Harvard Women's Health Watch

Ask the doctor: How should I treat a torn meniscus?

Q. An MRI of my knee shows I have a torn medial meniscus and mild osteo-arthritis. What treatment options should I consider?

A. A torn meniscus is a common cause of knee pain, and meniscal tears are especially common in people with osteoarthritis (OA). Menisci are small cartilage pads within the knee that help pad the bones in the joint and provide smooth knee motion. Meniscal tears may cause knee pain in people with OA. If you have knee pain and both conditions are detected, it is common to attribute the pain to the meniscal tear and to recommend surgical repair through an arthroscope. A surgeon inserts the scope and instruments into the knee joint through tiny incisions and trims the torn meniscus in a procedure called partial meniscectomy. Whether this approach results in better function has been debated.

Fortunately, this question was recently studied, and it looks like you have some choices. In March, researchers published a study of people ages 45 and older who had both a torn meniscus and mild to moderate OA. Study authors randomly assigned 351 participants to either partial meniscectomy followed by physical therapy or physical therapy alone, and compared them on tests of physical function and pain at six and 12 months. There was no significant difference in function or pain between the surgery and nonsurgery groups. This well-designed study indicates that you don't have to make a hasty decision regarding surgery, and you might try physical therapy first. If your pain and function do not improve, you can always consider surgery at a later date.

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