Meniscus lesions in children and adolescents

Meniscus injuries in children and teenagers occur more often than you'd think, especially in those who play contact sports or follow an intense training schedule. Knee pain after a pivoting movement, joint swelling, or being unable to fully straighten the leg should not be ignored. A proper evaluation, done in time, helps establish a treatment plan that is safe and suited to the child's age.

Below, we explain what a meniscus injury in a child means, how to recognize it, what investigations are needed, and what treatment options exist. The information is useful both for parents and for teenage athletes or active adults who want to better understand these common knee problems.

What is the meniscus and why does it matter?

The meniscus is a crescent-shaped fibrocartilaginous structure, located between the femur and the tibia. Each knee has two menisci: medial (inner) and lateral (outer). They contribute to the joint's proper function.

The meniscus:

• distributes pressure between the bones and protects the articular cartilage;
• stabilizes the knee during running and jumping;
• improves movement control (proprioception);
• reduces shocks transmitted to the bone.

Compared to an adult, a child has better blood supply to the meniscus, which means better chances of healing after a suture. After about 10 years of age, the structure starts to resemble that of an adult. In addition, the presence of growth plates calls for caution when choosing treatment.

Preserving the meniscus is a priority. Removing too much meniscal tissue increases the risk of joint wear in the following years.

How do meniscus injuries occur in children and teenagers?

The most common injuries occur during sports. The typical mechanism involves a rotational movement of the slightly bent knee, while the foot stays fixed on the ground. For example, a teenager who suddenly changes direction while playing soccer may feel a pop followed by pain.

Other causes include:

• direct impact to the knee;
• sudden hyperflexion;
• overload from repeated training;
• association with an anterior cruciate ligament tear.

The risk factors are well known:

• sports such as soccer, handball, basketball, skiing;
• increasing training volume without adequate rest;
• ligament instability;
• excess weight.

In most cases, there is a clear traumatic episode. However, some children complain of progressive pain, without a precise moment of injury. Repeated microtrauma can produce meniscal tears over time.

Types of meniscus tears

Tears are classified by shape and location. Understanding the type of injury helps choose the right treatment.

Morphological classification

Meniscus tears can be:

• longitudinal;
• radial;
• horizontal;
• oblique or complex;
• "bucket handle" type (a displaced fragment that can lock the joint).

Classification by blood supply

In children, a discoid meniscus (an abnormal rounded shape) appears mostly on the lateral side and tears more easily. Identifying this anatomical variant influences the surgical plan.

Symptoms of a meniscus tear

Symptoms vary depending on the size and location of the tear. The most common signs are:

• pain on the inner or outer side of the knee;
• swelling appearing a few hours after the injury;
• a locking sensation when straightening the leg;
• clicking or a catching sensation;
• instability.

A child may keep playing despite the pain. If the knee stays swollen for several days, or if repeated locking episodes occur, seek a pediatric orthopedic evaluation.

How does the doctor establish the diagnosis?

A correct diagnosis brings clear benefits: the right treatment, avoiding complications, and reducing the time off activity.

Clinical examination

The orthopedic doctor:

• palpates the joint line to identify painful points;
• performs specific tests (McMurray, Apley);
• checks ligament stability;
• evaluates mobility.

Imaging investigations

An X-ray rules out fractures or bone injuries, but does not show the meniscus. A knee MRI confirms the tear, establishes its type, and identifies any associated injuries. For good results, the doctor correlates the images with the clinical examination.

Even if the pain decreases, don't assume the injury has healed. Schedule a complete evaluation at a specialized center, such as Centrokinetic, where the team has experience in pediatric sports pathology.

Treatment of meniscus injuries in children and teenagers

The treatment plan depends on:

• age;
• the type of tear;
• the presence of locking;
• the level of sports activity.

The approach must be personalized. There is no single solution for all patients.

Conservative treatment

The doctor recommends it in carefully selected cases:

• small, stable tears;
• no joint locking;
• located in the vascularized zone.

The protocol can include:

• temporary rest from sports;
• a brace to limit flexion;
• a personalized physical therapy program;
• periodic check-ups.

Physical therapy aims to reduce inflammation, restore mobility, and strengthen the thigh muscles. Monitoring is mandatory. If symptoms persist, the doctor reassesses the surgical indication.

Arthroscopic surgical treatment

In many situations, a symptomatic tear requires arthroscopic surgery. The procedure is performed through small incisions, with the help of a video camera.

The main options are:

• meniscal suture — the doctor repairs the tear and preserves the tissue;
• partial meniscectomy — removes only the unstable fragment.

In children, suturing is the first option, if the anatomy allows it. Preserving the meniscus reduces the risk of joint degeneration.

Any surgery carries general risks: infection, joint stiffness, suture failure. That is why the procedure must be performed by a team experienced in knee arthroscopy.

Recovery after surgery

Proper recovery directly influences the long-term outcome. Follow the medical instructions and avoid returning to sport too early.

General stages

• controlling pain and inflammation;
• progressively increasing mobility;
• strengthening the muscles;
• balance and coordination exercises;
• functional testing before returning to sport.

Duration varies:

• 4-6 weeks after partial meniscectomy;
• 3-6 months after meniscal suture.

The program must be adapted to the child's age and growth stage. The doctor and the physical therapist set clear goals and periodically reassess progress. If persistent pain, fever, or significant swelling occur, seek a medical check-up immediately.

What happens if the injury is not treated correctly?

An ignored tear can lead to:

• repeated locking episodes;
• cartilage damage;
• chronic instability;
• limiting sports activity.

Early intervention reduces these risks. A proper evaluation provides an accurate diagnosis and a treatment plan tailored to your child.

The importance of a specialized team

Meniscus injuries in children require collaboration between the orthopedic doctor, the radiologist, and the physical therapist. The medical team's experience influences the treatment decision and the recovery process.

At a center dedicated to musculoskeletal conditions, such as Centrokinetic, you benefit from:

• a detailed clinical evaluation;
• access to modern investigations;
• a personalized approach;
• medium- and long-term monitoring.

Book an appointment now for a specialist consultation!

Frequently asked questions about meniscus injuries in children and teenagers

Can a meniscus tear heal on its own?

Small tears, located in the vascularized zone, can heal in certain cases with conservative treatment and careful monitoring. Most symptomatic tears require an orthopedic evaluation and, sometimes, surgery.

Is surgery mandatory?

Not always. The doctor recommends surgery if there is joint locking, persistent pain, or an unstable tear. The decision is based on the clinical examination and the MRI.

When can the child return to sport?

Return depends on the type of procedure and the progress of recovery. After a meniscal suture, resuming sport happens only after functional testing and medical approval.

Does the surgery affect the child's growth?

A properly performed arthroscopy does not affect the growth plates. The techniques used in pediatric orthopedics protect the structures that are still developing.

What signs require an urgent consultation?

Knee locking, persistent swelling, significant pain, or the inability to bear weight require a prompt specialist evaluation.

Disclaimer: This material is intended for informational purposes only and does not replace a specialist medical consultation. The diagnosis, treatment indication, need for surgery, and recovery program must be established individually by the orthopedic doctor, based on the child's age, the type of injury, and any associated conditions.

Sources

• Pediatric Orthopaedic Society of North America. "Meniscus Tears." POSNA Study Guide, https://posna.org/physician-education/study-guide/meniscus-tears. Accessed Aug. 7, 2026.
• Liechti, Daniel J., et al. "Meniscal Repair in Pediatric Populations: A Systematic Review of Outcomes." Orthopaedic Journal of Sports Medicine, vol. 7, no. 5, 2019, https://pmc.ncbi.nlm.nih.gov/articles/PMC6537073/. Accessed Aug. 7, 2026.
• Yang, Brian W., et al. "Outcomes of Meniscus Repair in Children and Adolescents." Current Reviews in Musculoskeletal Medicine, vol. 12, 2019, pp. 233-238, https://pmc.ncbi.nlm.nih.gov/articles/PMC6542894/. Accessed Aug. 7, 2026.