — whether from untreated tears or from meniscectomy — is one of the strongest risk factors for tibiofemoral osteoarthritis over a 15–20 year follow-up period.
Can I walk on a torn meniscus?
Many patients with meniscal tears can walk without significant difficulty, particularly in the days to weeks after the initial injury as acute swelling subsides. However, the ability to walk does not indicate that a tear is minor or safe to ignore. Continuing to load an unstable tear through impact activities can extend the tear, displace it, or cause further cartilage damage. If you suspect a meniscal injury, have it evaluated before returning to full activity.
My knee locked and I can't fully straighten it — what should I do?
A locked knee that cannot be fully extended is a potential orthopaedic urgency. This presentation is the classic sign of a displaced bucket-handle tear in which a large fragment of meniscus is mechanically blocking the joint. Contact us immediately at (301) 515-0900 or go to the nearest emergency facility for evaluation. Prompt treatment protects the articular cartilage from further damage caused by the impinging fragment.

Meet the specialists

Christopher S. Raffo, MD

Christopher S. Raffo, MD

Orthopedic Surgery · Sports Medicine

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John J. Christoforetti, MD

John J. Christoforetti, MD

Orthopedic Surgery · Sports Medicine · Hip Preservation Surgery

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James S. Gardiner, MD

James S. Gardiner, MD

Orthopedic Surgery · Sports Medicine

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Brian McCormick, MD

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Related conditions

Meniscal Root TearBucket-Handle Meniscal TearACL TearKnee OsteoarthritisChondral (Articular Cartilage) Defects
Medically reviewed by Christopher S. Raffo, MD
Last reviewed May 1, 2026

References

  1. Englund M, Roos EM, Lohmander LS. Impact of type of meniscal tear on radiographic and symptomatic knee osteoarthritis: a sixteen-year followup of meniscectomy with matched controls. Arthritis & Rheumatism. 2003;48(8):2178–2187. doi:10.1002/art.11088 (Long-term meniscectomy cohort demonstrating elevated OA incidence relative to matched controls; foundational reference for meniscal tissue preservation rationale.)
  2. Bernard CD, Kennedy NI, Tagliero AJ, et al. Medial Meniscus Posterior Root Tear Treatment: A Matched Cohort Comparison of Nonoperative Management, Partial Meniscectomy, and Repair. American Journal of Sports Medicine. 2020;48(1):128–132. doi:10.1177/0363546519888212 (Demonstrates superiority of root repair over meniscectomy and non-operative treatment in matched cohorts, with lower rates of treatment failure and conversion to TKA.)
  3. Krivicich LM, Kunze KN, Parvaresh KC, et al. Comparison of Long-term Radiographic Outcomes and Rate and Time for Conversion to Total Knee Arthroplasty Between Repair and Meniscectomy for Medial Meniscus Posterior Root Tears: A Systematic Review and Meta-analysis. American Journal of Sports Medicine. 2021;49(10):2919–2927. doi:10.1177/03635465211017514 (Meta-analysis confirming that repair of medial meniscal root tears significantly delays or prevents arthroplasty conversion compared with meniscectomy.)
  4. Lamba A, Regan C, Levy BA, Stuart MJ, Krych AJ, Hevesi M. Long-term Outcomes of Partial Meniscectomy for Degenerative Medial Meniscus Posterior Root Tears. Orthopaedic Journal of Sports Medicine. 2024;12(9). doi:10.1177/23259671241266593 (Documents poor long-term outcomes including high rates of arthroplasty conversion after meniscectomy for degenerative root tears, underscoring the importance of repair in appropriate candidates.)
  5. Englund M, Lohmander LS. Risk factors for symptomatic knee osteoarthritis fifteen to twenty-two years after meniscectomy. Arthritis & Rheumatism. 2004;50(9):2811–2819. doi:10.1002/art.20489 (15–22 year follow-up study identifying meniscectomy as an independent risk factor for symptomatic OA; supports the principle of maximum tissue preservation.)
  6. Luvsannyam E, Jain MS, Leitao AR, Maikawa N, Leitao AE. Meniscus Tear: Pathology, Incidence, and Management. Cureus. 2022;14(5):e25121. doi:10.7759/cureus.25121 (Contemporary review of meniscal tear epidemiology, tear classification, physical examination, and treatment algorithms — useful for incidence and general pathology statements.)
  7. Meniscus Tears. OrthoInfo. American Academy of Orthopaedic Surgeons (AAOS). orthoinfo.aaos.org/en/diseases--conditions/meniscus-tears/ (AAOS patient-facing resource; used to corroborate symptom descriptions, physical examination, and standard-of-care treatment guidance.)