A torn meniscus does not always require surgery. The decision is based on a combination of your symptoms, the characteristics of the tear, age, activity level, and response to conservative treatment.
Key Indicators for Torn Meniscus and Meniscus Surgery
- Persistent Symptoms After Conservative Care: If you continue to have knee pain, swelling, weakness, or instability after a period of rest, physical therapy, and medications, meniscus surgery may be recommended.
- Mechanical Symptoms: Locking, catching, or the knee “giving way” are strong indications for surgery, especially if these symptoms interfere with daily activities or prevent you from fully straightening or bending your knee.
- Tear Characteristics: Large, complex, or high-grade tears, especially those in the outer (red) zone of the meniscus, where blood supply is better, are more likely to require surgical repair. Tears in the inner (white) zone, which has poor blood supply, are less likely to heal on their own and may require removal of the damaged tissue (partial meniscectomy).
- Desire to Remain Active: Active individuals and/or athletes who wish to return to their previous activity often benefit from surgery, particularly if symptoms persist.
- Failure of Non-Surgical Management: If non-surgical options (rest, ice, NSAIDs, physical therapy, and in some cases a cortisone injection) do not relieve symptoms after several weeks, surgery for the torn meniscus may be considered.
When Meniscal Surgery May Not Be Necessary for a Torn Meniscus
- Minor Meniscus Tears with Minimal Symptoms: Small tears, especially in older adults or those associated with arthritis, may improve with conservative treatment and often do not require surgery.
- Tears without Mechanical Symptoms: If your knee is not locking or catching and you have minimal pain, non-surgical management is often preferred.
Types of Surgery for Torn Meniscus
| Surgery Type | Indication | Recovery Time |
| Meniscus Repair | Younger patients, tears in the red zone, suitable meniscus tear | 4-6 months |
| Partial Meniscectomy | Tears in the white zone, irreparable or degenerative tears | 3-6 weeks |
| Meniscus Transplant | Young patients, previous meniscectomy, persistent symptoms | 6-12 months |
Risks and Considerations for Meniscus Surgery
- Surgery carries risks such as infection, blood clots, nerve damage, and the potential for arthritis, especially after meniscectomy.
- Not all meniscus tears are repairable; the decision depends on tear location, size, and patient factors.
Summary
You should consider having a torn meniscus surgically treated if:
- You have persistent pain, swelling, or instability after conservative treatment,
- You experience mechanical symptoms like locking or catching,
- Imaging shows a large or complex tear, especially in the vascular (red) zone,
- You are young, active, and wish to maintain a high level of activity.
Always consult with an orthopedic surgeon to discuss your specific case and to weigh the risks and benefits of surgery versus continued conservative management.
Additional patient information and post-surgery care guidelines can be found here:
Patient Information.
If you want to learn more about meniscus root tears, see:
Medial Meniscus Posterior Root Tears.
(Image generated with AI)