Meniscus Tear (Acute)

What is an acute meniscus tear?

The meniscus is a tough, rubbery piece of cartilage that sits between the thigh bone and the shin bone — there are two in each knee, on the inner and outer side. They cushion the joint, help distribute load and contribute to the knee's stability.

An acute tear happens when a sudden movement — typically a twist on a planted foot — overloads the meniscus and causes it to split. It's a common injury in sport but can also happen during everyday activities like getting up from a deep squat.

Tears come in different patterns and locations. Some heal well, particularly in the outer part of the meniscus where there's a blood supply. Others tend not to heal on their own and may need surgical attention.

What does it feel like?

People often remember the moment of injury — a twist, a pop, sometimes immediate pain. In the days that follow, you may notice:

• Pain along the joint line, on the inside or outside of the knee

• Swelling, often coming on over hours rather than immediately

• Catching, locking or a sense that something is moving inside the joint

• Difficulty fully straightening or bending the knee

• Pain when twisting, squatting or going down stairs

A locked knee — one that physically cannot be straightened — is a particular pattern that warrants prompt assessment.

How is it diagnosed?

Examination usually points strongly to the diagnosis. Specific tests, combined with the location of pain and the mechanism of injury, allow an experienced clinician to make a confident assessment.

An MRI scan is typically arranged to confirm the diagnosis and characterise the tear — its size, location and pattern all influence what the right treatment looks like.

It's also important to check for associated injuries. Meniscal tears can occur alongside ligament damage, particularly with the ACL, and identifying this early changes the management plan.

What are the treatment options?

Some meniscal tears settle with rest, physiotherapy and time, particularly smaller tears in younger patients with healing potential. Others — particularly tears causing locking, persistent symptoms or blocking activity — are best managed with keyhole (arthroscopic) surgery.

When surgery is needed, the goal is to preserve as much meniscus as possible. Where the tear is repairable, repair offers the best long-term outcome. Where repair isn't possible, the damaged portion is trimmed back. The right decision depends on the specifics of the tear and your goals — Nev will work through this with you at your consultation.

When should you get it checked?

Seek a specialist assessment if:

• You can't fully straighten the knee

• The knee is locking or catching

• Swelling is persistent or recurrent

• Pain isn't settling within a few weeks

• You're unable to return to your usual activities

The earlier the right diagnosis is made, the more options remain — particularly when repair might be possible.