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Types of Meniscus Tears

by Princeton Orthopaedic Associates


,

Types of Meniscus Tears

by Princeton Orthopaedic Associates

Meniscus tears are classified based on tear shape and tear location. This classification helps determine whether the injury may heal with rest and therapy or if it needs surgical treatment. If you're looking to understand the type of tear you have, we have broken them down below:


Meniscus Tear Shapes

1. Meniscus Radial Tear

A radial tear cuts straight across the meniscus from the inner edge toward the outer rim, similar to the spoke of a wheel. These are common and usually occur in areas with poor blood flow, which limits the body’s ability to heal the tear on its own. Treatment often involves trimming the damaged section.

2. Meniscus Horizontal Tear

A horizontal tear runs between the upper and lower layers of the meniscus, dividing it in half like a sandwich. These tears are more common in older adults and may be repairable if located in the outer region of the meniscus, where blood supply is better.

3. Meniscus Vertical (Longitudinal) Tear

This tear runs lengthwise along the curve of the meniscus, following its C-shape. It is often seen in younger, athletic individuals and may respond well to surgical repair, especially when located in the outer third of the meniscus.

4. Meniscus Bucket Handle Tear

A bucket handle tear is a severe form of a vertical tear. In this case, a large portion of the meniscus flips inward into the knee joint, making it difficult to bend or straighten the knee. It often causes locking and typically requires surgery to correct.

5. Meniscus Flap Tear

A flap tear results in a loose piece of cartilage that creates an uneven edge. This flap may shift with knee motion, causing clicking, catching, or locking. If symptoms are persistent, the loose section is often trimmed during a minor procedure.

6. Meniscus Complex Tear

A complex tear includes multiple tear patterns—usually both radial and horizontal—and often occurs in worn or degenerated menisci. These are difficult to repair and typically require removal of the damaged sections.

7. Meniscus Oblique (Parrot Beak) Tear

An oblique tear forms at an angle, creating a curved flap that resembles a parrot’s beak. The flap can catch in the joint and lead to sharp pain or instability. Surgical trimming is often used if the tear is unstable.

torn meniscus locations


Meniscus Tear Locations

In addition to the shape of the tear, the location is a major factor in symptoms and treatment decisions. These are the meniscus tear locations:

  • Medial meniscus tear – inside of the knee
  • Lateral meniscus tear – outside of the knee
  • Posterior horn tear – back portion of the meniscus
  • Anterior horn tear – front portion of the meniscus
  • Meniscus root tear – where the meniscus anchors to the bone

Each location has different mechanical demands, and tears in different areas may feel different or affect how the knee moves.

Location and Healing Potential

The meniscus has three zones based on blood supply that affect how well a tear can heal:

  • Red zone (outer third) – good blood supply; better chance of healing on its own or after repair
  • White zone (inner third) – poor blood flow; limited natural healing
  • Red-white zone (middle third) – transitional; healing depends on tear size and stability

Long-Term Effects of Untreated Meniscus Tears

How long does it take a meniscus tear to heal? The answer is, it depends. However, if a torn meniscus is left untreated or heals poorly, it can lead to:

  • Chronic knee instability
  • Frequent swelling and inflammation
  • Faster joint cartilage breakdown
  • Higher risk of developing osteoarthritis

Early diagnosis, combined with the right treatment approach, helps protect long-term knee function and mobility.

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