Can a Meniscus Tear Heal on Its Own? When Rest Works and When It Doesn’t

Some meniscus tears heal on their own, and many do not. The answer depends mostly on where the tear is, what kind of tear it is, and how old and active you are. Here is how to tell which situation you may be in.

What the meniscus does

The meniscus is the knee’s shock absorber: two wedges of cartilage that spread load, steady the joint and keep the bone surfaces off each other. Lose it, and the knee tends to wear out faster. That is why the first question with a tear is whether it can be saved, not just trimmed.

Location decides healing

• Outer rim: has a blood supply. Small tears here sometimes heal with rest and rehabilitation.
• Inner portion: has almost no blood supply, and tears here generally will not heal on their own.

Larger or more complex tears generally do not heal without treatment, whatever their location. A bucket-handle tear is a large fragment folded into the joint, and it can lock the knee or stop it from straightening.

Two kinds of tear, two different questions

Acute tears happen in one moment: a twist, a pivot, a bad landing. They often happen during sport, and often arrive alongside an ACL injury. If the tear is in a zone that can heal, repairing it keeps the cartilage, which protects the knee from arthritis later.

Degenerative tears come from tissue that has weakened with age and frayed rather than snapped. For many of these, the research favors trying physical therapy first. In the MeTeOR trial, 351 patients aged 45 and over with a meniscal tear and mild-to-moderate arthritis were randomly assigned to surgery (a partial meniscectomy, which trims the torn part) or physical therapy. After six months there was no significant difference in function between the groups. However, 30% of the therapy group went on to have surgery within six months. (Katz et al., New England Journal of Medicine, 2013)

Signs a tear may need more than rest

• the knee locks, catches or will not straighten
• swelling keeps coming back
• the knee gives way
• pain hasn’t improved after a course of rehabilitation

What treatment looks like

Treatment starts with an exam and imaging review. Arthroscopy shows the tear’s pattern and zone, and that decides between stitching it, trimming the damaged part, or adding biologic augmentation. Where it can be stitched, it is. Recovery from a repair asks more of you than a trim does, but you keep the cartilage. Running and pivoting sports usually come back between three and six months after a repair, decided by testing rather than a date.

ELITE Sports Medicine treats meniscus tears at its offices in Port St. Lucie and Palm Beach Gardens. Read more about meniscus repair, call 561-202-8886 or request an appointment.