Meniscal Injuries of the Knee: Causes, Symptoms and Treatments

Meniscal injuries of the knee are among the most common orthopedic problems, yet they are often overlooked. The menisci, two crescent-shaped cartilage pads located between the femur and tibia, play an essential role in absorbing shock, stabilizing the joint, and distributing body weight. When they become damaged, they can cause pain, swelling, and difficulty moving. But who is at risk, and how can these injuries be managed?

What Are Meniscal Tears and How Common Are They?

Meniscal injuries are not just for athletes, they can affect anyone at any age. According to statistics, they account for 12-14% of all sports knee injuries. However, with increasing age, their incidence increases significantly due to the natural wear and tear of the meniscal tissue. For example, 35% of people over the age of 50 have asymptomatic meniscal tears, according to a recent study ( Bhattacharyya T et al., New England Journal of Medicine, 2023 ).

Meniscal injuries are mainly divided into:

• Traumatic injuries: Common in young people and athletes, caused by sudden movements such as twisting or rapid changes of direction. Sports such as football, basketball or rugby are particularly at risk.

• Degenerative lesions: Typical of adults over 40 years of age, linked to progressive wear of the cartilage and often associated with knee osteoarthritis. Up to 60% of people with advanced osteoarthritis have meniscal lesions ( Englund M et al., Arthritis & Rheumatology, 2023 ).

Main Symptoms: How to Recognize a Meniscal Injury

Meniscal injuries can present with varying symptoms, including:

• Pain localized on the inside or outside of the knee.

• Swelling, which may appear immediately or in the hours following the trauma.

• Difficulty fully bending or extending the knee.

• Episodes of “joint locking,” typical of bucket-handle or flap-type meniscal tears.

Not all lesions cause symptoms. In some cases, they can only be detected by imaging, without the person feeling any discomfort.

Treatments: From Physiotherapy to Surgery

Conservative Treatment

In less severe cases, especially for degenerative lesions, non-surgical treatment is often sufficient. It includes:

• Rest and physical therapy: A personalized program can reduce pain and improve knee function.

• Anti-inflammatory drugs: Useful for relieving pain and swelling.

• Infiltrations: Hyaluronic acid or corticosteroids can be used to reduce inflammation.

One study showed that targeted physiotherapy is as effective as arthroscopy in treating degenerative injuries, as long as no symptoms such as joint locking are present ( Kise NJ et al., BMJ, 2022 ).

Surgical Treatment

Traumatic or severe injuries that compromise the functionality of the knee may require surgery. Arthroscopy is the most commonly used procedure and allows you to:

• Repair the meniscus, if possible.

• Remove the damaged portion (selective or partial meniscectomy) when repair is not feasible.

Preservation of the meniscus is crucial. Excessive removal increases the risk of developing early osteoarthritis. Studies show that after a partial meniscectomy, the risk of osteoarthritis increases by 30-50% within 10-15 years ( Papalia R et al., American Journal of Sports Medicine, 2023 ).

Surgical treatment of meniscal lesions, especially through arthroscopy, represents an effective solution in cases of severe traumatic lesions or when conservative treatment does not relieve symptoms. Surgery allows the meniscus to be repaired, preserving joint function, or to remove only the damaged portion, reducing pain and joint blockage. Intervening promptly can prevent secondary joint damage and improve quality of life, especially in young or sports patients. Studies show that meniscal repair has better long-term results than simple removal, protecting against early osteoarthritis ( Papalia R et al., American Journal of Sports Medicine, 2023 ).

Prevention: How to Protect Your Menisci

Prevention of meniscal injuries is possible with some simple strategies:

• Strengthen muscles: Quadriceps and hamstrings stabilize the knee and reduce the risk of injury.

• Learn correct movements: Especially for athletes, it is essential to train with appropriate techniques to avoid twisting or excessive loads.

• Wear appropriate footwear: Shoes with good support can improve biomechanics and prevent injuries.

• Avoid unnecessary overload: Reducing the impact on your knees can prevent injuries, especially during intense work or sports activities.

Curiosity: Silent Meniscal Lesions

Did you know that many people live with meniscal tears without knowing it? Up to 35% of adults over 50 have tears that are detectable by imaging, but completely asymptomatic. This shows that not all tears require immediate surgery, but depend on the symptoms and the impact on quality of life.

Conclusions

Meniscal tears of the knee are a common problem that affects people of all ages. Although many injuries can be managed with conservative treatments, an accurate diagnosis is essential to choose the most appropriate treatment path. Prevention, through muscle strengthening and the use of proper techniques, is the key to maintaining healthy knees. If you have pain or suspect a meniscal tear, see a specialist for a thorough evaluation.

Scientific references:

Logerstedt DS et al., “Meniscal Injuries: Epidemiology and Management,” Journal of Orthopedic & Sports Physical Therapy , 2022.

Englund M et al., “Meniscal Lesions in the Presence of Knee Osteoarthritis,” Arthritis & Rheumatology , 2023.

Bhattacharyya T et al., “Prevalence of Asymptomatic Meniscal Tears in Older Adults,” New England Journal of Medicine , 2023.

Kise NJ et al., “Effectiveness of Exercise Therapy vs Arthroscopic Surgery for Degenerative Meniscal Lesions,” BMJ , 2022.

Papalia R et al., “Long-Term Outcomes After Meniscectomy and Risk of Knee Osteoarthritis,” American Journal of Sports Medicine , 2023.