Degenerative meniscus tear: physiotherapy or arthroscopy?

What a degenerative tear is

With age the meniscus becomes less elastic and can fray or split without a clear injury, sometimes just from getting up from a squat. These tears are very common on MRI, including in people with no pain at all, and they often sit alongside early arthritis.

That is why the MRI finding alone does not decide treatment. The pattern of symptoms matters more.

Physiotherapy and arthroscopy side by side

• Physiotherapy suits: pain and stiffness without true locking, early arthritis, most first presentations
• Arthroscopy may suit: true locking, a displaced flap that catches, persistent mechanical symptoms after good rehab
• Effort and time: physio usually 8 to 12 weeks of regular exercise; arthroscopy a short operation with weeks of recovery
• Risks: physio very few; arthroscopy the usual surgical risks and, after removing meniscus, possible faster wear
• Effect on arthritis: physio does not change it but often eases symptoms; arthroscopy does not treat arthritis and can make an arthritic knee worse
• Can you switch: starting with physio keeps surgery available later if needed

Making physiotherapy work

Focus on strengthening the thigh and hip muscles, regaining full straightening, and gradually loading the knee. Swimming, cycling and gym work in air-conditioned spaces suit Qatar's summer. Simple painkillers and activity changes help during flare-ups, and weight loss reduces the load on the inner knee.

When to see a knee surgeon in Doha

Book an assessment if your knee locks and will not straighten, gives way, or has not improved after three months of genuine physiotherapy. A hot, swollen knee with fever needs urgent care. At Aman Hospital, Dr. Gelber examines the knee, reviews standing X-rays and MRI, and explains whether surgery is likely to help or not.