| What We Treat
Meniscus Injuries
Twisted your knee and now it catches, swells or won’t quite straighten? Or been told a scan shows a meniscal tear? These are two very different situations — and only one of them usually points towards surgery.
Overview
What Is the Meniscus?
Each knee has two menisci — C-shaped wedges of tough cartilage that sit between the thigh and shin bones. They spread load, improve joint congruence and contribute to stability. They can be torn suddenly by a twisting force, or they can develop tears gradually as part of normal ageing. Those two scenarios look similar on a scan and behave completely differently in real life, which is why the distinction matters so much.
Tap a structure, or use the buttons, to compare the two very different presentations.
Traumatic Meniscal Tear
Usually a twisting injury on a planted foot, often during sport. Swelling develops over hours rather than instantly. Pain sits along the joint line, and there may be catching or a sense of the knee not fully straightening. In younger people with a repairable tear pattern, an early surgical opinion is genuinely worthwhile.
Symptoms
How It Tends to Feel
Meniscal symptoms are reasonably distinctive, though they overlap with other joint-line problems:
Joint Line Pain
Tenderness along the inside or outside edge of the joint, at the level of the gap between the bones.
Delayed Swelling
Swelling that develops over 12–24 hours after a twisting injury, rather than immediately.
Catching or Clicking
A sense of something catching within the joint during movement.
True Locking
The knee physically blocked from straightening fully. Uncommon, but important — it warrants prompt assessment.
Pain on Twisting
Turning on a planted foot, or getting in and out of a car, are classic aggravators.
Difficulty Squatting Fully
Deep knee bend loads the back of the meniscus and often reproduces the pain.
Causes & Risk Factors
What Drives It
Two distinct mechanisms produce meniscal tears, and they define two different clinical problems.
Twisting Injury
A rotational force through a bent, weight-bearing knee. The classic sporting mechanism, and the one most likely to produce a repairable tear.
Age-Related Change
Meniscal tissue becomes less resilient with age, and tears develop without trauma. Extremely common and often symptomless.
Coexisting Osteoarthritis
Degenerative tears and joint surface changes usually travel together and are best thought of as one problem.
Repeated Deep Squatting
Occupations involving prolonged kneeling and squatting are associated with a higher rate of meniscal pathology.
Previous Knee Injury
A previous ACL injury or meniscectomy substantially increases the likelihood of subsequent meniscal problems.
How We Can Help You
Treatment & Management
For the large majority of meniscal tears, a structured exercise programme is the right first step — and for degenerative tears, the evidence for this is now very strong.
What the evidence says
Multiple randomised trials, including METEOR and the Finnish FIDELITY trial comparing arthroscopic partial meniscectomy with sham surgery, found no clinically important benefit from surgery for degenerative meniscal tears over exercise therapy or placebo. This has driven a substantial international shift away from arthroscopy in this group.
Traumatic tears in younger patients are a different matter. Where the tear is in the vascular outer zone and potentially repairable, early surgical opinion is appropriate — repairing a meniscus preserves function far better than removing it.
When to Seek Help
Red Flags — Don’t Ignore These
Meniscal injuries are usually manageable. These features need prompt assessment:
⚠ Seek prompt medical assessment if you notice:
- A knee locked in a bent position that you cannot straighten (needs prompt orthopaedic assessment)
- Immediate, marked swelling within an hour of injury (suggests bleeding into the joint)
- Inability to weight-bear after an injury (possible fracture)
- A hot, red, swollen knee with fever or feeling generally unwell (possible joint infection — seek emergency care)
- Calf pain, swelling or warmth after injury or immobility (possible clot — seek same-day assessment)
These symptoms need same-day medical assessment. Please contact your GP or NHS 111 today, or attend A&E if they are severe or worsening quickly.
Common Questions
Frequently Asked Questions
My scan shows a tear — why aren’t you sending me for surgery?
Because for degenerative tears, high-quality trials including sham-controlled surgery have repeatedly shown no meaningful advantage over exercise. Meniscal tears are found in around a third of pain-free knees over 50. The tear on your scan may well not be what’s causing your pain.
Will the tear heal?
The outer third of the meniscus has a blood supply and can heal, which is why repairs are performed there. The inner two-thirds does not heal. But healing isn’t the goal — plenty of people become completely symptom-free with an unhealed tear, because symptoms come from irritation and loading, not from the tear existing.
What is true locking?
A knee physically blocked from straightening, where you can’t force it out with your hands. That’s different from a knee that’s stiff or that catches momentarily. True locking suggests a displaced fragment and warrants prompt orthopaedic assessment.
How long before I can run again?
For a degenerative tear managed with exercise, many people are running comfortably within eight to twelve weeks. For a traumatic tear, it depends on whether a repair is performed — repairs carry a longer, more protected rehabilitation of several months.
Get a Clear Answer About Your Knee
An honest assessment of what your knee actually needs, whether that’s a loading programme or a prompt referral — not a default trip to the scanner.
Book Your Initial AssessmentThis page is for general information only and isn’t a substitute for individual medical advice. If you’re experiencing any of the warning signs above, contact your GP or seek emergency medical care as appropriate.