July 20, 2025

What is the meniscus?

The meniscus is a C-shaped cartilage that acts as a cushion between the thigh bone (femur) and the shin bone (tibia). The mechanism of injury for meniscal tears often involves twisting or rotational forces applied to the knee, especially when the foot is planted and the knee is bent. This can happen during activities that require sudden changes in direction, such as in sports like football, soccer, and basketball. However, meniscal tears can also occur due to ageing changes in the knee, particularly in older adults, and thus this is not just a sporty person problem we see at the Optimal Health Lab.

Treatment options generally fall into two categories: conservative (non-surgical) and operative (surgical) management. Understanding the differences between these approaches is crucial for making informed decisions about rehabilitation and recovery.

Conservative Rehabilitation Management

Conservative management focuses on non-surgical methods to treat meniscal tears and allow suitable healing. This approach is often recommended for stable or degenerative tears, which are more common in older adults. The primary goal is to alleviate symptoms and improve knee function without invasive procedures.

  1. Physiotherapy: Getting a strengthening plan from your trusty OHL Physiotherapist can the muscles local to the knee joint (quadriceps, hamstrings, adductors, abductors, calves etc) and this helps to stabilize the knee joint and, in turn, reduce the load on the meniscus to allow reduced sensitivity, reduced inflammatory and a chance for healing.
  2. Activity Modification: Patients are advised to avoid activities that exacerbate symptoms, such as running or jumping. Instead, low-impact exercises like swimming or cycling are encouraged, but please see your Physiotherapy for advice specific to your meniscal situation (because simply avoiding everything can be detrimental as well).
  3. Pain Management: Non-steroidal anti-inflammatory drugs (NSAIDs) may recommended by your GP and ice application can help manage pain and reduce swelling.
  4. Bracing: In some cases, a knee brace may be recommended to provide additional support and stability.

Conservative management is often preferred for its lower risk of complications and long-term joint health benefits. However, it requires patience and commitment to a structured rehabilitation program with your trusty OHL Physio’s help!

Operative Rehabilitation Management

Operative management involves surgical intervention to repair or remove the damaged meniscus. This approach is typically considered for acute, unstable tears that cause significant symptoms like knee locking or buckling. The two main types of surgery are meniscus repair and partial meniscectomy.

  1. Meniscus Repair: This procedure involves stitching the torn pieces of the meniscus back together. It is usually recommended for younger patients with tears in the vascular (blood-rich) zone of the meniscus, where healing potential is higher.
  2. Partial Meniscectomy: In this procedure, the damaged portion of the meniscus is removed. It is often performed when the tear is in the avascular (blood-poor) zone, where healing is less likely.
  3. Meniscus Transplant: Transplanting donor meniscus into the joint is a newer procedure offered here in Melbourne, but it is having great results. Talk to your OHL Physio about who is doing this procedure if you’re keen to learn more about it.

Post-surgery rehabilitation is crucial for restoring knee function. The Physio-led rehabilitation program typically includes:

  1. Early Mobilization: Gentle range-of-motion exercises are initiated soon after surgery to prevent stiffness and promote healing.
  2. Strengthening Exercises: As healing progresses, the focus shifts to strengthening the muscles around the knee. 
  3. Gradual Return to Activity: Patients are gradually reintroduced to their regular activities, with a focus on avoiding high-impact exercises until the knee is fully healed.

Additionally, removing part of the meniscus can increase the risk of developing osteoarthritis in the long term.

Making the Choice

The decision between conservative and operative management depends on several factors, including the type and severity of the tear, age, activity level, and overall knee health. A thorough evaluation by a healthcare professional is essential to determine the most appropriate treatment plan. Get in touch to start your individualised assessment and physio-led rehabilitation program today by calling 9431 5955 or you can book with an OHL Physiotherapist via our Client Portal on our website.  

 





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