In Pakistan, meniscus Tear is managed by sports medicines. A meniscus tear is a partial or complete rupture of one of the two C-shaped fibrocartilage disks that cushion the knee between the femur and tibia. Tears are among the most common knee injuries, with an estimated annual incidence of 60-70 per 100,000 person-years and prevalence rising sharply with age — MRI studies show meniscal tears in 35% of adults over 50, most of which are asymptomatic.
A meniscus tear (ICD-10: S83.20-S83.28 traumatic; M23.2 degenerative) is a disruption of the medial or lateral meniscus — two semilunar fibrocartilage structures that sit between the femoral condyles and tibial plateau in each knee. The menisci are 3-5 mm thick at their periphery, tapering centrally, and transmit roughly 50% of joint load when the knee is extended and up to 85% when flexed. They are vascularized only at the outer 25-33% (the red zone); the inner two-thirds (the white zone) rely on synovial diffusion and have limited healing capacity. Tear morphology defines management: vertical longitudinal tears (often radial or bucket-handle) in younger patients are amenable to repair; radial, oblique flap, and horizontal cleavage tears are common in older patients and are usually degenerative.
The key symptoms of Meniscus Tear are: Sudden sharp pain at the joint line — medial pain for medial tears, lateral pain for lateral — typically after a twisting or pivoting injury on a flexed and planted knee., Knee swelling that develops over 6-24 hours; bloody effusion within 2 hours suggests an associated anterior cruciate ligament injury rather than isolated meniscus tear., Sensation of catching, clicking, or popping during knee flexion or rotation., True mechanical locking (inability to fully straighten the knee) when a torn fragment displaces into the joint; characteristic of bucket-handle tears., Pain on deep squatting, kneeling, or descending stairs., Joint-line tenderness on palpation reproducing the patient's pain — the single most sensitive bedside sign (sensitivity 76%, specificity 29%)., Positive McMurray or Thessaly test with palpable click and reproducible pain..
Diagnosis combines a focused injury history with clinical examination and selective imaging. The history asks about the mechanism (twist, pivot, squat), timing of swelling (rapid versus delayed), mechanical symptoms (locking, catching, giving way), and prior knee injury. Examination starts with inspection and palpation for effusion, range of motion, joint-line tenderness, and Lachman/anterior drawer testing for associated ACL injury. Provocative meniscal tests include the McMurray test (knee fully flexed, then extended with internal and external rotation; positive on pain or click at the joint line), the Apley grind test (prone with knee flexed at 90 degrees, axial compression and rotation through the tibia), and the Thessaly test (single-leg stance at 20 degrees of flexion with internal and external rotation; sensitivity 64-66%, specificity 53-92%). Plain radiographs (standing AP, lateral, sunrise, Rosenberg view) exclude fracture and assess osteoarthritis but do not show meniscal tears. MRI is the imaging gold standard with sensitivity of 90-95% for medial and 80-85% for lateral tears; degenerative MRI changes must be interpreted with clinical findings to avoid attributing knee pain to incidental tears. Arthroscopy is the definitive diagnostic test when imaging is equivocal but is now uncommon as a purely diagnostic procedure. The 2018 ESSKA meniscus consensus recommends a structured framework combining symptom pattern, mechanical signs, and tear morphology to choose between repair, partial meniscectomy, and non-operative care.
Outcomes depend on tear type, location, treatment, and adherence to rehabilitation. Peripheral vertical tears in young athletes treated with arthroscopic repair achieve 70-90% healing rates at 2 years; return to pre-injury sport is 80-90% by 6 months. Partial meniscectomy provides reliable short-term symptomatic relief in 80-90% of mechanical tears but accelerates joint-space narrowing over 5-10 years, with a 30-40% risk of symptomatic osteoarthritis at 15 years. Degenerative tears managed non-operatively have equivalent functional outcomes to surgical management at 1, 2, and 5 years in randomized trials. Root tear repair reduces conversion to knee replacement by approximately 50% versus non-operative treatment in observational cohorts. Long-term, knee replacement rates are 4-5 times higher after subtotal meniscectomy than after intact or repaired menisci; meniscal preservation is therefore strongly preferred in young patients.
Suspected meniscus tear with mechanical symptoms (true locking, catching, recurrent giving way) or persistent pain after 4-6 weeks of conservative care warrants sports medicine or orthopedic referral. Acute traumatic tears in active patients benefit from early specialist assessment to maximize repair options, whereas degenerative tears in older patients should first complete a structured exercise program.
Find specialists →Arthroscopic partial meniscectomy: walking without crutches in 1-2 weeks, return to office work in 1-2 weeks, recreational running in 4-6 weeks, pivoting sport in 6-8 weeks. Meniscal repair: protected weight-bearing for 4-6 weeks, full weight-bearing by 8 weeks, jogging at 3-4 months, return to pivoting sport at 4-6 months. Root repair: weight-bearing restrictions for 6-8 weeks, return to sport at 6-9 months.
Initial 6 weeks after repair: range-of-motion within bracing limits, quadriceps activation, partial weight-bearing. Weeks 6-12: progressive resistance training, closed-chain exercises, balance and proprioception. Weeks 12-16: jogging and sport-specific drills. Return to pivoting sport at 4-6 months after repair, 6-8 weeks after meniscectomy, guided by quadriceps strength symmetry and hop testing.
Choose a sports medicine physician or orthopedic surgeon affiliated with a high-volume knee unit that performs both meniscal repair and complex ligament reconstruction. Volume-outcome data favor centers performing more than 100 meniscal procedures per year. Ask the surgeon about repair rates versus meniscectomy rates and long-term follow-up data.
Medically reviewed by AIHealz Medical Editorial Board · May 13, 2026
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