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Meniscal Tears

As mentioned on the Knees page, the meniscal cartilage is between the two layers of articular cartilage. When healthy, this cartilage is very rubbery and helps to cushion the knee. In young athletes, this cartilage may be torn by an injury to the knee. Because the cartilage is pie-shaped with a very thin edge, many tears occur in this thin portion. This area has no direct blood supply, and therefore, has no ability to heal. It is usually necessary to remove the torn and damaged portions of this cartilage. Occasionally, the cartilage will tear in the thicker portion where there is blood supply, and when this occurs, the cartilage can be sewn back together through a very small incision.

In older patients, meniscal tears are often termed "degenerative." As a person ages, the meniscal cartilage may become more fragile and easily torn, and sometimes very minor trauma may cause a tear. It is very important to use good medical judgment as to when to perform arthroscopy in instances of degenerative tear. If the degree of arthritis in the knee is severe, arthroscopy will not improve the function of the joint and, in some cases, may make it worse.

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If, however, the weight bearing x-ray (an x-ray taken with the patient's full weight standing on the knee) shows maintenance of the space between the bones, then removal of the damaged cartilage usually will provide reasonable relief. However, it must be remembered that this is not a young, healthy knee, but rather a degenerative knee. Thus, recovery may be slow, and it may be expected that the arthritis will progress with time, ultimately leading to the need for a joint replacement.