Your meniscus is doing more than you probably realize — every step, squat, and pivot depends on it. When it tears, the pain can be sharp and immediate, or subtle and nagging. Either way, most patients ask the same question: do I need surgery, and if so, which kind? The answer turns on more than just the tear itself.

What Is the Meniscus?

Each knee has two C-shaped wedges of cartilage — the medial (inner) and lateral (outer) meniscus — sitting between the thigh bone and shin bone. They act as shock absorbers, distribute load evenly across the joint, and help stabilize the knee through every direction of motion. Without them, bone grinds on bone.

Meniscus tears are among the most common knee injuries. They can happen suddenly — a plant-and-twist in soccer, a cut in basketball, a hard tackle in football — or develop gradually from degenerative wear. In younger patients, acute tears dominate. In middle-aged and older patients, tears often come from everyday motion on tissue that has thinned over time.

Signs You May Have Torn Your Meniscus

Common signs include:

• Pain along the inner or outer joint line of the knee
• Swelling that builds over hours (unlike the sudden swelling of an ACL tear)
• A clicking, catching, or locking sensation — especially with straightening
• Difficulty fully bending or extending the knee
• Giving way on stairs, uneven ground, or while pivoting

Smaller tears may cause only mild stiffness. Larger bucket-handle tears that flip into the joint often cause mechanical locking — making it impossible to fully straighten the knee.

Will a torn meniscus heal on its own?

Sometimes — it depends on where the tear is. The outer edge of the meniscus (the "red zone") has a blood supply, so tears there can genuinely heal — on their own in some cases, or with a surgical repair. The inner two-thirds (the "white zone") has almost no blood supply, so those tears do not knit back together — although many of them stop hurting anyway after a few weeks of rest and physical therapy.

The tears that usually do not settle on their own are the mechanical ones: catching, clicking, locking, or a knee that will not fully straighten. A flipped fragment can grind on the joint surface and set the stage for arthritis later. An exam and MRI — not how the knee feels from week to week — are what tell you which kind of tear you have.

The Critical Decision: Repair or Trim?

Not all meniscus tears are treated the same, and this is the most important conversation to have with your surgeon. Two main options exist:

Meniscus repair: Torn edges are sutured together, giving the tissue a chance to heal. This is the preferred option whenever the tear pattern and tissue quality allow it — preserving meniscus reduces long-term arthritis risk significantly.

Partial meniscectomy (trim): The unstable, torn piece is carefully removed, leaving as much healthy meniscus as possible. Recovery is faster, but less cushion remains for the long haul.

The right choice depends on:

• Tear location: The outer third (“red zone”) has blood supply and can heal. The inner two-thirds (“white zone”) has no blood supply — those tears will not heal even with sutures and are trimmed.
• Tear pattern: Bucket-handle and vertical longitudinal tears in younger patients are often repairable. Horizontal and complex tears typically are not.
• Age and activity level: Younger, more active patients have more to gain from repair — decades of preserved cushioning justify a longer recovery.
• Concurrent injuries: An ACL reconstruction done at the same time actually improves the biological healing environment for a simultaneous meniscus repair.

The Arthroscopic Procedure

Both repair and partial meniscectomy are performed arthroscopically — through two or three small portals around the knee. A camera goes in, the tear is assessed directly, and the appropriate technique is applied. Most cases take 30–60 minutes as an outpatient procedure, so you go home the same day.

For a repair, sutures are placed across the tear to hold the edges together while healing occurs. For a trim, a shaver removes the unstable fragment and smooths the remaining tissue. Either way, the knee is thoroughly inspected for any additional damage — cartilage, ligaments, joint surface — addressed in the same setting.

Recovery: Repair vs. Trim

After a partial meniscectomy: Most patients are weight-bearing the next day. Swelling resolves over a few weeks. Return to sports or physically demanding work: 4–6 weeks with focused rehabilitation.

After a meniscus repair: Protecting the healing tissue is the priority. Expect crutches for 4–6 weeks, no running for 3–4 months, and a return to cutting or contact sports around 4–6 months. It is a longer road — but one that preserves the most meniscus and gives you the best chance at a knee that still performs well at 40, 50, and beyond.

Why Dr. Kelly for Meniscus Surgery

Dr. Shayne Kelly, DO is a fellowship-trained orthopedic sports medicine surgeon at Tri-City Orthopedics in Kennewick. His fellowship at the University of Missouri placed him at the center of high-level collegiate sports — where the knee he repaired had to perform for a D1 athlete for the next decade. That long-view thinking shapes every meniscus case: repair it when you can. Trim when you must. And never lose sight of what the joint needs for the rest of a patient’s life.