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July 27th, 2011
08:01 AM ET

Will my meniscus tear heal without surgery?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Wednesdays, it's Dr. Otis Brawley, chief medical officer at the American Cancer Society.

Question asked by Gloria from San Antonio, Texas

I just learned I have a tear in my meniscus. Can this heal any way other than surgery?

Expert answer

The meniscus is a crescent-shaped pad of fiber and cartilage. There are two in each knee sandwiched between the tibia (bone of the shin and lower leg) and the femur (the bone of the thigh or upper leg).

Their purpose is to distribute the force of weight placed on the knee while walking and running. The meniscus stabilizes the knee during rotation, and lubricates the knee joint.

A meniscal tear is a very common injury. Traumatic tears occur most often from twisting motions commonly found in soccer, football, basketball and other sports. Older patients are more subject to degeneration of the meniscus and can be prone to tears with minimal twisting or stress.

There may be little or no pain at the initial injury and athletes often continue playing after a meniscal injury. Within a day or so after the tear, there is usually pain, swelling and stiffness of the knee.

A large tear can impair the smooth bending motion of the knee and cause locking, catching or "giving out" of the knee. A smaller tear can be perceived simply as instability of the knee.

A health care provider may make a presumptive diagnosis through history and physical examination or may do imaging with ultrasound or magnetic resonance imaging.

Some patients may also get the definitive diagnosis through exploratory arthroscopy, which is a surgical procedure in which a scope is placed in the knee allowing the surgeon to directly see the meniscus.

Initial therapy of a torn meniscus in a stable knee involves avoiding things that cause pain. One should apply ice to the knee 15 minutes every four hours and elevate the knee.

Crutches and a leg cuff may be needed to enable walking without pain and protect the knee from unnecessary bending and twisting. Nonsteroidal anti-inflammatory drugs, such as ibuprofen, are also useful.

After the initial inflammation subsides, exercises to strengthen the quadriceps and hamstring muscles of the upper leg are usually prescribed. This is best done under the supervision of a physical therapist.

Conservative therapy with muscle strengthening is frequently all that is needed for minor tears in which good knee function returns as inflammation subsides.

The meniscus has very little blood flow, and it often does not heal. Some patients getting conservative therapy for an old tear may have an occasional knee problem and may eventually choose to have surgical treatment.

Candidates for early surgery are patients who have persistent difficulty after the initial inflammation subsides. These patients are often unable to bear weight, have restricted knee movement, have continued pain or have other knee problems such as ligament damage. These patients generally have larger, more complex tears.

The meniscal surgery may be a repair of the tear or removal of part or all of the meniscus. The operation is most often done by arthroscopy, but in some instances has to be done through an open procedure with a larger incision.

Long-term, patients with untreated tears of the meniscus or who have removal of part or all of the meniscus are at increased risk for osteoarthritis.

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soundoff (74 Responses)
  1. Kathy

    Had medial meniscus tear in left knee; arthroscopic surgery almost over a year ago now. Highly recommend having the surgery. Was walking on it immediately; however, for about a week after surgery iced and elevated as recommended. Didn't want any setbacks.

    December 16, 2013 at 14:18 | Report abuse | Reply
    • David C.

      Kathy, Can you recall how bad your tear was, or what area of your meniscus the tear was actually located? Mine tore about 8-10 weeks ago during 3 tough tennis matches; I think I tore it a bit more with each successive match. My knee started popping and has continued; I got an MRI after seeing my family physician, who properly diagnosed it immediately (his solid hunch). Following that I visited his referral surgeon, a guy who is with a renowned Cincinnati sports orthopedic group; he confirmed and we've scheduled surgery, and I then got a 2nd opinion from another renowned surgeon who also recommended I do the arthroscopic surgery in order to return to an active (tennis & biking) lifestyle. I'm 49 years old and in excellent physical shape, no more than 7-10 pounds overweight and very active physically. My question is whether you were into sports prior to the surgery and whether you were able to resume the sports; both doctors stated that with no complications I would be back on the tennis courts after 8 weeks, and at 100% in 12 weeks. I do know that NFL players who have this "exact same surgery" are typically back on the field in 3 weeks, if not 2. That seems like a brutal thing to do to yourself but it also speaks to the relative lack of damage and minimal invasiveness that is done for a typical torn meniscus surgery. Would you agree with my assessment as it relates to your own surgery and recovery?

      December 25, 2013 at 02:35 | Report abuse |
    • jake

      just want to let others know my story. tore my menisucs while sprinting 50m, took a bad step and leg came off on an awkards angle, even ground. heard a pop and instantly new i did something. came to a hault and then jogged over to the bench without to much pain. did some test and i couldt bend my knee past 90 degrees without severe pain in the lateral side of my knee. went to a doctor next day who confirmed lateral meniscus tear because everything as was in place...i already suspected this. he said go home come back in 3 weeks and see if its heald up if it hasnt surgery may be an option. knee became very stiff and felt like it was swollen but no obvious swelling was visible. basically lost alot of muscle over the next 4 weeks as i couldt do really anything. too much walking on it was painful. and i had crutches for 2 and a half weeks and a brace for around a month. decided not to go back to doc because i didnt want my meniscus partially removed.. i wanted to be conservative. its handy to know that i had no clicking, no locking. just pain and considerably reduced range of motion in the knee when bending backwaards and all round weakended knees and legs because of the lay off from activity. anyway i stretched every day with low intensity physical activity for about an hour and a half every day after about the 4 and a half week mark. knee was sore after exercise and especially at night time felt stiff. now at week 7. 85 percent strength return in leg. can do almost all activities except sprint at this point because im too scared to try and sprint just yet. 95 percent range of motion gained back. the last 5 percent is still painful. i cannot do a full squat where my ankles touch my bum. but i can do exercise squats etc with no pain. i do have slight pain to the touch on the lateral side where the injury occured and this is expected. i must say i believe i have been extremely lucky it did not tear at the handle or anything like that. i HAVE NOT had an MRI but i have no locking, clicking, catching and none of the meniscus tore out because there is no pain with movement, only when i try and stretch thequad to that last 5 percent a this point at week 7. its very possible i only had a grade 1 or a early grade 2 tear, but its worth nothing for the first 3 weeks i literally couldnt walk on it properly. major joint pai, aching and stiffness. though with rest, ice , elevation and a little bit of rehab /strecthing/minin squats etc to strengthen the legs the injury has subsides drastically at this point. though i will note that at say week 4 and 5 i was sitting there wondering if i was going to ever be able to return to full activity again but the last of the injury has subsided quickly. my point is surgery is definitly not always the option! they could have removed half my meniscus when it wasnt necessary because it was going to heal up anyway. surgeons are out to make money. you need to work out what the best options are for you. i have just recently started seeing a physio who has put me on to some great new exercises and stretches to strengthen muscles and weak areas which have faded/ standing out since the injury and he is confident he will be able to get me back to where i was before after i told him how well ive recovered from the meniscus tear, having only to gain some motion back in the leg. good luck people and i suggest if you DO NOT HAVE LOCKING OR INTENSE PAIN WITH GENERAL ACTIVITY AFTER 4-8 WEEKS your injury can likely be resolved conservatively. locking and catching off the knee is a different story. that could indicate the menisucs has torn in an area which will not heal on its own or an area which must be operated on otherwise it can lead to degeneration of other knee cartilage and further problems in the future.

      November 5, 2014 at 03:15 | Report abuse |
  2. Paul

    One has to remember that only the outer edge of the meniscus receives blood flow to allow for initiation of some form of healing. The inner portion of the meniscus receives very limited or no blood flow, hence, tears in this region will need consideration for surgery.

    Every case is different and numerous factors need to be taken into account prior to the consideration of surgery which include the person's age, general ability to heal, current lifestyle and the lifestyle they hope to lead into the future. Never an easy decision.

    February 18, 2014 at 22:49 | Report abuse | Reply
    • Paul

      A good start for learning more about the meniscus, other than through CNN, would be aidmymeniscus.com

      February 18, 2014 at 22:52 | Report abuse |
  3. Glennp

    Trying to understand if you have surgery to remove the damaged/torn areas, what fills in these voids now. Will the meniscus grow back? Confused, just found out my Rt knee inner and outer meniscus have tears (inner worst). Feeling good/movement good so just surprised with the review of the MRI results today, since thought everything was good since I've laid off sport.

    March 20, 2014 at 15:09 | Report abuse | Reply
  4. bhavya

    i have been suffering from lateral miniscus tear.. being a sports person and x country runner .. i hurt my knee while playing basketball. i have been recommended to get surgery done by my orthopedician.. but as i am under training for military i am confused to whether go for it or not. as it will affect in my training later. what is a better option ?? whether to take rest or go for surgery?

    May 17, 2014 at 12:03 | Report abuse | Reply
  5. radhay jagdish

    i had a medial meniscus partially tear with a linear fracture in the intrmedullary canal of the tibia. it occurred six weeks back . the fracture was not seen inthe x ray but only after amonth while doing an mri. please tell me for how long it will take to recover.

    July 28, 2014 at 06:39 | Report abuse | Reply
  6. allyssa

    Hey there,
    I have had a meniscus injury few days ago and it's been really painful for around 2 days but I don't feel the pain at all today which is the 3rd day. Is it normal ? I just feel a mild pain when I climb the stairs..

    September 17, 2014 at 09:50 | Report abuse | Reply
  7. Maile Smay

    get it right here

    hiidowj930.net

    September 25, 2014 at 20:10 | Report abuse | Reply
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    October 11, 2014 at 18:55 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.