What happens if a meniscus tear is left untreated?

Tears that often settle

A small tear in a stable knee, or a gradual degenerative tear in an adult over 40, often becomes less painful over weeks to months. The torn edge itself may not heal, but the inflammation settles and the muscles around the knee compensate. Many people with such tears on an MRI have few or no symptoms. In these cases, careful observation with a strengthening programme is a sound, evidence-based choice.

Tears that can cause trouble

• Unstable tears in younger, active people can extend with further twisting, turning a repairable tear into one that can only be trimmed
• Bucket-handle tears can flip into the centre of the joint and lock the knee
• Root tears stop the meniscus from absorbing load, which in many patients speeds up wear of the joint cartilage over months
• A tear combined with an untreated ACL injury exposes the meniscus to repeated giving way

Signs that it is not settling

Repeated locking or catching, swelling after every game or long walk, the knee giving way, or pain that is worsening rather than improving after six to eight weeks all suggest the tear is mechanically troublesome. Pain that wakes you at night, or a knee that is hot and very swollen, should also be checked.

Making a sensible decision

The question is not simply whether to operate, but which kind of tear you have and how your knee behaves. Dr. Gelber examines the knee at Aman Hospital, reviews or arranges imaging, and explains whether watching, rehabilitation, repair or trimming suits your tear and your activity level.