Meniscal tears refer to a common knee injury that affects the meniscus, a C-shaped piece of cartilage located between the femur and tibia bones in the knee joint. The meniscus acts as a shock absorber, helps distribute weight, and facilitates smooth movement of the knee joint.
Meniscal tears can occur due to sudden twisting or rotation of the knee joint, or as a result of wear and tear over time. Athletes and older adults are more likely to experience this injury.
Meniscal tears can be classified into three types based on the location and pattern of the tear:
1. Radial tears: These tears occur perpendicular to the meniscus and can extend from the inner edge of the meniscus to the outer edge.
2. Horizontal tears: These tears occur parallel to the plane of the meniscus and can be classified as either a flap tear or a cleavage tear.
3. Oblique tears: These tears occur diagonally across the meniscus and can be classified as either a vertical longitudinal tear or a horizontal longitudinal tear.
Symptoms of a Meniscus Tear
Symptoms of a meniscal tear may include pain, swelling, stiffness, a popping sensation, and difficulty straightening or bending the knee. In some cases, a meniscal tear may require surgery, while in others, conservative treatment such as rest, ice, physical therapy, and anti-inflammatory medication may be sufficient.
- Stiffness
- Swelling
- Persistent pain whenever the knee is moved or twisted
- Inability to fully straighten the knee
A torn meniscus may also be accompanied by joint that frequently locks in place and the inability to completely straighten the knee.
Diagnosis of a Meniscus Tear
If you are experiencing knee pain or other symptoms that suggest a meniscal tear, your doctor may recommend a medical workup that can include the following:
1. Physical exam: Your doctor will examine your knee to look for signs of swelling, tenderness, or limited range of motion. They may also perform specific tests to evaluate the stability of your knee joint.
2. Imaging tests: Imaging tests such as X-rays, MRI, or ultrasound may be ordered to help confirm the diagnosis of a meniscal tear and to determine the extent and location of the tear. With new techniques and improved technology, in-office ultrasound has become useful in the diagnosis of meniscal tears.
3. Medical history: Your doctor will also ask about your medical history, including any previous injuries or surgeries to the knee, and your level of physical activity.
4. Additional tests: Depending on your symptoms and medical history, your doctor may also order additional tests to rule out other conditions that could be causing your knee pain.
The results of these tests can help your doctor determine the best course of treatment for your meniscal tear, which may include rest, physical therapy, medications, or in some cases, surgery.
Treatment for a Meniscus Tear
If left untreated, a meniscus tear may result in a portion of the cartilage becoming loose and moving into the joint, causing the knee to slip out of place. Treatment usually depends on the severity of the tear and its exact location. Initial treatment methods for meniscus tears are generally conservative, such as placing ice on the knee, taking anti-inflammatory medications and elevating the knee to reduce swelling.
If symptoms continue despite these conservative measures, surgery may be necessary. Minimally invasive knee arthroscopy is one of the most commonly performed procedures to treat the condition. During this procedure, a flexible tube with a camera known as an arthroscope is inserted into the knee through a small incision. Small surgical instruments will be used to perform either a meniscus repair, which focuses on suturing the torn edges of the meniscus together to promote healing, or a meniscectomy, during which damaged meniscal tissue is trimmed away.
Physical therapy may also be effective at strengthening the muscles that support the knee joint. If these treatments are not effective and symptoms continue, meniscus repair surgery may be recommended. Meniscus repair is an arthroscopic surgery performed by orthopedic surgeons to remove the torn segment of the meniscus. The torn edges are then sutured together, which allows them to heal properly. Recovery from meniscus repair surgery can take several months of immobilization and the use of crutches. A physical therapy program is also effective after surgery to strengthen muscles and help the patient regain full mobility.
Meniscus Tear FAQs
Q: What is the Meniscus?
A: The meniscus is a C-shaped piece of tough cartilage located in the knee, that acts as a shock absorber between the shinbone and the thighbone. There are two minisci within each knee. The meniscus on the inside part of the knee is known as the medial meniscus and the meniscus located on the outside of the knee is referred to as the lateral meniscus.
Q: How Does a Meniscus Tear Happen?
A: A meniscus tear may be the result of an activity that forcefully twists or rotates the knee. A torn meniscus is a common knee injury that may be caused by playing sports, or a traumatic injury, and most frequently occurs when the knee joint is bent and the knee is then twisted. Torn menisci are common in athletes, but in some cases this condition may occur in older adults whose cartilage has worn away, as a result of many years of wear and tear of the joint.
Q: What Are the Symptoms of a Meniscus Tear?
A: Most individuals who have torn their meniscus experience a popping or clicking sensation when the injury occurs. Additional symptoms may include pain, swelling and stiffness in the knee. A torn meniscus may also be accompanied by joint that frequently locks in place and the inability to completely straighten the knee.
Q: How is a Meniscus Tear Treated?
A: Treatment for a meniscus tear often begins with conservative methods such as rest, ice or over-the-counter pain medication. If these treatments are not effective and symptoms continue, meniscus repair surgery may be recommended.
Q: What is Meniscus Repair Surgery?
A: Meniscus repair is an arthroscopic surgery performed by an orthopedic surgeon to remove the torn segment of the meniscus. The torn edges are then sutured together, which allows them to heal properly. Recovery from meniscus repair surgery can take several months of immobilization and the use of crutches. A physical therapy program is also effective after surgery to strengthen muscles and help the patient regain full mobility.
Q: When Would a Person Need a Meniscal Transplant?
A: When a meniscus is torn due to injury or overuse, it can often be repaired with surgery that involves suturing the damaged ends together. However, in cases where the meniscus is extremely damaged and cannot be repaired, it may need to be removed completely and replaced with donor cartilage. This type of transplant can provide cushioning to the joint and prevent the bones and other structures from rubbing together, alleviating considerable pain.
Q: Who Would Benefit From a Meniscal Transplant?
A: A meniscal transplant is typically much more successful in a younger, active individual who has damage due to an injury. Candidates for a meniscal transplant may include individuals who are physically fit, have stable knees and do not have arthritis. Older patients, especially those with osteoarthritis, are often better candidates for a joint replacement surgery instead of a meniscal transplant.
Q: What is the Meniscal Transplant Procedure?
A: This meniscal transplant is commonly performed as an outpatient procedure. The meniscal transplant procedure is performed arthroscopically, with tiny surgical instruments inserted through very small incisions. The arthoscope is inserted into the knee through a small incision. The meniscus and any remaining tissue are removed from the knee. The donor meniscus is attached to the shinbone and sutured in place. The incision is then closed and bandages are placed over the wound.
