Why You Shouldn’t Let a Meniscus Tear Go Untreated

Can a meniscus tear heal on its own?

If you’re reading this blog, the chances are you have already been diagnosed with, or suspect that you have a meniscus tear in the knee.

That means you’ve been suffering from some or all of the typical symptoms of instability, pain in or around your knee, swelling, weakness, reduced range of motion or a catching feeling.

And you probably want to know if you can get away with leaving it untreated.

The short answer is, usually not.

The good news is that there are conservative, non-invasive and highly effective treatments for a meniscus tear that do not involve surgery. And even if you do have to have meniscus surgery, the prognosis is usually very good for healing and full recovery.

Our Capital Orthopaedics sports medicine team is highly experienced at diagnosing and treating meniscus tears in the most effective way possible with the aim of getting you back to full mobility quickly, with the strength and flexibility to prevent re-injury.

For more information or to book an appointment, contact us here.

What is a meniscus tear?

The meniscus is a c-shaped, rubbery piece of cartilage that provides shock absorption in the middle of your knee joint. It can get damaged through overuse, an impact or a powerful twisting motion.

How can you tear a meniscus in the knee?

Many tears occur as a result of a twisting, wrenching or shearing action – it’s particularly common in sportspeople who do a lot of pivoting, such as basketball or football. The meniscus can also get torn due to wear and tear (degenerative tear) – especially if you do a lot of deep knee bends, such as in weightlifting. Impact injuries can also cause the meniscus to tear, for example in contact sports like rugby, in a fall or in a car accident.

In younger people, the meniscus is more rubbery and is likely to tear cleanly. As we get older, it gets more brittle and frayed, making it more liable to tear in multiple directions.

What are the common types of a meniscus tear?

Incomplete or intrasubstance tear: often these are a sign of early degenerative changes of the meniscus tissue. Incomplete and intrasubstance tears of the meniscus are stable injuries, and generally do not require any surgical treatment.

Radial Tear: the most common type of meniscus tear. These tears are in the ‘white zone’, where there is no blood supply, so there is little capacity for these tears to heal. Typically, the only option is to trim out the damaged portion of the meniscus (meniscectomy). Bigger radial tears are repairable.

Horizontal Tear: a horizontal tear runs along the outer fibres of the meniscus. A horizontal tear may be sewn together (meniscal repair), but only if it’s located in the outer edge of the meniscus, which has a healthy blood supply (red zone).

Flap Tear: a flap of meniscus may be causing symptoms of catching in the knee. In most cases, the flap can be removed without removing much tissue at all.

Complex Tear: this is a combination of tear patterns – involving both radial and horizontal tear patterns. Typically, complex tears are treated with by removing the damaged meniscus tissue, but can sometime be repaired.

Bucket-handle tear: a large, horizontal tear of the meniscus that can cause the knee to become completely stuck as meniscus tissue gets trapped in the knee joint. Bucket-handle tears often need urgent surgical treatment so that you can bend your knee again. These are usually repairable.

What are the symptoms of a meniscus tear?

Depending on the type of tear you have had, you may have symptoms of:

• Pain and tenderness which gets worse when you put pressure through the joint
• Swelling
• Feeling of your knee giving way
• Locking or catching feeling
• Reduced range of motion
• Difficulty walking up or down stairs
• Muscle weakness around your knee

What happens if you leave a meniscus tear untreated?

Some meniscal tears can be relatively minor, and the symptoms may disappear on their own – especially if the tear is near the outside edge of the meniscus, where there is a better blood supply (the red zone).

However, if you have ongoing symptoms, it’s likely you have a deeper tear, or a tear on the inner two-thirds of the meniscus (the white zone).

An untreated meniscus tear can result in the frayed edge getting caught in the joint, causing pain and swelling. It can also result in long term knee problems such as arthritis and other soft tissue damage.

How can Capital Orthopaedics help diagnose a meniscus tear?

If you have any of the symptoms listed above, it’s really important to get an accurate diagnosis sooner rather than later. Our specialist orthopaedic surgeons will do a physical exam and use an MRI scan to assess the location and severity of the tear.

When is surgery required for a meniscus tear?

If the tear is minimal and on the outer part of the meniscus, physiotherapy can be the best treatment. You will be given a programme of exercises to build up the strength around your knee and improve mobility as the cartilage heals.

If the tear is more severe and you are very active or you have a physical job, surgery is usually recommended.

How Capital Orthopaedics can help treat a meniscus tear in the knee?

We offer a range of treatment options, depending on the severity and location of the tear. If at all possible, our team of sports medicine physiotherapists will provide you with a rehabilitation programme to help strengthen your knee and return to full flexibility. We also provide injection therapies and shockwave therapies to stimulate healing and reduce inflammation.

If surgery is required, our consultant orthopaedic surgeons will carry out arthroscopic (keyhole) surgery. This may involve:

Meniscal repair

In some cases, the meniscus can be repaired by sewing together the torn edges. This is done arthroscopically (keyhole surgery using small incisions), so there is minimal damage to other structures of the knee.

After this operation, the meniscus continues to provide shock absorption – reducing the likelihood of knee arthritis in the future. It also increases the stability of the knee and return to pre-injury sports.

There are drawbacks with a meniscal repair, however. In patients over the age of 40, the torn edges are likely to be frayed – and, just as with frayed cloth, it is difficult to sew the fibres together effectively, so success rates are lower.

Also, recovery from a meniscal repair involves wearing a fixed 24/7 for four to six weeks, during which time, you must keep some weight off your leg.

Meniscectomy

Your surgeon may suggest a partial or total removal of your meniscus. This operation is carried out arthroscopically and you will be able to weight-bear and start rehabilitation exercises the next day after surgery.

The drawbacks of a meniscus removal are that the cushioning in your knee is gone – meaning the bones of your joint are at risk of impacting on each other, which will eventually lead to arthritis.

You should be able to return to daily activities within two weeks after a meniscectomy, or four to seven weeks after a meniscal repair.

With the right physiotherapy, along with injection therapy to stimulate healing in your knee joint, you may be able to protect against knee arthritis after meniscus surgery.

If you have any knee pain, instability, swelling or discomfort in your knee, contact the Capital Orthopaedics team here to book a consultation or to discuss your treatment options.

Frequently Asked Questions

How Long Does It Take for a Torn Meniscus to Heal Without Surgery?

With expert guidance and targeted programmes from physiotherapists, you should be able to build up the muscles around your knee to provide stability, help you develop flexibility and restore full range of motion within six to eight weeks.

Will Walking on a Torn Meniscus Make It Worse?

Walking on a torn meniscus will not make it worse, but you should be guided by pain. If your knee swells up and becomes painful, you should reduce the amount of walking to a level where you have no pain, and then build up again to longer distances / greater speeds or inclines.

Walking helps to lubricate your knee joints, builds up muscle and increases blood flow, all of which are beneficial to healing after a meniscus tear.