Meniscal root tear

Written by Dr Sheila Strover on March 14, 2025

A meniscal root tear is a tear of the knee meniscus close to the root region where the meniscus is anchored to the underlying bone.

Illustration of surgeon probing the meniscal root at the back of the ky.nee during arthroscop
A probe being used to examine the integrity of the root area.
Illustration of the top of the tibia with the two menisci in place, and red arrow showing a tear at the meniscal root.
Looking down from the top, the illustration shows a radial tear through the body of the posterior horn of the meniscus at the root.

What is the meniscal root?

At the front and the back of the meniscus anchoring fibres extend down into the flattened top of the tibia, fixing these ends but allowing the body of the meniscus to move, so that one can twist without stressing the meniscus.

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How serious is a meniscal root tear?

A meniscal root tear is a serious incident.

The meniscus itself is not initially damaged, but the sudden instability caused by the root issue needs to be addressed urgently or else the excessive mobility of the meniscus will lead to it becoming irreparably damaged.

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Meniscal root tears and knee instability

Meniscus root tears may be acute, where the tear occurs suddenly and is immediately associated with incompetence of the meniscus as a shock absorber.

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Meniscal root tears and arthritis

In older people it may only be recognised when investigation of arthritis symptoms reveal a meniscal extrusion, with the meniscus slipping out over the edge of the tibia bone.

Either situation may end up with the patient developing arthritis, but early recognition of an acute tear may result in referral to a specialist meniscus surgeon, and repair of the tear before arthritis is established.

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Classification of meniscal root tears

Meniscal root tears are classified as Types 1-5 depending on the situation and extent of the tear.

Reference: LaPrade classification system of meniscal root tears

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Rehabilitation

"The patient should remain non-weight-bearing for a minimum of 6 weeks following a transtibial pull-out meniscus root repair. Passive range of motion exercises in a safe zone of 0º to 90º of flexion is initiated postoperative day 1. After 2 weeks, the patient can be advanced in their knee flexion as tolerated. Progressive advancement to full weight-bearing begins at 6 weeks."

Santiago Pache et al

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A-Z Keywords - Meniscal root, Posterolateral corner, Meniscal avulsion, Meniscal root avulsion, Meniscal extrusion, Meniscus

Interpretation of Journal publications -

e-Books

Forum Discussion - "Medial Meniscus - Can it rip in two?" - Patients discuss complete radial tear of the meniscus and compare this with meniscal root tears.

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