Ordination Dr. Maximilian Kasparek
MK Orthopädie Währing
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knowledge
22. January 2026

Ski in­jury: Me­nis­cus tear af­ter sport & me­nis­cus refixation

Ski in­jury: What to do for a me­nis­cus tear du­ring a win­ter vacation?

A sud­den, sharp pain in the knee while ski­ing, snow­boar­ding, or cross-coun­try ski­ing may in­di­cate a me­nis­cal tear. The me­nis­cus is par­ti­cu­larly at risk du­ring ro­ta­tio­nal mo­ve­ments or when twis­ting the knee joint on the slopes.

A me­nis­cal tear is one of the most com­mon knee in­ju­ries fol­lo­wing a ski ac­ci­dent – a ty­pi­cal ski­ing in­jury, as the knee joint is ex­po­sed to enorm­ous stress in sports such as ski­ing and snow­boar­ding. The me­nis­cus can tear, espe­ci­ally du­ring ro­ta­ti­ons, jumps, ab­rupt ch­an­ges of di­rec­tion, or falls. The ski boot fi­xes the ankle joint, which me­ans that the forces ac­ting on it are trans­mit­ted to the knee with grea­ter in­ten­sity. This can lead to te­ars in the sen­si­tive me­nis­cus – espe­ci­ally if the knee is also bent du­ring a twis­ting movement.

But what to do if the pain oc­curs in the middle of a win­ter va­ca­tion on the slo­pes? Should you ski down the moun­tain or ra­ther be pi­cked up? Have sur­gery im­me­dia­tely or not? And what hap­pens af­ter the vacation? 

First aid on the slo­pes: Stay calm and re­act cor­rectly to a ski in­jury to the knee me­nis­cus tear

An­yone who suf­fers a me­nis­cal tear while win­ter sports usually no­ti­ces a sharp pain im­me­dia­tely, so­me­ti­mes ac­com­pa­nied by a “snap­ping” or “pin­ching” in the knee. Of­ten there is swel­ling and the knee can no lon­ger be fully ex­ten­ded or loaded.

You should do the following:

 

  • Stop im­me­dia­tely and re­li­eve the knee
  • Do not con­ti­nue if the knee is unsta­ble or very painful
  • Call the slope ser­vice or res­cue ser­vice to avoid un­neces­sary deterioration
  • Cool the knee, ele­vate it and do not put any more weight on it
In the hos­pi­tal: Have a me­nis­cus tear ope­ra­ted on im­me­dia­tely or not?

Af­ter the in­itial tre­at­ment (of­ten in an ac­ci­dent and emer­gency de­part­ment near the ski area), an MRI is usually per­for­med to as­sess the me­nis­cus tear pre­cis­ely. Not every tear needs to be ope­ra­ted on im­me­dia­tely. Con­ser­va­tive tre­at­ment with phy­sio­the­rapy, pain­kil­lers and rest is of­ten sufficient. 

An ope­ra­tion is only ne­ces­sary im­me­dia­tely if:

  • the knee is blo­cked (ex­ten­sion or fle­xion inhibition)
  • there is se­vere instability
  • there are ac­com­pany­ing in­ju­ries (e.g. cru­ciate ligament)

In most ca­ses, the ope­ra­tion can be plan­ned af­ter the vacation.

Back from win­ter va­ca­tion: What hap­pens at home?

Af­ter re­tur­ning home, the knee should con­ti­nue to be res­ted and coo­led. A vi­sit to the or­tho­pe­dist is highly re­com­men­ded in or­der to ob­tain a se­cond opi­nion and plan the next steps. 

The pos­si­ble tre­at­ment op­ti­ons for me­nis­cus tear include:

What is a me­nis­cus refixation

A pos­si­ble sur­gi­cal goal for a me­nis­cal tear is the so-cal­led me­nis­cus re­fix­a­tion – in this pro­ce­dure, the torn me­nis­cus tis­sue is not re­mo­ved, but sewn back to its ori­gi­nal lo­ca­tion. This tech­ni­que is pri­ma­rily used when the tear is fresh and is lo­ca­ted in a well-vas­cu­la­ri­zed area near the cap­su­lar at­tach­ment. Such tear shapes have the best chan­ces of he­al­ing, espe­ci­ally in youn­ger and ath­le­ti­cally ac­tive pa­ti­ents whose tis­sue is still highly regenerative.

When is me­nis­cus re­fix­a­tion useful?

✔ Fresh tear (wi­thin a few weeks)
✔ Tear is close to the cap­sule at­tach­ment (well-sup­plied zone)
✔ Espe­ci­ally for young, ac­tive patients
✔ Goal: Pre­ser­va­tion of na­tu­ral me­nis­cus function

The cen­tral goal of me­nis­cus re­fix­a­tion is to pre­serve the na­tu­ral me­nis­cus – and thus also its im­portant bio­me­cha­ni­cal func­tion: As a shock ab­sor­ber, the me­nis­cus pro­tects the ar­ti­cu­lar car­ti­lage from over­load. In con­trast to par­tial me­niscec­tomy (me­niscec­tomy), in which part of the tis­sue is cut out, the full buf­fer and sta­bi­lity func­tion of the me­nis­cus is lar­gely re­tai­ned du­ring refixation. 

Me­nis­cus refixation Par­tial meniscectomy
Goal Pre­ser­va­tion of the meniscus Re­m­oval of the da­ma­ged part of the tissue
He­al­ing chance High for fresh te­ars in a well-sup­plied area Ra­pid pain re­duc­tion, but less long-term protection
Af­ter­care Slightly lon­ger re­hab required Shorter re­hab, but more stress on the joint
Long-term pro­gno­sis Lower risk of osteoarthritis Hig­her risk of os­teo­ar­thri­tis due to lack of cushioning
Re­com­men­ded for Young, ac­tive patients Ol­der pa­ti­ents or worn menisci
Con­clu­sion: Ski in­jury: Re­act cor­rectly to a me­nis­cus tear

A me­nis­cus tear af­ter a ski­ing ac­ci­dent is un­p­lea­sant, but no re­ason to pa­nic. With the right re­ac­tion on the slo­pes, pro­fes­sio­nal dia­gno­stics on site and a clear tre­at­ment plan af­ter your re­turn, there is a good chance that the knee will be fully re­si­li­ent again – whe­ther with or wi­t­hout surgery. 

Fre­quently as­ked ques­ti­ons (FAQ)

I fell while ski­ing and have knee pain – can I still ski down to the val­ley mys­elf?

Only if the knee is sta­ble and there is no se­vere pain or blocka­ges. If in doubt, call the slope service. 

Do I have to have sur­gery im­me­dia­tely in the ski re­sort if a me­nis­cus tear is dia­gno­sed?

Only in cer­tain ex­cep­tio­nal ca­ses. Im­me­diate sur­gery is only ne­ces­sary if the knee is blo­cked, there is se­vere in­sta­bi­lity or other struc­tures have been in­ju­red (e.g. cru­ciate li­ga­ment). In most ca­ses, in­itial tre­at­ment on site is suf­fi­ci­ent and the sur­gery can be plan­ned at your lei­sure af­ter your return. 

What hap­pens if I don’t have the me­nis­cus tear ope­ra­ted on?

Smal­ler, sta­ble te­ars of­ten heal well with con­ser­va­tive the­rapy. The pre­re­qui­site is a con­sis­tent ap­proach with phy­sio­the­rapy, tar­ge­ted mus­cle buil­ding and me­di­cal su­per­vi­sion. It is im­portant to have the dia­gno­sis cla­ri­fied by a doc­tor and to take the sym­ptoms seriously. 

How long does it take for my knee to be able to bear weight again af­ter a me­nis­cus tear?

The he­al­ing time de­pends on the tear and the form of the­rapy. Con­ser­va­tive tre­at­ment ta­kes about 4–8 weeks; af­ter an ope­ra­tion, re­ha­bi­li­ta­tion can take se­ve­ral weeks to months. A cus­to­mi­zed re­ha­bi­li­ta­tion plan is crucial. 

What should I do when I get back home?

Con­ti­nue to rest the knee, see an or­tho­pe­dist early and plan physiotherapy.

Can I ski again af­ter a me­nis­cus tear and which sports are ad­vi­sa­ble af­ter he­al­ing?

In many ca­ses, yes. A re­turn is pos­si­ble af­ter suf­fi­ci­ent re­ha­bi­li­ta­tion, with good mus­cles and technique. 

Do you al­ways feel a me­nis­cus tear im­me­dia­tely?

Not al­ways. Some only feel an unsta­ble fee­ling or rest­ric­ted movement. 

What exactly does con­ser­va­tive the­rapy for a me­nis­cus tear mean?

Rest, tar­ge­ted phy­sio­the­rapy, mus­cle buil­ding, pos­si­bly splint or bandage.

When can I go back to work af­ter the ope­ra­tion?

De­pen­ding on the pro­fes­sion. Of­fice work usually af­ter a few days, phy­si­cally de­man­ding ac­ti­vi­ties later. 

Which home re­me­dies help with a me­nis­cus tear – and how long should you use them?

Cool with curd wrap, quark, coo­ling pad – 20–30 mi­nu­tes, se­ve­ral times a day in the first days af­ter the injury.

Have you in­ju­red your knee while ski­ing or play­ing sports, or do you su­spect a me­nis­cus tear?

In my pri­vate prac­tice in Vi­enna, we will cla­rify the exact dia­gno­sis and de­ve­lop a the­rapy plan together.
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Priv.Doz. DDr.
Maximilian Kasparek, MSc
haelsi Gesundheitszentrum im Achtzehnten Theresiengasse 46/2 1180 Vienna

+43 1 399 08 63
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