Infographic| Volume 39, ISSUE 4, P911-912, April 2023

Treatment of Degenerative Meniscus Tears


      Degenerative meniscus tears are generally atraumatic and a normal part of aging. They are typically observed in middle-aged or older people. Tears are often associated with knee osteoarthritis and degenerative changes. The medial meniscus is most commonly torn. The tear pattern is normally complex with significant fraying but other tear patterns, such as horizontal cleavage, vertical, longitudinal, and flap tears, as well as free-edge fraying are also observed. The onset of symptoms is usually insidious although the majority of tears are not symptomatic. Initial treatment should always be conservative and include physical therapy, NSAIDs, topical treatment, and supervised exercise. In overweight patients, weight loss can decrease pain and improve function. Injections, including viscosupplemenation and the use of orthobiologics, can be considered in the presence of osteoarthritis. Several international orthopaedic societies have issued guidelines for progression to operative management. Mechanical symptoms of locking and catching, acute tears with clear evidence of trauma and persistent pain with failure of nonoperative treatment are considered for operative management. Arthroscopic partial meniscectomy is the most commonly performed treatment for most degenerative tears. However, repair is considered for appropriately selected tears, with special emphasis on surgical technique and patient selection. Treatment of chondral pathology at the time of surgery for meniscus tears is controversial, although a recent Delphi Consensus statement concluded that debridement of loose cartilage fragments may be considered.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. American Academy of Orthopaedic Surgeons. Management of osteoarthritis of the knee (non-arthroplasty) evidence-based clinical practice guideline (3rd ed.). Available at Published August 31, 2021. Accessed July 31, 2022.

        • Giuffrida A.
        • Di Bari A.
        • Falzone E.
        • Iacono F.
        • Kon E.
        • Marcacci M.
        Conservative vs surgical approach for degenerative meniscus injuries: A systematic review of clinical evidence.
        Eur Rev Med Pharmacol Sci. 2020; 24 (1885): 2874
        • Hohmann E.
        • Angelo R.
        • Arciero R.
        • Bach B.R.
        • Cole B.
        • Cote M.
        • et al.
        Degenerative meniscus lesions: An expert consensus statement using the modified Delphi Technique.
        Arthroscopy. 2020; 36: 501-512
        • Leopold S.S.
        Editorial: The new AAOS guidelines on knee arthroscopy for degenerative meniscus tears are a step in the wrong direction.
        Clin Orth Relat Res. 2022; 480: 1-3
        • Lubowitz J.H.
        • Brand J.C.
        • Rossi M.J.
        Nonoperative management of degenerative meniscus tears is worth a try.
        Arthroscopy. 2020; 36 (327): 327
        • Noorduyn J.C.A.
        • van Loon T.G.
        • van de Graaf V.A.
        • Willigenburg N.W.
        • Butter I.K.
        • Scholten-Peeters G.G.M.
        Functional outcomes of arthroscopic partial meniscectomy versus physical therapy for degenerative meniscus tears using a patient-specific score: A randomized controlled trial.
        Orthop J Sports Med. 2020; 82325967120954392
        • Noorduyn J.C.A.
        • van de Graaf V.A.
        • Willigenburg N.W.
        • Scholten-Peeters G.G.M.
        • Mol B.W.
        • Heymans N.W.
        An individualized decision between physical therapy or surgery for patients with degenerative meniscal tears cannot be based on continuous treatment selection markers: a marker-by-treatment analysis of the escape study.
        Knee Surg Sports Traumatol Arthrosc. 2022; 30: 1937-1948