Meniscus injury

A torn meniscus, or locked knee, is a common sports or exercise injury caused by forceful twisting. It can result in a swollen and painful knee joint that requires treatment.

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At HCA UK we provide a range of services to help you recover as soon as possible:

  • An appointment with a leading specialist confirmed within 24 hours
  • See your consultant and receive diagnostic scans in one visit
  • Benefit from the latest in diagnostic and surgical equipment to speed up treatment and recovery
  • Receive leading orthopaedic care that 99% of patients would recommend to friends and family (2023 patient surveys)

What is the meniscus?

The menisci (plural of meniscus) are c-shaped cartilage structures within each knee. They sit between the bottom of the femur (thigh bone) and the top of the tibia (shin bone). The medial meniscus is on the inside of your knee joint and the lateral meniscus is on the outer side.

As your knee flexes, the meniscus allows for a smooth gliding motion and stops the bones from rubbing together. It also acts as a shock absorber, reducing the impact on your knee joint if you're running or undertaking any other kind of physical activity.

The outer third of the meniscus has a blood supply and is known as the 'red zone'. The rest of the meniscus has no blood supply and is called the 'white zone'. If this area is damaged, it is unlikely to heal by itself.

What is a meniscal injury?

A meniscus tear is a common sports injury and can affect people of all ages. Knee arthritis can also lead to a meniscal injury, as the degeneration of the cartilage in the knee makes the menisci more susceptible to damage.

Meniscus tears are typically categorised in six ways:

  • Radial tear: The most common type of meniscus injury. Radial meniscus tears are more common on the inner part of the cartilage, the medial meniscus, which is the white zone. If symptoms do not respond well to physiotherapy or rest, surgery can be performed to remove the affected cartilage.
  • Horizontal tear: Running from the top to the bottom of the cartilage's C shape, horizontal tears are treated differently depending on exactly where they occur. Injuries closer to the red zone are better suited to repair procedures, while larger tears and those in the white zone may be treated with the removal of the cartilage.
  • Bucket-handle tear: A common meniscus injury when a crescent-shaped cut forms in the cartilage. The resulting loose part of cartilage can, in some cases, get lodged in the knee joint and prevent a full range of movement as well as cause pain.
  • Incomplete tear: This is damage that occurs over time through wear and tear and may be the result of the cartilage becoming thinner and weaker rather than a sudden impact or movement. Physiotherapy, rest and medication are commonly utilised to treat this type of tear.
  • Oblique tear: Also known as a 'flap tear'. These tears are often characterised by a 'catching' sensation as the flap is agitated by the movement of your knee.
  • Complex tear: A tear that features patterns and characteristics of multiple tear types. These tears carry an extra risk of further complications and the risk of developing or worsening arthritis, so surgery is typically recommended. 

Meniscus injuries can sometimes occur at the same time as other issues within the knee, such as ACL injuries in those who suffer high impact through the joint.

Causes of meniscal injuries

In younger people, menisci are tough and rubbery but can tear when the knee is twisted with force. In older people, they become less elastic and can be torn during milder activities such as squats.

Meniscal tears can typically be categorised in two ways:

  • Traumatic tears: Sudden movements or changes of direction can cause your knee to hyperextend or twist unnaturally, which can result in a torn meniscus. This is common in sports such as football or dance.
  • Degenerative tears: Cartilage wears down over time, so older people may sustain a meniscal injury without as much physical exertion. This experience may also affect people whose job or choice of exercise puts strain on the knee joint – for example, activities that involve heavy lifting.
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What are the symptoms of meniscus injury?

  • A sharp pain when twisting the knee or squatting
  • A swollen knee joint, which may feel unsteady or stiff
  • A popping or locking sensation within the knee
  • Not being able to fully straighten or bend the leg
  • Inability to put weight on the leg
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When to see a specialist about a meniscus injury

The above symptoms can be a sign of various conditions within the knee, including a meniscus injury. If symptoms persist through rest and pain relief, our specialists have access to the very latest in diagnostic technology to provide a full picture of your knee issue.

Seeking expert help and a full diagnosis can help you understand the various treatment options available and get back to doing what you love the most. Some meniscus injury symptoms should prompt you to seek urgent help. Emergency treatment may be required if your knee joint has swollen considerably, moved out of place, or if you were injured and experienced a popping sensation with considerable pain.

How are meniscus injuries diagnosed?

Our consultants will carry out a physical assessment of your knee to see how well you can move it. They'll also ask you what you were doing when your knee began to hurt, and whether you have injured the knee in the past.

If your consultant suspects you have a meniscal tear, they may recommend an MRI scan. This will help them see the extent of the tear and whether the torn meniscus is obstructing the joint. If this is the case and your knee is locked, they may recommend surgery. Sometimes an X-ray is done if there’s a suspicion of other problems, like arthritis or fractures. 

Treatment options for a meniscus injury

It's important to reduce the pain and swelling in the knee, so your doctor will recommend anti-inflammatory medications and ice packs in the first instance. This helps to settle the symptoms of meniscal tears in most people. The size of your meniscus injury will play a significant role in how it is treated. Smaller tears in or close to the red zone of the meniscus may respond well to non-surgical options. However, tears of 2cm or more typically need surgical intervention

  • Physiotherapy: Exercises will not heal the tear in the meniscus but strengthening the surrounding muscles can stabilise the joint, potentially reducing stiffness and pain. Physiotherapy for meniscus injuries typically focuses on improving strength and stability in the major leg muscles such as the calves, quadriceps and hamstrings.
  • Meniscal repair: If you injure your meniscus in an area with a blood supply, then meniscal repair may be suitable. This keyhole surgery involves closing the tear in your meniscus using sutures and allowing it to heal over time. Physiotherapy will likely be recommended as part of your recovery process.
  • Meniscus removal: If your knee is locked or other treatment options have not eased your symptoms, your doctor may recommend surgery to remove the portion of the meniscus caught in the knee joint. This procedure is known as a meniscectomy and the torn part of the meniscus is removed. 
  • Meniscus transplant: In rare cases, you may be suitable for a transplant, where healthy meniscus tissue is taken from a human donor and placed into your knee joint. 
  • Knee replacement: This is only appropriate if there is significant arthritis in the knee as well, together with ongoing pain, stiffness and dysfunction.
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How to book an appointment with a consultant after a meniscus injury

If you're experiencing symptoms of a meniscal injury and want to meet with one of our knee specialists to understand your treatment options:

  1. Book online now or call the phone number on this page
  2. If you've received a referral letter from a GP or hospital, have it to hand in case we need any details from it
  3. If we cannot immediately schedule your appointment, we'll phone or email you within 24 hours to confirm when and where a specialist can see you.

Meniscal injury FAQs

It should be possible to walk in straight lines relatively unaided after tearing your meniscus, although pain, discomfort and stiffness may all be present. You may struggle to change direction, carry extra weight through the joint, squat or run after suffering this injury. Meniscus tears can worsen over time if left untreated, though the rate at which this can happen varies. Should the tear progress, you'll likely experience increased pain. 
This depends on the specifics of your injury. If your injury is small, stable and only affects the red zone, which is uncommon, it may heal naturally over time. Surgical intervention may be required to repair the tear, for example in a horizontal tear that runs through the red zone or the red-white zone – an area that sits on the borders between them. If you significantly damage the white zone of your meniscus, it's unlikely that it'll heal itself and surgery will likely be required for a long-term recovery.

If you don't seek treatment for a meniscal injury, the issue likely won't heal by itself. This can result in added pressure being applied to other areas of your knee joint, potentially leading to further injuries. A minor meniscus tear may be exacerbated if left untreated and you return to physical activities such as sports too soon. An untreated meniscus tear may also increase the chances of osteoarthritis developing in the affected knee over time. 

Smaller meniscus tears may take up to three months to heal in younger people or as many as six months in older age ranges.

Should you require arthroscopic knee surgery, the recovery from the procedure typically takes up to six weeks. Our physiotherapy experts will provide you with an extensive plan for rehabilitation after a meniscus tear.

Your specialist may discuss emerging treatment options such as Platelet Rich Plasma (PRP) injections. This may be a non-surgical way to promote the recovery of a torn meniscus.
The cost of meniscus treatment varies as there are multiple potential approaches, ranging from physiotherapy for minor injuries to an arthroscopic meniscectomy. Once your consultant has diagnosed the cause of your symptoms, they'll talk you through the full range of care options available.

You may find that physiotherapy for a meniscus tear causes short-term stiffness and soreness as you build up the muscles surrounding your knee joint, but this should be manageable with over-the-counter pain management medication and will hopefully ease long-term discomfort.

If you undergo surgery, you'll likely be asleep during the procedure and therefore feel no pain. Again, some stiffness may be felt post-operation, but your underlying pain should be gone.

You won't be able to drive immediately after surgery to fix a torn meniscus, so you'll need someone to pick you up from the hospital. Whether recovering from surgery or undergoing physiotherapy, you should only drive if you can comfortably perform an emergency stop.
Why choose HCA UK

Why choose HCA for torn meniscus treatment?

All-in-one appointments: We'll confirm your appointment within 24 hours and we are often able to book a consultant appointment and any required diagnostic scans in one visit to minimise disruption to your schedule.

Leading imaging equipment: All our diagnostic centres have the latest technology and all imaging is reported on by expert musculoskeletal radiologists.

Expert consultants: You'll be treated by a consultant with extensive experience in the specifics of your condition.

'Outstanding' official ratings: We have a higher proportion of leading ratings from the Care Quality Commission than any other private hospital group in the UK.

Strict standards: Our experts in treating meniscal injuries follow the British Orthopaedic Association (BOA) code of practice.

High patient satisfaction: We're delighted to report that 97% of people said they received ‘very good’ or ‘excellent’ orthopaedic care at HCA UK (2023 patient surveys).

Our Meniscal Injury consultants

Dr Oliver Guttmann

Dr Oliver Guttmann

Cardiology

Mr Christian Brown

Mr Christian Brown

Urology

Mr Tev Aho

Mr Tev Aho

Urology

Dr Oliver Segal

Dr Oliver Segal

Cardiology

Our meniscal injury locations

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Institute of Sport Exercise and Health (ISEH)

170 Tottenham Court Road W1T 7HA London
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London Bridge Hospital

27 Tooley Street SE1 2PR London
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The Harborne Hospital

Mindelsohn Way B15 2FQ Birmingham
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The Lister Hospital

Chelsea Bridge Road SW1W 8RH London
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The Princess Grace Hospital

42-52 Nottingham Place W1U 5NY London
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The Wellington Hospital

Wellington Place St John's Wood NW8 9LE London

This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.