Torn or Frayed Meniscus Healing and Treatment

Meniscus tears may be treated with rest, physical therapy, and/or surgery. Which option is best for you depends on several factors, including the location of the injury, your overall health, and whether you have a full tear, partial tear, or frayed meniscus.

A frayed meniscus is when the edges of the cartilage have become worn over time. A partial or full meniscus tear is a more profound and sudden pulling apart of the cartilage. Surgical repair is an option for the latter injuries, but a frayed meniscus cannot be fixed this way. (It would be like attempting to sew shredded ends of a piece of fabric back together.)

This article explains whether pain from a meniscus tear or frayed meniscus can get betters on its own and when you may need surgery.

Types of Meniscus Tears

The meniscus is a C-shaped piece of cartilage attached to the knee joint from the shinbone. Its purpose is to cushion the joint. 

The meniscus can get torn, but not all tears are the same. The type of tear determines how much damage there is to your knee and what your recovery will be like.

Degenerative Meniscus Tears

As you age, the strength of your tissue changes. Just as your skin gets wrinkled and your hair turns gray, your meniscus changes over time. 

The tissue gets weaker and more brittle. When people over the age of 40 get a torn meniscus, the tissue tends to be less healthy and less likely to heal, with or without surgery.

When meniscus tears happen from age, they are called degenerative meniscus tears. The symptoms typically start without a major injury. The tissue will show signs of age and looks frayed at the edges, which is why it's sometimes called a "frayed mensiscus."

Trying to repair a frayed meniscus surgically is like sewing together frayed fabric—the tissue won't hold together.

Meniscus Tears Due to Injury

Younger, healthier meniscus tissue in people in their teens and 20s tends to tear more cleanly and is often caused by an injury. 

The tissue is rubbery and robust. When it tears, it tends to do so without the frayed edges that happen in older people. 

The tissue also tends to tear in a single line rather than in multiple directions. These types of tears are often better suited for surgical repair.

Factors That Influence Healing

Certain things can affect a meniscus tear's ability to heal, including the location and stability.

Tear Location

Even though the meniscus tissue is healthy in younger people, a tear still may not heal if it happens along the inner two-thirds of the meniscus. 

The blood supply to the outer one-third of the meniscus contains the blood vessels required for healing. Tears that extend beyond this area are less likely to heal, with or without surgery.

Stability of a Meniscus Tear

A partial meniscus tear, which doesn't go all the way through the meniscus, is stable. A more profound tear that extends through the meniscus is unstable.

An unstable tear—even one that is surrounded by healthy tissue and a good blood supply—might not heal. Unstable tears tend to pull apart or cause symptoms before a lot of healing has taken place.

Surgery can stabilize some meniscus tears. If the torn meniscus is healthy tissue with a good blood supply, surgery to stabilize the tear may allow for healing.

When Do Meniscus Tears Need Surgery? 

For a meniscus tear to heal, it needs three things:

• Healthy tissue
• Good blood supply
• Stability

If you are having surgery for a symptomatic torn meniscus, a repair is generally necessary only if the tear is unstable, you have healthy meniscus tissue, and the tear is in an area of good blood supply. 

Your healthcare provider will also consider your age, your activity level, and any other health issues you may have to decide if surgery would be an option for you.

If the tear isn't a good candidate for surgical repair, your provider may remove the torn portion of the meniscus (partial meniscectomy).

Alternatives to Surgery

Some meniscus tears will get better without surgery. For example, a degenerative meniscus tear will often have symptoms that improve over time and never require surgery.

Research has shown that older patients often respond well to physical therapy as first-line treatment for symptoms of a meniscus tear.

Summary

Meniscus tears or a frayed meniscus are common knee injuries, especially as people get older. These injuries sometimes require surgery, but not always. Some tears can heal on their own or with physical therapy.

A frayed meniscus is more tricky to fix with surgery than a full meniscus tear. You might be a good candidate for meniscus tear surgery if you have healthy tissue, a good blood supply, and a stable injury.