Meniscus Surgery After Fifty: Why Degenerative Tears Are Treated Differently From Sports Tears

The MRI report arrives in the patient portal before the appointment does. Somewhere in the second paragraph, between words like “signal” and “posterior horn,” sits the phrase a 58-year-old gardener was dreading: complex tear of the medial meniscus. She has not fallen, twisted, or done anything heroic. The knee simply started aching on the stairs one spring and never quite stopped.

Her nephew tore his meniscus playing soccer at 24 and was in the operating room within a month. So she assumes the same path is coming. Then the surgeon says something surprising: let’s try physical therapy first.

That conversation happens in clinics every day, and it confuses people. Why would the same word on two scans lead to such different plans? The answer sits at the heart of how meniscus surgery after 50 is decided, and it has less to do with age itself than with what kind of tear the knee has and what the surrounding cartilage looks like.

What is a degenerative meniscus tear, and why does age change the picture?

Each knee has two menisci: C-shaped pads of rubbery fibrocartilage that sit between the thigh bone and shin bone, spreading load across the joint and acting as shock absorbers. The inner (medial) meniscus takes most of the strain during walking, which is why it tears far more often than the outer (lateral) one.

A meniscus can fail in two broad ways. A traumatic tear happens when a healthy pad is twisted or crushed in a single moment, typically during pivoting sport. A degenerative tear is different in kind, not just in cause. Over decades, the collagen fibers lose water and elasticity, small splits appear along the grain of the tissue, and eventually the pad frays or splits horizontally, sometimes with no memorable event at all.

Blood supply is the other half of the story. Only the outer rim of the meniscus has its own vessels; the inner two-thirds is nourished by joint fluid alone. Degenerative tears tend to sit in that poorly supplied inner zone, in tissue that is already worn, and they usually arrive in company. The cartilage coating the bone ends is often thinning too, which is the early stage of osteoarthritis.

That company matters enormously. A population MRI study found meniscal tears in roughly a third of adults over 50, and most of those people had reported no knee symptoms in the previous month. The tear and the pain were not reliably the same thing. For a surgeon, a degenerative tear in an arthritic knee looks less like a mechanical fault to fix and more like one feature of a joint that is aging as a whole.

How does meniscus surgery after 50 actually work?

Almost all meniscus surgery is arthroscopic, meaning the surgeon works through two or three incisions about the width of a pencil, using a narrow camera and slim instruments while watching a screen. The joint is filled with sterile fluid to create space and a clear view. The operation is usually done as a day procedure under general or spinal anesthesia, and the whole thing typically takes well under an hour.

Two very different things can happen once the camera is inside. The first is partial meniscectomy: trimming away the torn, unstable fragment and smoothing the remaining edge so it no longer catches. The surgeon removes as little tissue as possible, because every millimeter of meniscus lost shifts more load onto the bone underneath. The second is meniscus repair: stitching the torn edges back together with sutures or small anchors so the tissue can heal.

Repair depends on biology. It only works where blood can reach, which means the outer rim, and it works best in tissue that is still springy and intact rather than frayed. That is exactly why the two age groups diverge. A clean longitudinal tear in the vascular rim of a 24-year-old is a candidate for repair. A horizontal, fraying tear in the avascular center of a 58-year-old usually is not, because the stitched edges would have nothing to heal with.

So when people over 50 do have meniscus surgery, it is most often a partial meniscectomy aimed at a specific mechanical symptom, such as a knee that locks or a loose flap that catches. Surgeons also inspect the joint surface during the procedure, and what they find there shapes the advice given afterward.

Why are degenerative tears treated differently from sports tears?

Put the two situations side by side and the logic becomes clear. The differences are not about how much a person deserves treatment; they are about what each knee can realistically gain from an operation and what it stands to lose.

Feature	Sports (traumatic) tear	Degenerative tear
Typical age	Teens to 40s	Mostly over 50
How it starts	Sudden twist, pivot, or impact	Gradual, often no clear event
Tear pattern	Vertical, longitudinal, bucket-handle	Horizontal, complex, fraying
Surrounding cartilage	Usually healthy	Often thinning (early osteoarthritis)
Blood supply at tear site	Often in the vascular rim	Usually in the poorly supplied center
Repair feasible?	Frequently	Rarely
Usual first step	Early surgical opinion, often repair	Physical therapy and activity modification
Role of surgery	Restore stability, protect cartilage	Relieve mechanical locking if rehab fails

A young athlete with a bucket-handle tear has a displaced piece of meniscus jamming the joint, in an otherwise pristine knee. Removing or repairing it quickly protects cartilage that could last another sixty years. Leaving it risks a lifetime of instability.

In the degenerative knee, the calculation flips. The tear is often one of several wear changes, the pain may be coming from the arthritic surface rather than the tear, and trimming meniscus removes cushioning from a joint that already has less to spare. This is why guideline bodies, including NICE, advise against arthroscopic procedures for knee osteoarthritis unless there is true mechanical locking. The tear is treated differently because it is, in effect, a different disease wearing the same name.

Torn meniscus physical therapy vs surgery: what the trials found

For decades, a torn meniscus on MRI in a painful middle-aged knee led almost automatically to arthroscopy. Then researchers started asking whether the operation was actually doing the work.

The METEOR trial, published in the New England Journal of Medicine, randomized adults aged 45 and over who had a meniscal tear plus mild to moderate osteoarthritis to either arthroscopic partial meniscectomy followed by physical therapy, or physical therapy alone. At six and twelve months, pain and function scores improved by a similar amount in both groups. About one in three people assigned to therapy alone later chose to have surgery within six months, which is an honest signal that rehabilitation does not satisfy everyone, but the group that stuck with therapy did as well overall.

A Finnish trial went further and compared partial meniscectomy with sham surgery, in which patients received anesthesia and skin incisions but no trimming, for degenerative tears without arthritis. At twelve months, outcomes were no better in the group that had the real procedure. That result unsettled many surgeons, because it suggested that a large part of the perceived benefit came from rest, rehabilitation, time, and expectation rather than from the trimming itself.

Later work, including a systematic review in the BMJ, pooled these studies and reached the same broad conclusion: for degenerative tears, surgery offers at most a small, short-lived advantage over exercise therapy, and carries the risks of an operation.

The caveat deserves equal weight. These trials largely excluded people with a truly locked knee, where a fragment physically blocks movement. For that group, surgery remains the standard answer. Evidence, in other words, narrowed the indication rather than abolishing it.

Who is usually offered meniscus surgery after 50, and who is asked to wait?

Surgeons rarely decide on the scan alone. They weigh the story, the examination, the MRI, and sometimes a standing X-ray, which shows how much joint space remains far better than MRI does.

The people most often offered arthroscopy sooner are those with mechanical symptoms that match the tear: a knee that locks in a bent position and will not straighten, or a flap that catches with a painful click during specific movements. A displaced fragment is a physical obstruction, and no amount of quadriceps strengthening dissolves it. People whose pain is clearly localized to the joint line over the tear, with relatively healthy cartilage on imaging and persistent symptoms after a proper course of rehabilitation, also sit in the surgical conversation.

Those usually asked to wait, and often to skip surgery entirely, include people whose knee aches diffusely, swells after activity, and stiffens in the morning, with X-rays showing narrowed joint space. That pattern points to osteoarthritis as the main driver, and trimming the meniscus does not treat arthritis. Anyone who has not yet tried a structured therapy program is typically asked to complete one first, because the trials above show it works for most people.

Other factors tilt the scales. Higher body weight increases load on the joint and is associated with faster arthritis progression after meniscectomy, so weight management and strengthening may be prioritized. Smoking, poorly controlled diabetes, and blood-thinning medication raise surgical risk and healing concerns, which the team will discuss rather than ignore.

None of this is a verdict on how active someone is allowed to be. It is a judgment about where the pain is coming from and what an operation can realistically change. The treating team makes that call with you, not for you.

Meniscus repair vs removal: is it better to have a meniscus repaired or removed?

If repair were always possible, surgeons would always choose it, because the meniscus protects the joint for life. Studies tracking people for years after partial meniscectomy show higher rates of osteoarthritis in the operated knee than in the other knee, and the more tissue removed, the greater the risk. Keeping meniscus is keeping cushioning.

But repair has strict conditions. The tear needs blood supply, which means the outer third. The tissue needs enough integrity to hold stitches. The knee needs to be stable, since a loose anterior cruciate ligament keeps re-tearing a repaired meniscus. And the patient needs to tolerate a much longer recovery, including weeks of restricted weight bearing and bending while the repair knits.

Degenerative tears fail most of those tests. They sit in the avascular zone, the tissue is frayed rather than cleanly split, and healing capacity in worn cartilage is lower. Attempting repair in that setting risks a prolonged rehabilitation followed by a tear that never heals and a second operation. This is why, for people over 50, repair is the exception and partial meniscectomy is the rule when surgery is chosen at all.

There are exceptions, and good surgeons look for them. A peripheral longitudinal tear in an otherwise healthy 55-year-old knee, especially after a genuine injury rather than slow wear, may well be repairable, and age alone is not a reason to refuse. Some surgeons also repair horizontal cleavage tears in selected cases, though the evidence here is thinner.

Meniscus transplantation, using donor tissue, exists but is reserved for younger people who have lost most of a meniscus and have good cartilage. It is not a routine option in the degenerative knee. Ask your surgeon which category your tear falls into and why.

How long is too long to wait for meniscus surgery?

This question carries real anxiety behind it. People picture a tear getting bigger, grinding away cartilage, and shutting a window of opportunity. For degenerative tears, that picture is mostly wrong.

The trials that compared surgery with therapy randomized people and followed them for a year or more. Those who stayed in the therapy arm did not end up worse off at twelve months than those who had surgery early, and those who crossed over to surgery after several months of therapy still improved. Waiting to see whether rehabilitation works did not appear to close any door. For a fraying degenerative tear, a few months of well-structured exercise is a reasonable diagnostic test as well as a treatment: if the knee settles, you have your answer without an operation.

The urgent exceptions are mechanical. A knee that is locked, unable to fully straighten because a fragment is jammed, should be assessed promptly, typically within days to a couple of weeks, because a displaced piece grinding against cartilage can damage the joint surface and because living with a locked knee is miserable and risky for falls. A large bucket-handle tear in a younger, healthier meniscus is also treated sooner, since repair success falls as the displaced tissue deforms and dries out.

There is a softer form of “too long” too. If pain has kept someone off their feet for months, the thigh muscles waste, balance deteriorates, and cardiovascular fitness drops. Waiting in that sense has a cost regardless of the operation. The goal of a therapy-first plan is active waiting: strengthening, keeping weight controlled, and reviewing progress at set intervals with the team, usually around six to twelve weeks, so that the decision is revisited rather than drifting.

What happens on the day of knee arthroscopy?

Most people arrive in the morning and go home the same afternoon. After checking in, you meet the anesthesia team to decide between a general anesthetic, where you are fully asleep, and a spinal or regional block, where the leg is numbed and you are sedated. Both are common for knee arthroscopy, and the choice depends on your health history and preference.

In the operating room, a tourniquet is often placed around the thigh to limit bleeding and keep the view clear. The surgeon makes two or three small incisions around the kneecap, fills the joint with saline, and inserts the arthroscope. The first job is a systematic look around: cartilage surfaces, ligaments, both menisci. This inspection is why the plan can change on the table; a tear that looked trimmable on MRI may turn out to be more extensive, or the cartilage may be more worn than expected.

If a partial meniscectomy is done, the unstable fragment is removed with small graspers and a motorized shaver, and the remaining rim is smoothed. If a repair is attempted, sutures or small anchors are placed across the tear. The incisions are closed with a stitch or adhesive strips and covered with a dressing, and the knee is wrapped in a compression bandage.

Recovery staff check sensation and circulation, help you stand with crutches, and make sure pain is controlled before discharge. You cannot drive yourself home. Written instructions cover dressing care, ice, elevation, and the first exercises. Photographs taken inside the joint are usually shared at follow-up, and it is worth asking to see them: they show you exactly what the surgeon saw and why they did what they did.

Partial meniscectomy recovery time: what the first days and weeks look like

The first 48 hours are about swelling control. The knee feels puffy and warm, the dressing may show a little pink fluid, and walking is possible but slow. Ice, elevation above heart level, and gentle ankle pumps to keep blood moving are the core tasks. Most people after partial meniscectomy are allowed to put weight through the leg straight away, using crutches for comfort rather than protection.

By the end of the first week, many are walking without crutches around the house and have started simple exercises: straightening the knee fully, tightening the thigh muscle, sliding the heel to bend the knee. A stitch check or dressing change usually falls around this time. Desk-based work is often resumed within a week or two; jobs involving kneeling, ladders, or heavy lifting take longer.

Weeks two to six bring the real work. Physical therapy builds quadriceps and hip strength, restores balance, and gradually reintroduces stairs, cycling, and longer walks. Swelling after activity is a useful gauge: if the knee balloons after a session, the dose was too high. Mayo Clinic and Cleveland Clinic describe recovery from partial meniscectomy as typically taking around four to six weeks, with return to higher-impact activity depending on strength and swelling rather than the calendar.

Repair follows a different and slower script. Weight bearing may be limited and knee bending restricted for several weeks to protect the stitches, and full recovery is more often described in the range of three to six months.

Two honest notes. Knees with arthritis often take longer to calm down than the operation itself would suggest, because the surgery does not change the cartilage. And a rehabilitation program is not optional aftercare; in the trials, it was the treatment that did most of the heavy lifting.

Can you walk if your meniscus is removed?

Yes, and usually within a day of surgery. The confusion comes from the word “removed.” Modern surgery almost never takes out an entire meniscus. Total meniscectomy was common in the mid-twentieth century, and long-term follow-up of those patients taught orthopedics a painful lesson: knees without a meniscus developed arthritis far earlier and more severely. That evidence is precisely why today’s standard is partial meniscectomy, trimming only the torn, unstable portion and leaving as much healthy rim as possible.

After a partial meniscectomy, the knee still has most of its shock absorption. People walk, climb stairs, cycle, swim, garden, and in many cases return to running or racquet sports. What changes is the margin. The remaining meniscus carries more load per square millimeter, and the bone and cartilage beneath feel more of each step. Over years, that shows up as a higher likelihood of arthritis in the operated knee compared with the other side, especially if a large amount of tissue was taken, the cartilage was already worn, or body weight is high.

This is the trade a surgeon is weighing when they counsel against trimming a degenerative tear that is not locking the knee: removing tissue to chase pain that may be coming from arthritis anyway, while nudging that arthritis forward.

For walking itself, the practical questions are about the first few weeks. Crutches are for comfort, not because the joint is fragile. A slight limp early on is usually from swelling and muscle inhibition, not damage, and it fades as the quadriceps switch back on. Hills and uneven ground come back later than flat pavement. If walking is getting harder rather than easier after the first week, that is a reason to call the team rather than push through.

Will your knee ever be the same after meniscus surgery?

The honest answer is that it depends on what “the same” means and what the knee was like beforehand.

For a younger person with a repaired traumatic tear and healthy cartilage, the aim is a knee that functions normally for decades, though repaired tissue is never quite identical to the original and re-tear is possible. For someone over 50 having a partial meniscectomy for a locking degenerative tear, the realistic goal is narrower: stop the catching, reduce the sharp mechanical pain, and get back to walking and daily life. The background ache of an arthritic joint, the stiffness after sitting, the swelling after a long day, these come from the cartilage surface and are not addressed by the operation.

People who understand that distinction before surgery tend to be far less disappointed after it. Those who expected the scan to be “fixed” and the knee to feel 30 again often feel let down, not because the surgery failed, but because it was never going to treat the part of the problem that bothered them most.

The long view matters too. Studies following people after partial meniscectomy show higher rates of radiographic arthritis in the operated knee years later than in unoperated knees. That does not mean every patient develops symptoms, and arthritis was often already present. It does mean that the knee’s trajectory is shaped more by cartilage health, body weight, muscle strength, and activity choices than by the tear itself.

So the knee is rarely exactly the same. But a strong, well-conditioned knee with early arthritis and a trimmed meniscus can carry a person through a very full life. The work that makes that possible happens mostly outside the operating room.

Degenerative meniscus tear treatment: risks of surgery and the alternatives

Knee arthroscopy is among the safest operations in orthopedics, but safe is not the same as risk-free, and the risks weigh more heavily when the expected benefit is small.

Complications that can occur include infection of the joint or incisions, bleeding into the knee, blood clots in the calf veins, stiffness, nerve irritation causing patches of numbness around the scars, and the general risks of anesthesia. A rarer but serious concern is that the operation does not relieve the pain, or that pain worsens as arthritis progresses in a knee with less meniscus. Surgeons quote the specific likelihoods in their own consent discussions, and those numbers should come from them rather than from a magazine.

The alternatives are not consolation prizes; for degenerative tears they are the first-line treatment. A structured exercise program typically runs for six to twelve weeks and focuses on quadriceps, hamstring, and hip strength, flexibility, and balance, progressing gradually. Activity modification means swapping deep squats and pivoting for cycling, swimming, or walking during the painful phase, not giving up movement. Weight management reduces load through the joint with every step. Simple analgesics and anti-inflammatory medicines, used as directed by a clinician, can make rehabilitation tolerable; decisions about which to take, and for how long, belong with the prescriber.

Corticosteroid injections into the joint can calm a flare for weeks to a few months, mainly by damping inflammation in the lining; they do not heal the tear. Other injectables, such as hyaluronic acid or platelet-rich plasma, are offered in some settings, but the evidence for them in degenerative meniscal tears is mixed, and major guidelines do not endorse them as proven treatments.

When arthritis is advanced and symptoms dominate daily life, the relevant surgical conversation is usually about joint replacement, not arthroscopy. That is a different decision, with its own evidence base.

What people often get wrong about meniscus tears after 50

“The MRI shows a tear, so the tear is causing my pain.” Not necessarily. Tears are common on scans of middle-aged knees that do not hurt at all. Surgeons combine the scan with the examination and X-rays to decide where the pain is really coming from, and cartilage wear is often the louder voice.

“A tear can’t heal, so it has to be cut out.” Degenerative tears in the avascular zone do not knit back together, that part is true. But symptoms frequently settle anyway as inflammation calms and muscles strengthen. The tear can remain on the scan while the knee stops complaining.

“Physical therapy is just what they offer when they won’t operate.” In randomized trials, therapy matched surgery for most people with degenerative tears. It is the evidence-based treatment, not a waiting room.

“Having the knee ‘cleaned out’ will help the arthritis.” Arthroscopic washout and debridement for osteoarthritis has been tested against sham and against therapy and did not deliver meaningful benefit. NICE and other guideline bodies now recommend against it unless the knee is mechanically locking.

“If I wait, I’ll miss the window.” For degenerative tears, trials found no penalty for trying therapy first. The genuine time-sensitive situation is a locked knee or a displaced tear in healthy tissue.

“Once a meniscus is trimmed, running is over.” Many people return to running and sport after partial meniscectomy. What changes is the importance of strength, weight, and sensible training load for protecting the joint over the long haul.

“Younger patients get surgery because they matter more.” They get it because their tears are often repairable and their cartilage is worth protecting with a repair. Older knees are treated differently because the biology differs, not the value of the person.

Questions to ask your care team before deciding

A good consultation about meniscus surgery after 50 should leave you understanding not just what is being offered, but why this option for this knee. These questions tend to open the right doors.

• Is my tear degenerative or traumatic, and where in the meniscus does it sit?
• How much cartilage wear do you see on the X-ray and MRI, and how much of my pain do you think comes from arthritis rather than the tear?
• Do I have true mechanical locking, or catching and pain that might settle with time and rehabilitation?
• Have I completed a structured physical therapy program yet, and if not, what would a good one look like and for how long?
• If surgery is recommended, is the plan repair or partial meniscectomy, and what would make you change that plan once you are inside the knee?
• What specific improvement should I expect, and what symptoms will the operation not change?
• What are the risks in my particular case, given my health, weight, and medications?
• How would surgery now affect the long-term health of this knee, including arthritis risk?
• What does the rehabilitation plan look like afterward, and who leads it?
• If I choose to wait, what signs should prompt me to come back sooner, and when will we review?

Bring someone with you if you can; two sets of ears catch more. Write the answers down, and do not be shy about asking for the arthroscopy photographs or the imaging to be shown and explained. A clinician who welcomes these questions is giving you a glimpse of how they will communicate after surgery too.

Finally, a second opinion is a normal part of surgical decision-making, not an insult. The evidence in this area has shifted substantially, and it is reasonable to hear how two experienced surgeons read the same knee.

When to call your doctor

Most knees with a degenerative tear can be managed at a measured pace, but some signs should not wait for the next scheduled appointment.

Before surgery, contact your care team promptly if the knee becomes locked and you cannot straighten it fully, if it gives way and you fall, if it swells rapidly and feels tense and hot, or if you develop fever alongside a swollen, painful joint, which can signal infection inside the knee. Sudden severe pain after a new injury, or an inability to put weight through the leg, also warrants same-day assessment.

After arthroscopy, call the surgical team or seek urgent care if you notice any of the following:

• Calf pain, tightness, or swelling in the operated leg, or sudden breathlessness or chest pain, which can indicate a blood clot
• Fever, chills, or spreading redness, warmth, or pus around the incisions
• Swelling that keeps increasing rather than settling after the first few days, or a knee that feels tense and hard to bend
• Numbness, tingling, or coldness in the foot that was not present before
• Bleeding that soaks through the dressing
• Pain that is escalating despite rest, elevation, and the medicines you were given
• Difficulty walking that is getting worse instead of better after the first week

None of these necessarily means something serious has happened, but each deserves a conversation with a clinician who knows your case rather than a guess at home. Keep the contact numbers from your discharge paperwork somewhere visible, and err on the side of calling. The team would always rather hear from you about a problem that turns out to be minor than find out late about one that was not.

Frequently asked questions

How long is too long to wait for meniscus surgery after 50?

For a degenerative tear without locking, trials found no penalty for trying several months of physical therapy first; people who later crossed over to surgery still improved. The exception is a locked knee that cannot straighten, which should be assessed within days to a couple of weeks. Your team will usually set a review point around six to twelve weeks into rehabilitation to revisit the decision.

Is it better to have a meniscus removed or repaired?

Repair is preferred whenever it is feasible, because keeping meniscus protects the joint from arthritis. It requires a tear in the blood-supplied outer rim, healthy tissue that can hold stitches, and a stable knee. Degenerative tears usually fail those conditions, so partial meniscectomy is the common choice after 50 when surgery is done at all. Your surgeon decides based on what the tear looks like inside the joint.

Will your knee ever be the same after meniscus surgery?

It depends on the knee you started with. Surgery can stop locking and catching, but it does not change arthritic cartilage, so background ache and stiffness may persist. Studies show higher long-term arthritis rates in knees that have had meniscus removed. Many people return to full activity, and outcomes depend heavily on strength, body weight, and the health of the cartilage rather than on the tear alone.

Can you walk if your meniscus is removed?

Yes. Surgeons now remove only the torn, unstable part, not the whole meniscus, and most people walk with crutches for comfort the same day and without them within a week or two. The remaining tissue still cushions the joint, though it carries more load, which is why strengthening and weight management matter for the knee’s long-term health.

Torn meniscus physical therapy vs surgery: which works better for degenerative tears?

Randomized trials found that structured exercise therapy produced similar pain and function improvement to arthroscopic surgery at one year for degenerative tears, and a sham-controlled trial found no added benefit from the trimming itself. Therapy is therefore the recommended first step. Surgery remains appropriate for true mechanical locking or for symptoms that persist after a proper rehabilitation program.

What is the typical partial meniscectomy recovery time?

Mayo Clinic and Cleveland Clinic describe recovery from partial meniscectomy as typically around four to six weeks, with desk work often resumed within one to two weeks and higher-impact activity returning as strength and swelling allow. Meniscus repair takes longer, often three to six months, because weight bearing and bending are restricted while the stitched tissue heals. Knees with arthritis may take longer to settle.

What is degenerative meniscus tear treatment without surgery?

It centers on a six to twelve week program of quadriceps, hamstring, and hip strengthening with balance and flexibility work, plus temporary activity changes such as swapping pivoting sports for cycling or swimming. Weight management reduces joint load. A clinician may discuss analgesics or a corticosteroid injection to calm a flare, with decisions about medicines left to the prescriber. The tear itself does not heal, but symptoms often settle.

Does a meniscus tear on MRI always need treatment?

No. Tears are common findings on scans of middle-aged knees that do not hurt, and the tear is not always the source of pain. Clinicians combine the MRI with a physical examination and standing X-rays to judge whether symptoms come from the tear, from cartilage wear, or both. A tear that causes no mechanical symptoms and little pain may need nothing more than strengthening and monitoring.

Does meniscus repair vs removal change my arthritis risk?

Yes. Follow-up studies show higher rates of arthritis in knees that have had meniscus tissue removed, and the risk rises with the amount taken, pre-existing cartilage wear, and higher body weight. Repair preserves tissue and is favored when biology allows, which is more often the case in younger traumatic tears. For degenerative tears, surgeons minimize how much they trim for exactly this reason.

Why does a surgeon recommend therapy for me but surgery for someone younger?

Because the tears differ, not because of age itself. Younger traumatic tears often sit in the vascular rim of healthy tissue and can be repaired to protect decades of cartilage life. Degenerative tears usually lie in the poorly supplied center, alongside early arthritis, where trials show therapy works as well as surgery. Guideline bodies therefore recommend against arthroscopy in arthritic knees unless there is true locking.

References

• Cleveland Clinic: Torn meniscus
• MedlinePlus: Knee arthroscopy

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.