Meniscus Root Tears

The meniscus is a C-shaped cartilage structure that functions as a shock absorber in the knee. The “root” refers to the attachment point where the meniscus anchors to the bone. A root tear disrupts this attachment, rendering the meniscus functionally ineffective — similar to having no meniscus at all.

This loss of function dramatically increases joint contact pressures and accelerates cartilage wear.

Meniscus root tears can present subtly and are often mistaken for arthritis or a simple strain. Common symptoms include:

• Deep knee pain, especially with weight-bearing
• Pain with squatting, kneeling, or rising from a seated position
• Swelling after activity
• A feeling of instability or “giving way”
• Mechanical symptoms such as clicking or catching (less common)

These tears are frequently seen in middle-aged and older adults, sometimes occurring with minimal trauma.

Unlike peripheral meniscus tears, root tears significantly alter knee biomechanics. Studies show that untreated root tears can lead to:

• Rapid cartilage loss
• Early onset osteoarthritis
• Progression to knee replacement within a few years

Because of these consequences, root tears require a more thoughtful and proactive treatment strategy.

Non-Surgical Management

In select patients with advanced arthritis or low functional demands, non-operative treatment may be considered. This includes activity modification, physical therapy, and injections. However, this approach does not restore meniscus function.

Surgical Repair

For appropriate candidates, meniscus root repair aims to restore the meniscus’s native biomechanics and protect the joint surface. When performed early and in the right patient, repair can:

• Reduce pain
• Slow or prevent arthritis progression
• Preserve long-term knee function

Patient selection is critical, and factors such as cartilage health, alignment, and body weight play a role in outcomes. Furthermore, now with the addition of Cartiheal Agili-C, we are able to treat and reverse some of the arthritic changes on the cartilage concurrently with the meniscus root repair.

Meniscus root tears highlight the importance of early evaluation by a knee specialist familiar with joint preservation techniques. Delaying treatment can result in irreversible cartilage damage.

Meniscus root tears are increasingly recognized as a unique and serious knee injury, yet many patients across Chicago and the surrounding suburbs remain unfamiliar with their long-term consequences. Unlike more common meniscus tears, root tears can dramatically alter knee biomechanics and accelerate joint degeneration if not properly treated.

As a board-certified orthopaedic surgeon specializing in sports medicine and joint preservation, I frequently evaluate patients from Chicago and surrounding suburbs as well as Northwest Indiana who present with knee pain that has been misattributed to arthritis or simple wear-and-tear. Early recognition and appropriate treatment of meniscus root tears can be critical in preserving long-term knee health.