Types of Meniscal Tears
There are many different types of meniscal tears. Broadly, tears can be described as partial thickness, meaning they only affect one side, or full thickness, meaning the tear goes all the way through the meniscus. Tears can be further described based on their appearance. Common types of traumatic tears include bucket handle tears, flap tears, and radial tears
- There are many different types of meniscal tears. Broadly, tears can be described as partial thickness, meaning they only affect one side, or full thickness, meaning the tear goes all the way through the meniscus. Tears can be further described based on their appearance. Common types of traumatic tears include bucket handle tears, flap tears, and radial tears
- Longitudinal tears can frequently be surgically repaired if they occur in an area of the meniscus that has good blood supply to facilitate healing after the repair.
- Radial tears are the most common type of tear. These tears occur in an area of the meniscus where there is no blood supply, which limits the capacity for healing. For that reason, surgery is usually required.
- Bucket handle tears are large, painful tears that cause significant swelling. They are called bucket handle tears because the long strip of torn tissue is separated from the rest of the meniscus and resembles the handle of a bucket. They are most commonly seen in young athletes, under age 35.
- Flap tears are less common. When they cause symptoms, surgery can be performed to remove the flap.
- Root tears (not pictured) occur near where the meniscus attaches to the underlying bone. Approximately 10-20% of meniscus tears are root tears. Root tears are can accelerate cartilage damage and can lead to early osteoarthritis.
Zones of Vascularity
- The location of the tear has a significant impact on the ability of the tear to heal and the corresponding treatment.
- The meniscus has three zones of vascularity. The Red zone is the outer perimeter and has an adequate blood supply to facilitate healing.
- The Red-White zone is the transitional area in the middle with an intermediate blood supply and capacity for healing.
- The White zone is the innermost part with no blood supply and no ability to heal.
- Tears in the white zone are generally treated by removal of the meniscus, also called a meniscectomy.
- Tears in the red zone have a good blood supply which provides the necessary biological substances for healing following surgical repair.
- Tears in the red-white zone need to be assessed to determine whether surgical repair is required for healing.
