Meniscus tear (torn knee cartilage): symptoms, treatment and recovery

The NHS says a meniscus tear usually happens when you twist your knee while playing sport, but can also happen from more minor injuries such as twisting when standing up. Symptoms include knee pain or tenderness, stiffness or swelling around the knee (the swelling may not start for a few hours or days), difficulty bending, straightening or moving the knee, the knee giving way when you try to stand, and a crunching or clicking feeling when you move it.

The NHS notes that the symptoms can be similar to sprains. The NHS knee pain page lists a knee that is unstable, gives way when you try to stand, is unable to straighten, or made a popping sound at the time of injury as possible signs of a torn ligament, tendon or meniscus, or cartilage damage.

Arthritis UK describes the meniscus as two wedge-shaped pieces of meniscal cartilage that act as shock absorbers between the shinbone and thighbone, one on the inner side of the knee joint (medial) and one on the outer side (lateral). They cushion and stabilise the joint, and are tough and rubbery. When people say they have torn cartilage in the knee, Arthritis UK says they are usually talking about a torn meniscus.

The NHS says a meniscus tear is a common type of damage to cartilage in the knee and that it usually gets damaged because of an injury.

The NHS lists what to do and what to avoid in the first days. A pharmacist can advise on painkillers and the types of knee support you can buy.

• Stop any exercise or activities and rest your knee when you can during the first few days.

• Put an ice pack (or a bag of frozen peas) wrapped in a towel on your knee for up to 20 minutes every 2 to 3 hours.

• Wrap a bandage around your knee or wear a knee support, and remove it when you sleep.

• Keep your leg raised on a pillow as much as possible.

• Take paracetamol or ibuprofen gel or tablets to ease pain.

• Do not use heat packs, avoid hot baths, do not drink alcohol, do not massage your knee and do not carry anything heavy.

• Do not completely stop moving your knee: after a few days of resting, try some gentle movements.

The NHS says a meniscus tear can get better on its own without treatment, but it can take a while to heal. Sometimes physiotherapy may be recommended to help reduce pain and improve movement and strength in the knee. If the damage is severe, you may need arthroscopy surgery to repair or remove the damaged cartilage.

The NHS says in many areas you may be able to get help such as physiotherapy from NHS community musculoskeletal (MSK) services without needing a referral from a GP.

The NHS describes arthroscopy as a type of keyhole surgery for checking or repairing joints, in which the surgeon makes small cuts around 2mm to 3mm wide near the joint, puts a tiny camera with a light into the cut, and repairs the joint if needed. It can take 30 minutes to 3 hours depending on the type, and a knee arthroscopy is the most common type of arthroscopy.

You may have a general, local or spinal anaesthetic depending on the procedure. The NHS says you should be able to go home as soon as you feel well enough, which for most people is within a few hours, though sometimes you need to stay overnight, and you must not drive if you have had a general anaesthetic. Complications are rare but can include a reaction to the anaesthetic, joint pain, numbness or tingling, blood clots and infection. You may need time off work, and how long depends on the type of arthroscopy and your job.

The NHS says most symptoms of a meniscus tear are not serious, but to see a GP if knee pain is stopping you doing normal activities or affecting your sleep, the pain is getting worse or keeps coming back, your symptoms have not improved after treating it at home, or your knee is stiff for more than 30 minutes after waking up.

The NHS says to get an urgent GP appointment or help from NHS 111 if you have very bad knee pain after a fall or injury, are unable to walk or put weight on your knee, the skin around your knee is swollen and feels hot, you have knee pain and a high temperature or feel hot, cold or shivery, or you cannot bend or straighten your leg.

Go to A&E if your knee has moved out of place, changed shape or is pointing at an odd angle, or you have any tingling or no feeling in your knee, leg or toes. Do not drive to A&E; ask someone to drive you or call 999.

On the NHS, a GP or an NHS community MSK service can assess the knee and arrange physiotherapy, and a scan or hospital referral if needed. The NHS says that a doctor can refer you to hospital for a scan or specialist treatment such as surgery.

Private physiotherapy and orthopaedic review are also available and can offer quicker MRI scans. Because many tears heal with time and physiotherapy, it is reasonable to ask what a scan or operation would change before agreeing to it.