Meniscus Tear of the Knee
Table of Contents
The role of the meniscus
The meniscus is a C-shaped fibrocartilage inside the knee joint that handles shock absorption, load distribution, and joint stability. The medial meniscus has a smaller range of motion than the lateral, so it tears 2–3 times more often. In younger patients tears occur from rotational forces during sports; in middle-aged and older patients, even gentle motions can tear a meniscus already weakened by degeneration.
Main symptoms and diagnosis
When a torn cartilage fragment becomes caught between the joint surfaces, locking occurs and the knee cannot fully extend while bent. Joint-line tenderness, pain on squatting, and joint swelling are also common. The McMurray test is positive when rotating and extending the lower leg reproduces a click and pain, and MRI is used to identify the type of tear (longitudinal, horizontal, bucket-handle).
Conservative treatment — Korean medicine approach
- Acupuncture and electro-acupuncture: Needling points such as Xiyan (knee eyes), Yanglingquan, and Yinlingquan, with electrical stimulation at 2 Hz, promotes endorphin release and relieves pain.
- Pharmacopuncture: Anti-inflammatory pharmacopuncture is injected at tender points along the joint line to calm synovial inflammation.
- Herbal medicine: A modified Dangguisu-san dissolves blood stasis and improves local circulation, while Gwanjeoldan (deer antler, Achyranthes) supports cartilage recovery.
Criteria for surgery
Recurrent locking or a Grade III or higher bucket-handle tear requires arthroscopic surgery. However, degenerative horizontal tears or mild radial tears often respond well to conservative treatment. Tears in the vascular zone (red zone) have intrinsic healing capacity and recovery can be promoted with Korean medicine treatment, while tears in the avascular zone (white zone) require careful prognostic monitoring.
Rehabilitation and prevention
Once the acute phase is over, quadriceps and hamstring strengthening exercises reinforce knee stability. Avoid squatting and excessive twisting motions, and when returning to sports follow the principle of gradual loading to prevent recurrence.