The menisci are two crescents of cartilage that sit between the thigh bone and shin bone, spreading load and helping the knee stay stable. They tear in two quite different ways, and the difference matters more than almost anything else on this page.
A traumatic tear happens to a younger knee during a twisting incident, often alongside other damage. A degenerative tear happens gradually in a middle aged or older knee as the tissue becomes less resilient, and frequently produces symptoms without any incident at all.
More information
Why the distinction matters
For degenerative tears, a substantial body of good quality evidence has compared arthroscopic partial meniscectomy with exercise therapy, and with placebo surgery, and has not found a meaningful advantage for the operation. That has changed practice significantly. If you have been told you have a torn cartilage on a scan and are middle aged, the first line treatment is a proper exercise programme rather than an arthroscopy.
It is also worth knowing that meniscal tears show up on scans in a large proportion of people over fifty who have no knee pain whatsoever.
When surgery is appropriate
A knee that is genuinely locked, meaning you physically cannot straighten it, needs urgent orthopaedic assessment, because a displaced fragment can be trapped in the joint. Younger patients with traumatic tears, particularly where the meniscus can be repaired rather than trimmed, are a different conversation.
What treatment involves
Settling the irritation, restoring movement, then a progressive strengthening programme for the quadriceps and the hip. Improvement is usually measured over two to three months rather than weeks.
Frequently Asked Questions
Does a torn meniscus need surgery?
What is the difference between a traumatic and a degenerative tear?
When is a meniscus tear urgent?
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