What are meniscal tears?

Meniscal tears are tears or separations in the shock-absorbing in the knee. This cartilage (meniscus) lies between the shinbone (tibia) and the thighbone (femur). It helps spread weight, makes the knee bend smoothly and moves fluid around the joint to lubricate it.

A torn meniscus can be painful. If it is not treated, a tear can also increase the risk of .

What causes meniscal tears?

Anyone can get a meniscal tear. A tear usually happens when an active child, teen or young adult suddenly twists their knee. Sometimes this happens in sports that involve a lot of pivoting and sudden starts and stops. Meniscal tears often happen at the same time as injuries to the anterior cruciate ligament (ACL).

Orthopedics and Sports Medicine at Seattle Children's

Seattle Children’s pediatric orthopedics team partners with researchers around the world to make sure we are using the latest treatment approaches and technologies.

 

What are the symptoms of meniscal tears?

A torn meniscus may cause these symptoms:

  • A popping sound or feeling at the time of the injury
  • Pain in the knee joint
  • Pain that gets worse when you push gently on the knee
  • Knee joint locks up
  • Clicking sounds in the knee

How are meniscal tears diagnosed?

The doctor will ask about any pain and then examine the knee. The doctor will gently apply pressure and move the foot and leg to check for the discomfort and clicking sounds that signal a meniscal tear. We will also check for swelling in the knee.

If we suspect a tear, we may take . We may ask for an so we can get a better look at the in the knee.

In some cases, we may also insert a small viewing instrument (arthroscope) that is the width of a pencil into the knee. This lets us look at the damage on a large monitor that is like a television screen.

How are meniscal tears treated?

Sometimes small meniscal tears may heal on their own with rest. But surgery to repair the meniscus is often the best treatment. We usually recommend surgery to get the best results.

Seattle Children’s pediatric orthopedic surgeons have the training and experience to repair meniscal tears in children, teens and young adults.

Surgery for meniscal tears

Surgery is the quickest way to get back to regular activities, including sports. It lessens the chances that arthritis will develop in the knee in the future.

We usually use a called arthroscopy to repair meniscal tears.

The doctor inserts a small tool called an arthroscope into the knee. The doctor then uses pictures displayed on a large monitor like a television screen to guide their actions.

The doctor will make a series of small cuts (incisions) around the knee. The incisions will be just big enough to accept the tools the doctor uses.

Based on the injury, the doctor may:

  • Sew the meniscus together
  • Use tiny hooks to attach the torn pieces to one another
  • Pinch the pieces together using a special kind of stitch (suture)

If the torn pieces are not big enough to stitch together, the doctor may trim the meniscus using tiny scissors, shavers or clippers.

Then the doctor will close up the incisions. Often, we use thread that the body can absorb so you do not have to come back to the clinic to have stitches removed.

Learn more about arthroscopic surgery (PDF) (Spanish).

Physical therapy after surgery

After surgery, our rehabilitation specialists will help set up a regular program of physical therapy (PT). Our PT programs, including sports PT, are designed to help patients:

  • Recover range of motion
  • Rebuild strength and stability
  • Restore balance
  • Regain confidence in using their knee

We offer rehabilitation services in our dedicated sports gym.

Why choose Seattle Children’s for meniscal tear treatment?

Seattle Children’s Orthopedics and Sports Medicine specialists treat injuries to the bones and joints of children, teens and young adults up to age 21, including those with meniscal tears.

  • The knee experts you need are here
    • Our sports medicine and sports surgery team includes experienced pediatric , , , , nurses and  who know how to evaluate and treat all types of knee problems.
    • Many young people with meniscal tears need surgery. For those who do, we have pediatric orthopedic surgeons with expanded fellowship training in sports medicine.
    • To restore health and function, we also use nonsurgical methods, like physical therapy (PT), including sports PT. We have the largest team of physical therapists in the Pacific Northwest who specialize in the care of babies, children, teens and young adults.
  • Knee care from birth through young adulthood
    • Our experts have the knowledge, training and skills to treat the youngest children, who are still growing, through young adults in their early 20s. We have special training in the physical, emotional and social needs of young people of all ages.
    • We tailor treatment to each person’s specific problem and consider their age and development. Young people with knee injuries may need different care than adults do. When treating a meniscal tear in a growing child, doctors must take into account the  on bones above and below the knee.
    • For imaging that uses radiation, we use the lowest amount possible (PDF) to make the best image. We have a low-dose radiation X-ray machine, called the EOS. It makes safer full-body images. We also have the largest group of pediatric radiologists in the Northwest.
  • Our approach to surgery improves life for our patients
    • We offer several surgical options for repairing a torn meniscus or, if needed, trimming away small torn pieces. We are careful to choose the option that best matches each patient’s condition.
    • To decrease the risk of early arthritis, we strive to save and repair the torn meniscus whenever possible.
    • Our surgical methods limit the risks of injury to in children who are still growing. This increases the chances that your child will be able to return to sports.
    • Seattle Children’s surgeons are experienced in  of the knee for young people.
  • Support for the best recovery
    • Your team at Seattle Children’s does more than plan and provide care. We also make sure you and your family understand the condition and treatment options. We support you in making choices that are right for you.
    • Our rehabilitation programs are designed so that each patient will get back range of motion, rebuild strength and stability, restore balance and regain confidence in using their knee.
    • To help patients return to play quickly and safely, we do more than treat the current injury. We focus on preventing repeat or new injuries.
    • For your convenience, our doctors see patients at several locations around Washington. Seattle Children’s sports physical therapy is available at our hospital campus and Odessa Brown Children’s Clinic Othello in Seattle as well as in Bellevue, Everett and Federal Way to make ongoing rehab easier for you.
    • Seattle Children’s supports your family with a range of resources. Our Child Life specialists, Family Resource Center and Guest Services are here to help.
  • Research to improve care
    • Our team members partner with experts at other children’s hospitals on multicenter studies. Together, they work to understand more about the best ways to treat knee injuries in young people.
    • We track results of our patients so we can improve care and provide families with accurate information about our success rates, the risk of complications and the chance that patients will return to their previous level of activity. To help with this effort, we may ask you or your child to fill out questionnaires about their knee function after treatment.
    • Orthopedics and sports medicine care is about more than just the joints, muscles and bones. For example, we know that physical health and mental health can affect each other. We have done research on topics like depression symptoms in those with an ACL (knee ligament) injury so we can better address all of our patients’ needs.
    • Learn more about current orthopedics research at Seattle Children’s.

Contact Us

Contact Orthopedics and Sports Medicine at 206-987-2109 for an appointment, a second opinion or more information.

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