【Orthopedics】What is the best treatment for meniscal injury?

For meniscal injuries, the optimal treatment strategy depends on several key factors—including the tear’s location, size, pattern, chronicity, and the patient’s age, activity level, and symptoms. There is no single “best” treatment for all cases; rather, management must be individualized.

Conservative (non-surgical) management is often the first-line approach for stable, non-displaced tears—particularly those located in the vascularized outer third of the meniscus (“red-red” or “red-white” zones), where healing potential is higher. This includes relative rest, activity modification, physical therapy to strengthen the quadriceps and hamstrings, anti-inflammatory medications, and sometimes corticosteroid injections for short-term symptom relief. Many patients with degenerative or small, asymptomatic tears improve significantly with this approach.

Surgical intervention—typically arthroscopic surgery—is indicated when conservative measures fail or when the tear causes mechanical symptoms such as locking, catching, persistent swelling, or giving-way. Repair is preferred over resection whenever feasible, especially in younger, active patients with acute, peripheral tears in well-vascularized zones, as it preserves meniscal tissue and reduces long-term risk of osteoarthritis. In contrast, partial meniscectomy (removal of only the torn portion) may be necessary for complex, degenerative, or poorly vascularized tears (e.g., in the inner “white-white” zone), where healing after repair is unlikely.

Emerging options—such as meniscal transplantation for select patients with symptomatic post-meniscectomy syndrome and significant functional impairment—are considered in specialized centers but remain adjunctive and highly selective. Regardless of treatment path, long-term joint health depends on maintaining lower-limb biomechanics, neuromuscular control, and body weight management.