Knee Meniscus


The knee joint is a very complex joint, which is made by the lower end of the thigh bone or the femur on the top and the upper end of the shin bone or the tibia below. It also has knee cap or the patella in front, which essentially moves in a groove over the front of the lower end of the thigh bone called trochlea. The lower end of the thigh bone and the upper end of the shin bone articulate with each other in two compartments, the inner or the medial compartment and the outer or the lateral compartment.

The two compartments have a fibrocartilaginous disk in between the two articulating surfaces each. These C-shaped articulating fibrocartilaginous disks are called the meniscus (plural – menisci).

MRI showing knee meniscus.

MRI showing knee meniscus.

The meniscus helps in smooth movement of the knee, which includes flexion and extension, gliding as well as rotation. They act as shock absorbers and helps in spread of the forces of the joint over a wider surface area and hence decreasing the pressure and preventing damage to the articular surface.

These menisci are attached from the outer side to the joint capsule from where they also received their blood supply and the nutrition.

There is no blood supply to the meniscus from inside the joint. Hence, the blood supply of the meniscus is richest to the outer most part of the meniscus and decreases gradually as it goes towards the inside of the joint so much so that there is almost no blood supply to the inner most part of the meniscus.

This peculiar characteristic is important in understanding the pathology and their management. Medial meniscus is the commonest meniscus of the two to be torn. Medial Meniscus is less mobile because it is attached firmly to the inside of the joint capsule and the deep part of the medial collateral ligament.


The meniscus as every other part of the body also ages as we grow older, the process being called degeneration. The process of degeneration may be accelerated due to knee injuries which may or may not be recalled for; in the form of one specific trauma or multiple micro injuries.

Contact sports may be a factor in early degeneration of the meniscus and of the joint. Meniscus are usually injured due to twisting force over the knee in which the meniscus is caught between the two articulating surfaces and gets ripped to form a tear. Meniscus is more prone to a tear if it is degenerative.

A meniscus injury can occur in isolation or may be a part of multiple injuries to the knee, which may include ligamentous injury especially the anterior cruciate ligament, medial collateral ligament or injury to the cartilage of the knee. Occasionally, meniscal tear may be found with stress fracture or bone marrow lesion or bone marrow edema of the adjacent bone.

Meniscal tear in young population is mostly caused due to sporting activity or an accident. Meniscal tear in elderly population can be caused due to microtrauma or injury, which may or may not be recalled. There are multiple types of meniscus tear like horizontal, vertical, radial, bucket handle and complex.

The bucket handle tear is usually found in younger population. The meniscal tear usually involves one of the two menisci, the most common being medial meniscus.

Presentation of a meniscal tear

A meniscal tear may present with a sudden onset of pain and swelling after an injury or fall. The swelling usually occurs over a period of few hours or may be overnight.

An audible click or pop may be heard at the time of injury. It may also present with feeling of giving way or an episode of locking in which the knee is stuck in a specific position and may or may not get free by maneuvering it out of it. The patient may also have limp due to pain and may need the help of cane or crutches to ambulate.

In patients with degenerative meniscus, the presentation may be subtle, in the form of pain and recurrent effusions or swelling of the knee, which may subside over time only to recur. These patients usually have a point tenderness to touch in the area of the tear.

The physical examination done by the physician may be suggestive of a tear. The physician also examines for other injuries of the knee including the ligamentous injury. X-rays of the knee on the first line of investigation and they are done to rule out any fractures or subluxations of the knee. MRI is confirmatory investigation and the investigation of choice to confirm a meniscal tear.

The MRI also helps to know the configuration of the tear, which in turn helps in planning of the treatment.

Treatment of a meniscal tear in presence of arthritis

Meniscal tear under degenerative setting can be initially treated conservatively with the use of antiinflammatory medications, elevation, icing, compression, use of physical therapy with or without the use of cortisone shot.

These all help in decreasing the inflammation and the swelling of the knee and helping in returning the function of the knee to normal. If the patient does not have relief from all these conservative measures or there is recurrence of the symptoms, then an MRI can be done to confirm diagnosis and a surgical treatment in the form of arthroscopic management of the meniscus can be done.

Treatment of meniscal tear in the younger population

Younger population usually presents with acute presentation of the meniscal tear. An MRI is usually performed in these patients to confirm the diagnosis as well as rule out other injuries to the knee. It is always advisable to keep the native meniscus in place especially in younger population because meniscectomy has been shown to enhance or accelerate the osteoarthritic changes in the knee in the future.

If the meniscal tear is repairable, it should be repaired with the use of sutures on the meniscus.  This was usually performed arthroscopically and should be done as soon as possible to improve the chance of healing and full recovery. If the meniscus is non-repairable then a partial meniscectomy has to be performed to debride the meniscus and remove the loose flaps which are contributory to the pain, catching sensation and swelling in the knee.

Surgical treatment

Patients are usually called on the day of surgery and operated arthroscopically. Post surgery, patients are discharged to home in a couple of hours with prescription for pain medications, along with brace and crutches if needed. Patients who undergo meniscal repair are usually given a femoral block, which will make their leg weak for about 24 hours.

They are also provided with the ice pack to control their pain and swelling. All patients are encouraged to use ice, elevation for one week after the surgery or more if the pain and swelling persist. Patients can take off their dressing in 72 hours and shower keeping the dressing dry.

Post-meniscal surgery rehabilitation

The patients are usually seen one week after the surgery. Patients who have undergone meniscectomy do not need the use of brace and are put in physical therapy to improve their movements, range of motion as well as strength in their muscles. It may take 3 to 6 weeks to recover from the surgery.

These patients usually do not have any limitation with regards to their movement and can perform activities of daily living within the limits of toleration of pain.

They are usually allowed advance activities by 6 to 10 weeks after surgery. The patients who undergo meniscal repair do need to be in a knee brace. They are usually allowed to bear partial weight on the operated extremity with the brace locked in extension and the help of axillary crutches for ambulation.

They are seen one week after the surgery and physical therapy is initiated. They are allowed to move their knee through range of motion without weightbearing. They are encouraged to strengthen their muscles as well as improve their range of motion.

Range of motion and weightbearing is usually allowed at 6 to 8 weeks post surgery when the brace has gradually weaned off. The patients are not allowed to participate in contact sports for about 3 to 4 months after the surgery.


  • Infection
  • Bleeding
  • Nerve or vessel Injury
  • Failure of repair to heal
  • Hemarthrosis

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Based on 116 reviews
I had an extremely friendly and personalized medical consult with Dr Karkare. Dr Karkare was very knowledgeable and very professional. His communication skills was extremely good and explained my medical condition in very simple words. The office visit was very helpful in understanding my medical condition. Thank you Dr Karkare
Padmanabhan Nagaraj
20:49 25 Sep 23
Dr. Karlkare and his staff were excellent. Dr. Karkare explained everything clearly and took his time getting to know my Dad.
Anna Acker
22:46 07 Sep 23
Dr Vedant Vaksha had done emergency surgery in 2020 after a traumatic injury.His office at Complete Orthopedics handled the continued care thereafter.Dr V and his staff had been Professional and friendly throughout the process, taking the time to explain all the questions on how to proceed and what to expect.Whenever I needed to speak with Dr V or the office they were a phone call away, without waiting or calling several numbers like in so many other medical offices.The office was accommodating to scheduling to my needs at all times. Dr Vedant Vaksha earned the following5 out of 5 stars, highly recommended.
John Kuey
20:58 05 Sep 23
Dr. Vaksha helped me recover from an injury. I am very thankful that he took the time to explain the best treatment for my injury. Also thankful for the wonderful office staff!
Joseph Castelli
22:30 02 Aug 23
The office is wonderful!… Dr Paresh was very helpful and attentive and made my sister in laws recovery so much better.. Thank you for everything
Jazz Lorenzo
17:48 14 Jul 23
The ladies are very welcoming, the service is great, the doctor is very professional and caring and the building is super clean. I really like to come here, the atmosphere is very friendly... Come and you will love it too.
Joan Carasco
14:41 30 Jun 23
Dr. Nakul Karkare is awesome! And patriotic! Thank you, Dr. Karkare for displaying the American Flag in your waiting room, honoring and mourning our military personnel, this Memorial Day, who died while serving in the United States Armed Forces.
00:52 30 May 23
Excellent and skilled orthopedic practice specializing in joint replacements. Dr Karkare was trained at the Hospital for Special Surgery and has excellent results, as do his associates!! Would gladly refer family members to the practice!!
00:24 30 May 23
I had such a wonderful experience with Complete Orthopedics in Stony Brook. Not only did Dr. Kuo fix my broken wrist with such kindness and care, but the office staff, including Billing, Reception and the X-Ray Technician, was always so helpful, going out of their way to ensure that each patient felt welcome, answering any questions with a smile, and ensuring any issues with insurance/billing were handled with the utmost professionalism. I highly recommend their practice!
Victoria DeMatteo
19:49 10 May 23
I'm very happy St. Catherine's sent me to this office for treatment after I broke my collar bone! Unfortunately the break was too severe to repair on its own and I had to have it rebuilt a week after the injury. Dr. Vaksha did a great job fixing it. I'm three months out, and I have full use of the arm and shoulder. The whole office staff is very professional, accommodating, and welcoming. I hope to not need orthopedic services again, but Dr. Vaksha will be my number one choice if I or anyone in family suffers such am injury.
Tina Rivera
20:42 08 May 23
No one likes going to the doctor. But these people make it painless. I go for knees, hips and shoulders. At almost 70 Complete Orthopedics keeps my active life style running smoothly. Whether chasing my Grandson and even surfing again, I highly recommend them!!
Thomas Slavin
15:02 02 Mar 23
Dr. Kuo knowledgeable and competent surgeon- very good experience and more importantly great result.
Joseph McCoy
21:23 25 Feb 23
Dr Vaksha was so kind and helpful. He took extra time with us and explained things so thoroughly. Highly recommend. Office very clean.
Susan Bosinius
20:20 19 Feb 23
Dr Vaksha, is a great doctor very professional knows what he talking about. Treat patient with upmost respect. Thank You
Troy Spencer
16:46 19 Jan 23
Dr. Karkare is an amazing doctor, very caring and attentive, the girl at the front desk is very kind and helpful. .elizabeth .thank you so much .
blanca ventura
21:32 26 Oct 22
Been going to this place before my accident and after I had my knee surgery. So happy how I been treated and how well I am getting. Thank you all and specially Dr. VAKSHA for everything and getting back on track.
Ita Opico
19:01 25 Oct 22
Love this place From the minute I called I was treated kindly. When I arrived The Dr saw me right away he was compassionate and ordered the appropriate tests for me. I came back in for my follow up and had the same great experience.
Christine Rostock
21:28 23 May 22
Dr Vaksha and Dr karkare are 2 of the best orthopedic doctors around my wife Susan had a very serious broken ankle in March of 2019 she didn't think she was going to walk again Dr vaksha did an excellent surgery on her ankle he said it was his toughest he ever did he put a lot of hardware in her ankle and told her she would be alright she made remarkable recovery thanks to his surgery as of now she regained 100 percent use of her ankle she would highly recommend him to anyone. My own experience with Dr karkare has been wonderful he takes his time with you listens to what you have to say and prescribes various treatments and is very caring I would highly recommend him to anyone I would give both doctors a 10 plus rating we are very happy with them the best.
Harry Jones
23:31 19 May 22
Complete orthopedics is a wonderful place to go when you hurt or injured a great staff and wonderful doctors very knowledgeable and helpful I would recommend this place to all of my family and friends that is in me of orthopedic care I give them 10 thumbs up
Wayne Pemberton
17:39 18 May 22
The staff is very professional and helpful. Dr. Vaksha is excellent. He takes time to listen and offer suggestions to help you get better. I’m very thankful and happy to be a patient here at Complete Orthopedics.
Phoenix Rising
19:54 16 May 22
Dr.Karkare is the best. He listens to everything and explains everything I recommend him to everyone. I am so happy he is my doctor.
Myrna James
00:48 13 May 22
Dr.Kuo is amazing very attentive,caring,and passionate and staff is awsome too.Thank you for everything Dr.kuo.
Erick Murillo
23:17 12 May 22
I was in a car accident November 1 I was referred to Dr. Vaksha For shoulder surgery . I he was amazing he made me feel very comfortable and explained everything that was going to happen from surgery all the way through my physical therapy highly recommend Dr. Vaksha
Yolanda Ojeda
19:37 09 May 22
My appointment with Dr. Vaksha was amazing. Dr. Vaksha was very thorough and kind. I would refer this office to anyone who needs a great orthopedic doctor.
John Senechal
19:54 05 May 22
Scheduling my appointment was quick and easy. The staff was super friendly and down to earth. I was seen on time. The appropriate test, “x-rays” were taken before the conversation with doctor, something I really liked, test for analysis and conversation was done upfront. Dr. V had a great personality and was no BS, straight forward diagnosis and a play on next steps. I am happy I found them and would refer them to friends and family.
00:46 03 May 22
I have seen Dr. Kuo two times already and he's awesome along with his staff. Very friendly office and I'm glad to be a patient here.
Camaris A
20:01 28 Apr 22
Amazing team!! Very caring, profesional, and friendly!! Dr. Kevin Kuo, you are the best, very passionate, caring, and helping thank you for getting me better and being so kind to me! Elizabeth you the best thank you for you help always and you big smile and positive actitud❤️🙏🏼
breidy valerio
19:01 22 Apr 22
The staff is truly exceptional, they make you feel comfortable and welcomed. The doctors are amazing,always professional, compassionate and great listeners.
Elizabeth Collado
03:25 09 Apr 22
What a great place! The place is clean and organized.The staff is wonderful. Setting up physical therapy is right there as well.I'm so glad I found this place.
Donna Anne
22:45 05 Apr 22
This was my 1st time breaking something in my 27 years on this planet. I was recommended here by a friend Dr. Vashka helped me from day 1 and still continues to check in on me and my healing ankle. Would highly recommend
tyron davis
16:06 01 Apr 22
Brand new office, same great doctors! Rooms are clean, plenty of parking, physical therapy attached, Dr. Karkare and his staff are awesome. Thank you!
Emily B
02:49 24 Mar 22
Dr.VAksha is the best, I love the way he treats me as his patient, he is caring,understanding and very attentive to my needs
Mirna Caballero
14:53 03 Mar 22
Great staff. Dr. Vaksha is awesome and takes the time to listen to his patients. He is very compassionate. I would highly recommend this office.
Bebe Doyle
01:24 23 Feb 22
After suffering from a severe ankle injury Dr. V was able to help me heal and return back to work completely to a job where I stand for 12 hours a day. The office is very clean and I appreciated the reminders of my appointments via phone call and through text. The patient portal made it easy for me to access all my documents including work notes. The office staff is wonderful and Rebecca was able to schedule me with a busy schedule and awesome at answering all of my questions including referring me to a great physical therapy office. I highly recommend this office to anyone who’s looking for knowledgeable and kind orthopedic office.
Elizabeth Birchwell
21:31 28 Jan 21
The staff here are great, I was seen at the time of my appointment and was well taken care of!
Shaun Berry
18:14 07 Jan 21
They are an excellent practice. The front and back office people are amazing and so helpful. Rebecca is such a kind and understanding person. I had an issue with paperwork and she cleared it right up. Dr. Karkare is very knowledgeable, helpful, and caring.
Matt S.
19:31 18 Nov 20
Rebecca K. - What a true burst of sunshine. Very friendly and definitely an asset to the practice!
Laura Aston
18:17 17 Nov 20
Great experience, the Doctor is nice but the staff is incredible. I worked with Linda, who was profession and assisted me beyond what any person has done at other practices. Complete Ortho should be complimented for having such a person on their staff.I highly recommend this place!!!
Joe Allen
17:26 17 Nov 20
Linda and Becca they are so good ever time I come they are very nice I would tell everyone I no to come to this office..
Barbara Victor
16:45 17 Nov 20
I was rear ended in an auto accident , Dr Vashka was recommended by a friend of mine .I was experiencing Back , neck , and shoulder pain . After a thorough examination and given exercises to do at home , I am feeling much better , and I ended up avoiding surgery . The staff at Complete Ortho is extremely attentive and show great care when making an appointment and are very friendly and i never waited more than 5 minutes for my appointment . So I would strongly recommend Complete Orthopedics for any aches and pains that one might be experiencing.....
Bill Becht
04:44 17 Nov 20
It was the afternoon of Friday Sept. 24. We were in Pt. Jefferson and my wife, Mary Ann, broke her hip. We went to Mather Hospital and it was determined that she would have to have an operation to have it repaired. This would be her third time under the knife in the past year. It just so happened that we were very fortunate enough to have Dr. Karkare, who was on standby, perform the surgery. He put in a rod and two screws in her hip. She spent a few days in the hospital and then went to Gurwin rehabilitee for another few weeks.It has now been almost six weeks and we both worked the election the other day. If it wasn’t for Dr. Karkare’s expertise she never would have been able to work. She is able to walk with a walker and is doing physical therapy three times a week.We can not thank the doctor enough for the compassion and dedication that he puts into his work. It allows Mary Ann do the things that she likes to do, even on a limited basis for a while. I know that with her will, perseverance and the great work that the surgeon performed she will be back on her feet in no time.Sincerely:John V. PlumpEast Northport, NY 11731
Jack Harris
14:36 06 Nov 20
In the year of 2018 I was referred to Dr. Karkare because I was experiencing severe knee joint pain. After exhausting physical therapy and trying to labor through the pain, I had to make a quality of life decision. Total knee replacement was the only viable option. Dr. Karkare made my decision easy as he walked me through the whole process from surgery to recovery.On 12/13/19 ( Friday the 13th) I enter Lenox Hill Hospital in great hands. From the time I entered Dr. Karkare’s office for the first time until now, his staff has been amazing. Andrea the medical coordinator walked me through all the paper work and necessary preparations for the surgery. Courtesy and kind would be an understatement. Dr. Karkare went over and beyond from the wellness checks and phone calls all to assure me that I was important to him. This was the right decision no pain and no limp. Complete Orthopedics should be your choice!
Kenneth Randolph
22:18 25 Sep 20
Dr. Vadshka has a great bedside manner. He really takes his time and explains treatment options.
T Lee
12:33 09 Sep 20
I suffered with pain in both knees for years. My orthopedic doctor kept recommending knee replacement . I fought it for years, as I was just afraid. When I had no choice and could barely walk , it was recommended I see Dr. Karkare. We set up a consultation and my wife and I left his office feeling totally confident and comfortable with moving ahead with the surgery. He explained everything to us, and the office staff set everything up for us and made the process easy. So about one month after our initial meeting I had the first knee done. I was up walking mere hours after the surgery, and on the workout machines the next morning. I went home two days after the surgery, and yes walked my daughter down the aisle at her wedding only one week after the surgery without even a cane! Three months later I had the other knee done and went home the very next day. Dr. Karkare put my fears to rest . I would highly recommend him. His expertise gave me my life back. Thank you Dr. Karkare.SincerelyVito Congro
Ethel Congo
23:58 12 Aug 20
Dr Rhodin really cares for his patients. When I see him he makes sure to review my progress in detail.
Micki Cahill
15:03 08 Feb 20
My mom had a total hip replacement by dr karkare. He is the BEST orthopedic doctor.Her incision is almost invisable.She is going back for her other hip next week. The office staff is the best, love Andrea.You wont find a better doctor.
21:06 13 Jul 18
There is no better Orthopedic doctor you will find. Broke my ankle three places on a Saturday. Called Dr. Karkare. He had is team ready at the hospital and operated on me within 6 hours after my injury. Now After 3 months of great care by him and his staff, I am walking to normalcy.
Spacecom Tel
04:13 23 Mar 18

I am Vedant Vaksha, Fellowship trained Spine, Sports and Arthroscopic Surgeon at Complete Orthopedics. I take care of patients with ailments of the neck, back, shoulder, knee, elbow and ankle. I personally approve this content and have written most of it myself.

Please take a look at my profile page and don't hesitate to come in and talk.