Meniscal damage: what the findings mean for your knee

A visible tear is not necessarily the cause of knee pain. Degenerative meniscal changes in particular are also common in people without symptoms. In knee osteoarthritis, several joint structures may contribute to pain. The most striking term in the report is therefore not automatically the most important treatment target. We ask when your symptoms started and which movements are difficult. Are you constantly unable to straighten the knee, or do you avoid straightening it because of pain? Does it swell after activity? What can you still manage when walking, climbing stairs or gardening? During the examination, we assess movement, painful areas and stability. This information helps us interpret the imaging findings and consider other possible causes.

An MRI can show meniscal tears and possible accompanying injuries. It can support decisions, especially after a recent injury or when a specific question about surgery needs answering. However, it is not required before every course of treatment. An X-ray does not show the meniscal tear itself but can clarify bone changes or signs of osteoarthritis. If an MRI is appropriate, we arrange it with an external provider. We review existing MRI images ourselves and discuss them with you alongside the radiologist’s report. If possible, bring both, for example image access via a QR code or a CD. Recurrence of familiar symptoms does not, on its own, mean new images are needed. We check whether there is a new question that would change the next steps.

For degenerative meniscal changes, non-surgical treatment is usually the first approach. This primarily involves an adapted exercise programme, aiming to improve strength, movement and knee control. It can make everyday life easier even if the tear remains visible on imaging. We discuss what activity you can currently manage and whether physiotherapy would help. You can learn suitable exercises there; continued progress also depends on a plan you can follow at home. Tell us if an exercise causes symptoms or if you are unsure how to do it. A short course of medication or a suitable support or other aid may also be considered. We take accompanying conditions and medicines you already use into account. Non-surgical treatment is also possible for some recent tears. Whether it is appropriate depends on the type of injury and the findings. Persistent locking should not simply be treated with further exercises.

Finding a meniscal tear does not automatically lead to knee arthroscopy, also called keyhole surgery. With degenerative changes, routine partial removal is generally not expected to offer additional benefit over suitable non-surgical treatment. A recent injury with a displaced tear that restricts movement needs a different assessment. An early surgical opinion may be useful here. If surgery is planned, as much functioning meniscal tissue as possible should be preserved. Depending on the tear, repair with sutures may be an option; partial removal is another possibility. What is suitable depends on the specific findings. Even a minor procedure carries risks, such as infection, blood clots or persistent symptoms. Ask for an explanation of which problem the procedure is intended to improve and what rehabilitation afterwards would involve for you. If this question arises in your care, we discuss which findings matter and whether a further surgical consultation is needed.

Name an activity you would like to manage more easily again: a walk, the stairs at home or getting up after a long journey. As treatment progresses, this provides a way to discuss whether you can do more and how your knee responds to activity. Persistent or increasing swelling, repeated giving way or a new restriction in movement are reasons to review the plan. After surgery, weight-bearing and return to sport also depend on the procedure and the surgical team’s instructions. Without knowing your findings, a fixed number of weeks would not be a reliable guide.