Treatment for a torn meniscus ranges from physical therapy and rest to arthroscopic surgery, depending on the tear’s location, size, and your age and activity level. Many tears, particularly in people over 45, improve just as well with physical therapy as they do with surgery. More severe or mechanically problematic tears often need a surgical procedure to either trim or stitch the damaged cartilage.
How a Torn Meniscus Is Diagnosed
A doctor will typically start with a physical exam, bending and rotating your knee in specific ways to pinpoint the problem. The most commonly used hands-on test, the McMurray test, involves bending your knee deeply while rotating it. In one study of 255 patients, the McMurray test correctly identified about 80% of meniscus tears when performed a few weeks after injury, with a specificity of 79%, meaning it was also reasonably good at ruling out tears that weren’t there.
Physical exams alone aren’t definitive, though. An MRI is the standard next step, giving a detailed picture of the tear’s exact location, shape, and size. That information drives the entire treatment decision, because where the tear sits inside the meniscus determines whether it can heal on its own.
Why Location Inside the Meniscus Matters
The meniscus has a very limited blood supply, and blood is what delivers the nutrients and cells needed for healing. Only the outer 25% of the meniscus, called the “red zone,” has capillary blood flow. Tears in this peripheral zone have a real chance of healing, either on their own or after a surgical repair.
The inner 75%, called the “white zone,” has no blood supply at all. Tears here will almost never heal on their own, no matter how much time you give them. A middle transitional area, the “red-white zone,” falls somewhere in between. This blood supply map is the single biggest factor in deciding whether your tear gets repaired, trimmed, or treated without surgery.
Non-Surgical Treatment
For many people, especially those with degenerative tears (the kind that develop gradually with age rather than from a sudden injury), surgery isn’t necessary. A large study published in JAMA Network Open followed more than 270,000 people aged 45 to 70 with meniscal tears. Half had surgery, half did physical therapy: 16 half-hour sessions over eight weeks. After five years of follow-up, knee function and the risk of developing osteoarthritis were similar in both groups.
A typical rehab program focuses on rebuilding strength and flexibility around the knee. Early exercises include quad sets (tightening the thigh muscle with your leg straight), straight-leg raises, and gentle range-of-motion work. As your knee tolerates more, you progress to squats, step-ups, and balance exercises. The goal is to make the muscles around the knee strong enough to compensate for the damaged cartilage.
Non-surgical treatment also includes the basics: icing, anti-inflammatory medication, and temporarily reducing activities that load the knee, like deep squats or pivoting sports. Many people return to normal activity within several weeks on this approach.
Injections
Platelet-rich plasma (PRP) injections, which use a concentrated portion of your own blood to promote healing, have shown some promise for meniscus tears. A systematic review of 13 PRP studies found consistent improvements in pain and function, with more than 80% of patients avoiding surgery at mid-term follow-up. However, MRI imaging showed limited evidence that the meniscus itself was structurally healing. The overall quality of PRP research remains moderate to low, so it’s best viewed as a potential option for symptom relief rather than a proven fix.
Corticosteroid injections can reduce inflammation and pain in the short term but don’t promote healing. Other biologic injections, like stem cell therapies, have early but very limited data behind them.
Surgical Options
When surgery is needed, it’s almost always done arthroscopically, through two small incisions using a tiny camera and instruments. The two main procedures are fundamentally different in what they do.
Partial Meniscectomy (Trimming)
This is the more common procedure. The surgeon trims away the torn, unstable flap of meniscus and smooths the remaining edge. It’s typically used for tears in the white zone, where the cartilage can’t heal anyway. Recovery is fast: you can put weight on the knee right away, regain full range of motion within one to two weeks, and return to sports or heavy work in four to six weeks, provided swelling and pain have resolved.
Meniscus Repair (Stitching)
When the tear is in the red zone, the surgeon stitches the torn edges back together, giving the tissue a chance to heal with its blood supply intact. This preserves more of the meniscus, which is better for the joint long term, but recovery takes significantly longer. You’ll likely be on crutches and restricted from bearing full weight for up to six weeks. Range of motion is intentionally limited during that period to protect the repair. Returning to sports or demanding physical work typically takes three to six months.
The choice between these two surgeries comes down primarily to the tear’s location and your age. Younger, active patients with red-zone tears are the best candidates for repair. Older patients or those with white-zone tears are more likely to have a partial meniscectomy.
Long-Term Risks After Surgery
Removing meniscus tissue, even a small portion, increases stress on the joint cartilage underneath. A study in the journal Osteoarthritis and Cartilage tracked long-term outcomes and found that 17% of people who had a partial meniscectomy eventually sought care for knee osteoarthritis, compared to 10% after a meniscus repair and just 2.3% in the general population. The rate of osteoarthritis consultations after partial meniscectomy was roughly six times higher than in people who never had knee surgery.
This is one reason surgeons increasingly favor repair over trimming when the tear location allows it, and why physical therapy is often tried first for degenerative tears. Preserving as much meniscus as possible protects the joint over time.
Meniscus Transplant
For younger patients (generally under 50) who’ve already had a total or near-total meniscectomy and now have significant knee pain, a meniscus transplant using donor tissue is an option. Candidates need to have relatively healthy joint cartilage still remaining; advanced cartilage degeneration, obesity, knee instability, or inflammatory arthritis can rule it out. This is a less common procedure reserved for a narrow group of patients, but it can delay or prevent the need for a knee replacement down the line.