Meniscal tears are a very common cause of knee pain, transient locking, catching, clicking and occasional feelings of painful giving way.
The majority of meniscal tears occur in adults and develop in areas of pre-existing or developing weakness. Small fissures appear at the surface of the meniscus and these are worked and kneaded by the action of the knee, gradually progressing in length until they begin to produce symptoms, usually when a part of the meniscus begins moving independently and sometimes snagging or catching under the knuckles of the joint. Symptoms may develop insidiously and characteristically vary in severity with periods of relative relief interspersed with periods when the knee is symptomatic. Pain associated with meniscal pathology is usually well localised to the medial or lateral tibiofemoral compartments. The diagnosis is usually confirmed by medical imaging, and particularly by MRI scanning. If the symptoms associated with meniscal tears fail to settle with simple conservative treatment arthroscopic investigation and treatment may be required.
In children and young adults meniscal tears are occasionally associated with significant injury, in which case they can sometimes result in bleeding inside the knee or in loss of function, and typically the knee may lock with a fragment of meniscus trapped under the knuckle. These injuries very often require urgent surgical treatment.
In certain circumstances large meniscal tears may be repairable, particularly if they are fresh, occur in young individuals, and involve the peripheral part of the meniscus where the blood supply to the meniscus is reasonably good and therefore associated with potential to heal. Meniscal suture when performed usually involves a short period of protected weight bearing and a longer period of splintage, a range of motion brace usually supplied which limited knee flexion beyond around a right angle.