Meniscus Tear Treatment: Surgical Repair Is Required for Mechanical Symptoms

A torn meniscus cannot spontaneously reduce or "flip back" into place. Mechanical symptoms (locking, catching, giving way) from displaced fragments (bucket-handle, flap tears) require arthroscopic intervention.

Why Surgery Is Often Necessary

• Poor healing potential: Only outer 10–30% (red-red zone) has vascular supply; inner white-white zone is avascular.
• Mechanical blockage: Displaced fragment physically prevents full extension/flexion.
• Progressive damage: Unstable tears propagate; abrade articular cartilage → early osteoarthritis.

Treatment Algorithm

• Nonoperative trial (4–6 weeks): Small, stable, peripheral tears without mechanical symptoms; PT, NSAIDs, activity modification.
• Arthroscopic partial meniscectomy: Irreparable tears (degenerative, complex, white-white zone); remove unstable fragment, preserve rim.
• Arthroscopic repair: Vertical longitudinal tears in red-red/red-white zone, especially <40 yrs; sutures/all-inside devices; 6-week protected weight-bearing.
• Meniscal transplant: Young, symptomatic post-meniscectomy patients with intact alignment/ligaments.

Key Point

No manual manipulation, bracing, or exercise can reduce a displaced meniscal fragment. Mechanical locking = surgical indication. Early repair preserves chondroprotection.