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Meniscus Tear

The ends of both the femur and tibia are covered with articular cartilage.  This type of cartilage is designed to be slippery and smooth which gives our knee joint a quiet and smooth arc of motion.  This cartilage is protected by a different type of cartilage called the meniscus.  The meniscus is a C-shaped piece of cartilage located in the knee, that acts as a shock absorber. 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. A tear in the meniscus may be caused by forcefully twisting or rotating the knee. A torn meniscus is a common knee injury that may be caused by playing sports or traumatic injury, and most frequently occur when the knee joint is bent and the knee is then twisted. Torn menisci are common in both athletes as well as older individuals through years of wear and tear of the knee joint.

As the knee ages, the articular cartilage becomes thinner and can commonly develop arthritis.   When arthritis is found within the knee, the smooth and slippery surface that was once there has now turned into a rough surface that can grind away at the intact meniscus.  This leads to fraying and degenerative meniscus tears which are very common in the middle-aged and the elderly.

Symptoms of a Meniscus Tear

Meniscus tears are usually defined by mechanical symptoms such as a distinctive popping or clicking sensation during the injury and afterward. Most people will still be able to walk or play a sport using their injured knee, but the knee typically becomes swollen and stiff within a few days. The most common symptoms of meniscus tears include:

  • Persistent pain whenever the knee is moved or twisted

  • Pain with changing directions when walking

  • Stiffness

  • Swelling

  • Inability to fully straighten the knee

  • Locking or catching with requires some maneuvering to unlock

Diagnosis of a Meniscus Tear

A meniscus tear is typically diagnosed after a complete evaluation of the patient's symptoms is conducted and a medical history obtained. The knee will be examined for tenderness along the joint line, which usually signifies the presence of a meniscus tear.  There are special maneuvers that can be done which may cause your physician to suspect the meniscus as the cause of your knee pain.    Once a meniscus is suspected, the diagnosis can be confirmed with an MRI of the knee.  This allows for the visualization of the ligaments, menisci, articular cartilage of other soft tissue structures in and around the knee.

Treatment for a Meniscus Tear

The treatment of meniscal tears individualized to each patient and their meniscus tear.  Treatment options depend on the tear location, severity, acuity and the expectations of the patient.  Initial treatment methods for meniscus tears are generally conservative, such as ice, activity modifications, 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 tube with a camera known as an arthroscope is inserted into the knee through a small incision about the size of a pencil. 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.

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