The meniscus is a piece of cartilage in the knee joint that serves as a cushion between the thigh bone (femur) and the shin bone (tibia). There are two menisci in each knee, one on the inner (medial) side and one on the outer (lateral) side.
Despite a belief that meniscus injuries are most commonly a sporting injury, our physios see and treat this type of knee injury across all groups. Certainly, there are many athletes, particularly those who play sports with a lot of pivoting, twisting or sudden directional changes (such as tennis, basketball, football, skiing and soccer). However, we regularly treat adults and older people who experience natural wear and tear that weakens the cartilage in the knee joint.
A meniscus injury can lead to pain, swelling, and stiffness in the knee joint, as well as a reduced range of motion. In severe cases, this type of knee injury may require surgery to repair or remove the damaged tissue.
Physiotherapy for a meniscus injury aims to reduce swelling, restoring mobility and strengthening muscles around the knee. Treatment includes gentle range-of-motion exercises, progressive strengthening, balance training and gradual return to activity.
When it comes to knee injury treatment, consistency is vital if the patient is to avoid stiffness, improve stability and minimise the risk of reinjury.
Knee patients often ask us whether they should have surgery for a meniscus injury. As with many treatments, there are both short and long-term factors to consider. There is a significant amount of research on the efficacy of meniscectomy, particularly partial meniscectomy.
Here are some key findings from the available evidence:
Partial meniscectomy can be effective for relieving pain and improving function in patients with symptomatic meniscus tears, particularly in the short-term (up to 2 years post-surgery). However, the long-term benefits of the procedure are less clear, as some studies have found that partial meniscectomy can lead to an increased risk of osteoarthritis in the affected knee joint over time.
The effectiveness of meniscectomy can depend on several factors, including the location and severity of the meniscus tear, the age and overall health of the patient, and the type of meniscectomy performed. For example, one study found that patients with degenerative meniscus tears (as opposed to traumatic tears) were less likely to experience significant improvements after partial meniscectomy.
Total meniscectomy (in which the entire meniscus is removed) is generally less effective than partial meniscectomy and can lead to a higher risk of complications, including osteoarthritis and knee instability.
In some cases, non-surgical treatments such as physiotherapy, exercise, and pain management may be just as effective as meniscectomy for managing symptoms of meniscus tears.
Overall, the evidence suggests that meniscectomy can be an effective treatment option for some patients with symptomatic meniscus tears, particularly in the short-term. However, the long-term benefits and risks of the procedure should be carefully considered, and our advice is often that non-surgical treatments should be explored before opting for knee surgery.
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