I receive this question a lot in my clinic and online. It’s very common for people to have a meniscus tear. It’s also difficult for that person to do what he or she loves to do because of the knee pain. That leads to the inevitable question: Do I need surgery for a meniscus tear?
I’ve been diagnosed with a meniscus tear in my knee? Do I have to undergo surgery?
That’s a terrific question and another one I get frequently from patients. There are a few ways to look at this question. For starters, whether or not a patient undergoes surgery is his or her decision. Meniscus tears are by no means an emergency, so surgeries to treat them are elective.
Will a meniscus tear heal on its own?
The idea that a patient needs surgery if he has torn a meniscus in his knee is based on the idea that the meniscus very likely will not heal. There is little blood supply to promote healing of the meniscal tissue, so most meniscal tears remain torn.
Meniscus tears on MRI
The bigger factor when deciding on surgery to trim out a meniscus tear (partial meniscectomy) or repair it comes down to symptoms. A person can have a meniscus tear without it causing pain. Studies have shown that a small percentage of the population over 40 has a meniscus tear and doesn’t even know it.
Also many meniscus tears are found through MRIs ordered as part of an inadequate workup. Physicians who don’t take an appropriate history or perform a thorough physical exam and instead go straight to ordering an MRI often find meniscus tears on the MRI. These could be incidental findings and not the cause of the symptoms.
Do your symptoms cause you to need surgery for a meniscus tear?
On the other hand, patients with symptoms caused by a meniscus tear often require surgery. If he has localized pain, locking or catching of the knee, or pain with twisting motions or squatting, the meniscus tear is likely causing those symptoms.
Few nonsurgical treatments help patients if meniscal tears are symptomatic. Physical therapy, activity modification, anti-inflammatory medications, and injections are acceptable treatment options, but they often don’t help much. At some point, if a patient can’t perform the activities that he wants to do because of a symptomatic meniscus tear, arthroscopic surgery is a reasonable option.
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