About the author:

Howard J. Luks, MD

A Board Certified Orthopedic Surgeon in Hawthorne, NY. Dr Luks specializes in the treatment of the shoulder, knee, elbow, and ankle. He has a very "social" patient centric approach and believes that the more you understand about your issue, the more informed your decisions will be. Ultimately your treatments and his recommendations will be based on proper communications, proper understanding, and shared decision-making principles --- all geared to improve your quality of life. Please read our Disclaimer

14 comments on “Should I Have Meniscus Surgery?

  1. Hi
    Thanks for such a helpful & informative article as I have been searching on this subject for the last few days. Actually I got an injury on my right knee 1 month ago while playing. I was on turning position with my right leg stretched & got an impact on knee from lateral side while another player hit some of his body part over my knee. I got bit unbalanced & kind of a twist on my knee as I landed on ground. Hope you got some picture in mind. Anyways I had rest & care. Also did RICE treatment. Now there is no pain & swelling at the moment but my knee cannot bend fully. I can just walk & avoiding any stress or weight on my my leg. One of my doctor suggests to keep it going with care & we will review again after a month. I got MRI test & shown it to another doctor but he prefered to get arthroscopic surgery. I am so confused now what should I opt for. I myself wana get some way out to recover without surgery but not sure if it would be better for me or not in the longer term. I am 32 yr old male with an active routine. Below are the findings of MRI report:
    * A linear fluid signal intensity is seen in posterior horn of lateral meniscus extending up to the inferior articular surface appearing hyper intense on T2WFS.
    * Fluid signal intensity cruciate area is seen in posterior horn of medial meniscus extending up to its superior & inferior articular surface and also extending up to the posterior surface appearing hyper intense on T2WFS.
    * ACL is thickened with abnormal fluid signal intensity areas within its substance appearing hyper intense on T2WFS.
    * Bone bruise is seen involving the sub articular surface of medial & lateral tibial & femoral condyles appearing hyper intense on T2WFS.
    * Joint effusion is seen with extension into lateral bursa of knee joint.
    Can you please help me for this.
    Thanks

    1. It’s too early to tell… most docs would tell you to try Physio for a few weeks and see how the knee feels. IT will take a while(few months) for your knee to recover.

  2. I’m 55, active, and have been diagnosed with: Subtle horizontal the tear within posterior body of the medial meniscus extending to the inferior surface and questionable subtle horizontal tear of the posterior horn medial meniscus. No displaced meniscal tissue.

    The doctor has provided options of either physical therapy or surgical removal of the torn portions of the meniscus. There was no recommendation as to which option is the best for someone active.

    The pain is not bad so I can probably live with this but I do wish to remain active.

    If I remain active and do not have the torn portion removed does this increase the possibility of further tearing versus having a portion of the meniscus removed and smoothed during surgery?

    I’m trying to weigh the benefits of one option over the other and it’s not clear how my desire to remain active should be factored into this decision.

    1. The research is fairly clear in this area…. most people will remain active after non-surgical management. Surgery can actually accelerate your arthritic process. So, surgery is usually reserved for those who do not respond to PT and non-surgical treatment.

  3. Dr. Luks,

    First, thank you for such an informative website. I am writing because I have been diagnosed with a meniscus tear. I am 61 years old. This past mid-November, I noticed that my left knee had a bit of discomfort, but assumed I had some kind of “strain” that would go away. By mid-December, the discomfort had become painful, so I made an appointment to see an orthopedic assistant in my HMO. X-rays were taken and he told me that I had “a bit” of osteoarthritis in my knee, but also probably a torn meniscus (although he could not see the meniscus on the x-ray). He recommended physical therapy. The problem was that I was leaving the country for three weeks. He said, however, that walking would be good as long as I didn’t overdo it, and I could begin physical therapy when I returned. While I was gone, I walked quite a bit (no strenuous walking or hiking, just village touring); by the end of my trip, my knee was considerably more painful. I began physical therapy a week ago, after my return, and things are not getting better. My knee is still very stiff, especially after inactivity, and I cannot completely straighten it (almost, but not quite); of more concern is that it feels like there is something “caught” inside in the front of my knee that prevents me from straightening it. My physical therapist told me that I must keep doing exercises to increase range of motion, and try to walk “normally,” rather than “protectively”–but it feels like I’m forcing my knee to work against whatever is caught in there and it feels very counter-intuitive to me to force it, even gently, as I have quite a bit of pain and am fearful that I will cause more damage. I asked the physical therapist if I should see an orthopedic surgeon just to be sure; she was hesitant and then said, “If you want to, sure.” So I made an appointment with an orthopedic surgeon at my HMO. If he does not recommend an MRI, would it be appropriate for me to request one? I want to know exactly what’s going on with my knee before I consent to any surgery. And I absolutely do not want any part of my meniscus removed (except for the trimming of a torn piece), if at all possible. So, to end this little saga, my two main questions are: 1) Is it okay to continue physical therapy, even if it feels “wrong,” with regard to the continuing pain and whatever is “caught” in my knee?, and 2) Should I get a second orthopedic surgeon’s opinion, in addition to the first one I’ve made an appointment with? I prefer a surgeon who’s inclined towards a conservative approach.

    Thank you for your time.

  4. I am 79, male, like to dance. Had a horizontal tear on the rat lateral meniscus about 16 months ago. Have been wearing sleeve a lot of the time plus PT and my own moderate exercise. But there is discomfort a lot of the time.

    Do you think that surgery can still repair this? What is your opinion about PRP or stem cell treatments which are really expensive and still experimental alone or in combination with surgery. The docs here in CA don’t seem to know about the “special techniques” that you mention; the two that I consulted said nothing about them.

  5. Hello Dr. Luks, Thank you for your articles pertaining to meniscus tears. I am hoping that you would be able to give me some guidance on my situation which I am not getting a whole lot of from my Ortho. I am a very active 30 year old, playing hockey and lacrosse year round. I am a hockey goalie and noticed a sharp pinch/burn sensation on the side of my knee only when I went down into my butterfly (I did not notice a certain circumstance when this could have occurred). The pain only occurs when the inside of my knee has some pressure put on it right below the joint line. I continued to play a couple games until the pain became too sharp. Later, I was diagnosed with a derangement of my anterior horn of my lateral meniscus.

    I can fully extend and bend my knee with no pain and can run, jump squat etc. While the pain has subsided over the course of a month and a half, I do still experience discomfort on the outside of my knee, when placing pressure on the inside of my knee at that specific location. With hockey season complete, do you think it may be wise to continue to avoid placing pressure on the inside of the knee and continue to see if the injury heals, or consider shots or surgery in the next month or two as I would like to be healed to play next season. I do enjoy playing hockey and do not feel that I would be able to enjoy it as much if I have to endure this pain when I do this specific movement. Thank you again for your articles and the information you provide!

    1. HI Taylor …
      Tough to say for sure without examining you and looking at your MRI.
      The pain from many tears will subside over time and not require surgery, while in other situations the pain will persist. It can be a difficult decision making process.

  6. Thank you for your helpful articles. I’m a 66 year old female with moderate medial compartment osteoarthritis with a complex tear of the body of the medial meniscus with nondisplaced flap tear within the posterior horn of the medial meniscus. My dr wants remove and clean up the torn meniscus. With this diagnosis, am I a candidate for PT or do I need to have surgery? Would prefer to avoid surgery but am concerned that PT won’t help flap tear.

  7. Hello Dr Luks, luckily I have just found this site and link. My Father is 84 years old and just had an MRI that showed he has a meniscus tear. He apparently will have outpatient surgery. I am very worried after reading some advice given here. I am also very worried about his recovery and his quality of life after the surgery at age 84.

    The pain sometimes is bad and can keep him up at night but is much better at other times. Do you think at his age it is a good idea or is he at a greater risk of developing other problems with meniscus surgery?

    1. HI Wendy….
      I find it hard to imagine that an 84 yo would benefit from a knee arthroscopy. Most 84 year olds also have arthritis, so the results from surgery tend to be very limited, short-lived and carry the risk of making the arthritis much worse.
      Virtually all of the scientific literature about degenerative meniscus tears shows that physical therapy is often just as beneficial at decreasing the pain. Another paper showed that knees that underwent surgery had developed worsening arthritis compared to knees managed with just PT. A study out of Europe showed that sham surgery was just as effective as meniscus surgery.

      In general, elderly folks have osteoarthritis as the primary cause of their knee pain.
      For that reason most docs would try physical therapy, a compression sleeve , and perhaps a course of Euflexxa, or ORthovisc injections first.

      Good Luck and I hope this helps.

  8. Hi Dr. Luks, I’m 46 years old, a competitive cyclist for 7 years very active prior to this.. 2 years ago, i got into duathlon, and i started having knee pain during runs,. the pain ranged from mild to moderate in those 2 years. i treated it religiously with ice and condition seemed to improve tremendously the following day…. went for an MRI recently, it showed radial tear on the body of the medial meniscus. i’ve stopped running for 2 months now and the pain is close to zero. prolonged walking only gives mild discomfort and the same with cycling 2 hours or more. I’m done with training and racing, for now it’s cycling for fitness and swimming as cross training. ” quality of life ” decision tells me not to choose surgery…for now. My question is if i don’t have a surgery now, there’s a big chance i will regret it later? will the condition worsen as i age? will the onset of arthritis or osteoarthrites be early for me? i really find your articles helpful, my sincerest thanks to you Doc Howard.

    1. Joseph …
      The research shows that if the torn pieces are removed– a partial menisectomy– then your risk of developing osteoarthritis (OA) will likely increase compared to your risk right now with a radial tear. Other research supports the fact that most people will do equally well with PT vs surgery.

      That being said, there are many of us now capable of repairing (suturing) radial tears— which are not degenerative. But it may not be easy to find an Ortho willing to do this.

      We (Ortho Community) can’t say that your symptoms will not worsen over time because of non-surgical treatment. With surgery (and a partial menisectomy), if your OA progressed your symptoms would worsen, no doubt.

      Choices are to consider a repair, continue with non-surgical mgmt, continue with your current training, and consider PT if you feel it would help with strength and conditioning.

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