What is a horizontal meniscus tear? 

Описание: HORIZONTAL CLEAVAGE TEARS OF THE MENISCUS—WHAT YOU NEED TO KNOW


Meniscus tears come in all shapes and sizes—but the horizontal cleavage tear is one of the most misunderstood. Let’s break it down.

Dr. P’s 3 Secrets – Horizontal Cleavage Tears of the Meniscus

1. A Horizontal Tear Splits the Meniscus Like a Sandwich

Instead of tearing vertically or radially, a horizontal cleavage tear separates the top and bottom layers of the meniscus—like pulling apart the layers of a pita. This kind of tear often starts from degeneration and can create a “flap” that causes pain, swelling, and mechanical symptoms like clicking or catching. Sometimes even a cyst will develop.

2. They’re Often Hidden—and Often Missed

These tears can be tough to see on imaging unless you’re looking closely. MRI can miss them if the radiologist or surgeon isn’t experienced in spotting subtle splits in the meniscus layers. That’s why listening to your symptoms, taking a good history and doing a careful physical exam is just as important as the imaging.

3. Not All Need Surgery—and Some Are Ideal for Biologic Repair

If the tear creates an unstable flap or causes locking, surgery most likely is necessary. But here’s the exciting part: horizontal cleavage tears that haven’t yet reached the surface—meaning they’re still contained between the layers—are often the best tears to treat with biologic injections like bone marrow aspirate cells and PRP. These biologics can flow between the split layers and potentially stimulate healing. Since these contained tears can be invisible even during arthroscopy, they are the last tears you want operated on—and the first tears we aim to repair without surgery.

Want to find out if your horizontal meniscus tear can avoid surgery?


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Medical Disclaimer: This post is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider for personalized diagnosis and treatment.