Meniscal Tears

• What causes meniscal tears?

  Any child can get a meniscal tear. A tear usually happens when an active child or teenager suddenly twists their knee. Sometimes this occurs while children are playing sports that require a lot of pivoting and sudden starts and stops. Meniscal tears often happen at the same time as injuries to the anterior cruciate ligament (ACL).

At Seattle Children’s, we specialize in treating injuries to the bones and joints of children and teenagers who are still growing.

• The experts you need are here

  • Your child is cared for by an orthopedics team, including pediatricians, pediatric orthopedic surgeons, nurse practitioners, physician assistants, nurses and physical therapists.
  • To restore your child’s health and function, we often use nonsurgical methods, like physical therapy (PT), including sports PT. We have the largest team of physical therapists in the Pacific Northwest who specialize in the care of babies, children, teens and young adults.
  • If your child needs surgery, we have pediatric orthopedic surgeons with expanded fellowship training in sports medicine and the experience to treat meniscal tears in children and teens.

• Care from birth through young adulthood

  • A child’s knee injury is more difficult to treat than an adult’s. This is because doctors must avoid injury to the growth plates on children’s bones above and below the knee. Here, your child’s team has special training in the medical and surgical needs of young people.
  • To decrease the risk of early arthritis, we strive to save and repair the torn meniscus whenever possible.
  • We have the largest group of board-certified pediatric radiologists in the Northwest. If your child needs imaging that uses radiation, we use the lowest amount possible (PDF) to produce the best image.

• Our approach to surgery improves quality of life

  • We offer several surgical options for repairing a torn meniscus or, if needed, trimming away small torn pieces. We are careful to choose the option that best matches your child’s condition.
  • Our surgical methods limit the risks of injury to growth plates. This increases the chances that your child will be able to return to sports.
  • Seattle Children’s surgeons are experienced in minimally invasive surgery of the knee for children and teens.

• Support for the best recovery

  • Our rehabilitation programs are designed so that your child will recover range of motion, rebuild strength and stability, restore balance and regain confidence in using their knee.
  • To help your child return to play quickly and safely, we do more than treat their current injury. We focus on preventing repeat or new injuries.
  • For your convenience, our doctors see patients at several locations around Washington. Seattle Children’s sports physical therapy is available in Seattle, Bellevue, Everett and Federal Way to make ongoing rehab easier for you.

Your child may notice:

• A popping sound or feeling at the time of the injury
• Pain in the knee joint
• Pain that gets worse when you push gently on the knee
• Knee joint locks up
• Clicking sounds in the knee

Diagnosing Meniscal Tears

At our clinic, our doctors ask about any pain your child is having. We then examine your child’s knee. The doctor gently applies pressure and moves your child’s foot and leg to check for the discomfort and clicking sounds that signal a meniscal tear. We will also check for swelling in your child’s knee.

• Imaging tests your child may need

  If we suspect a tear, we may take X-rays. We may ask your child to have an MRI (magnetic resonance imaging) scan so we can get a better look at the soft tissue in the knee.

  In some cases, we may also insert a viewing instrument (arthroscope) that is the width of a pencil into your child’s knee to get a look at the damage on a large monitor that is like a television screen.

Sometimes small meniscal tears heal on their own with rest. But repairing the meniscus with surgery is often the best treatment.

Seattle Children’s pediatric orthopedic surgeons have the training and experience to repair meniscal tears in children and teens.

• Surgery for meniscal tears

  Surgery is the quickest way to get your child back to regular activities, including sports. It lessens the chances that your child will develop arthritis in the future.

  We usually use a minimally invasive procedure called arthroscopy to repair meniscal tears.

  The doctor inserts a tool called an arthroscope that’s about the width of a pencil into your child’s knee. The doctor then uses pictures displayed on a large monitor like a television screen to guide their actions.

  The doctor will make a series of small cuts (incisions) around your child’s knee. The incisions will be just big enough to accept the tools the doctor uses.

  Depending on your child’s injury, the doctor may:

  • Sew the meniscus together.
  • Use tiny hooks to attach the torn pieces to one another.
  • Pinch the pieces together using a special kind of suture.

  If the torn pieces are not big enough to stitch together, the doctor may trim the meniscus using tiny scissors, shavers or clippers.

  Then the doctor will stitch up the incisions. Often, we use thread that can be absorbed by the body so that you do not have to bring your child to the clinic to have stitches removed.

  Learn more about arthroscopic surgery (PDF).

• Physical therapy after surgery

  After surgery, our rehabilitation specialists will help your child set up a regular program of physical therapy. Our PT programs, including sports PT, are designed to help your child:

  • Recover range of motion.
  • Rebuild strength and stability.
  • Restore balance.
  • Regain confidence in using their knee.

  We offer rehabilitation services in our dedicated sports gym.