AskThePedipod
Farokh Wadia
What are Meniscal injuries?
Mr Farokh Wadia, Consultant Paediatric Orthopaedic Surgeon
1 August 2026
Tears of the knee's cartilage cushions, where preserving the meniscus is the priority in children.
What are the menisci?
The menisci are two C-shaped pads of cartilage cushions that sit between the thigh bone and the shin bone in the knee. They act as shock absorbers, help distribute load, and contribute to the knee’s stability. There is one on the inner (medial) side and one on the outer (lateral) side.
What is a meniscal injury?
A meniscal injury is a tear within this cartilage. In children and young people, tears often occur after a twisting injury during sport. Some children are born with an abnormally shaped (discoid) meniscus, which is more prone to tearing.
Signs and symptoms
• Knee pain, often on one side
• Swelling, particularly after activity
• Clicking, catching or locking of the knee
• Difficulty fully straightening or bending the knee
How is it diagnosed?
Clinical examination is followed by an MRI scan, which is the best way to see the meniscus and assess the type and location of a tear.
Treatment options
Treatment depends on the type, size and location of the tear, and on the child’s age. Some stable tears settle with rest and physiotherapy. Others are best treated with keyhole surgery (arthroscopy) to repair the tear. In children and young people, preserving meniscal tissue is a priority because the menisci protect the knee over the long term, so repair is favoured over removal wherever possible.
Outlook
Children heal well, and meniscal repair has a good success rate in the young. Most return to full sporting activity following appropriate rehabilitation.
When to seek advice
If your child has persistent knee pain, swelling, locking, or a knee that will not fully straighten after an injury.
This information is for general guidance only and is not a substitute for a consultation with Mr Wadia. If you are worried about your child, please seek medical advice.
FAQs
Can a child’s torn knee meniscus heal without surgery?
Only minor tears located on the outer edge of the meniscus can heal without surgery because this area has an excellent blood supply; however, most meniscus tears including complex tears or tears in the inner zone often require surgical repair. A meniscus tear in a child is usually caused by a twisting sports injury or an underlying structural variant known as a discoid meniscus.
Clinical management and rehabilitation priorities:
Conservative therapy: Utilizing temporary bracing, activity restrictions, and focused physical therapy to stabilize the knee if the tear is stable.
Arthroscopic repair: Minimally invasive keyhole surgery to stitch the torn cartilage together, prioritizing saving the meniscus over removing it whenever possible to protect the young joint.
Mechanical red flags: Immediate specialist evaluation is required if the child’s knee locks, catches, clicks painfully, or cannot give full extension.