Meniscal tears are a frequent cause of knee pain, swelling and instability. Meniscus tears are common among athletes but also occurs in less active people. People who play contact sports are most at risk for meniscus tears, but anyone can suffer from a tear regardless of their age or activity level. In fact, MRI studies have show that meniscal tearing is even very common in those without any knee pain.
Anatomy
The femur, tibia, patella and fibula all meet to form the knee joint. The menisci are two semicircular wedge shaped piece of collagen sitting between the surface of the thighbone and shinbone. They help to provide stability, cushion and support to the joint as the body moves. The menisci protect the cartilage and help stabilize the knee and leg.
Often when athletes tear their meniscus they also suffer from other knee injuries.
Meniscal tears are categorized by where the tear occurs and the shape. High contact activity (tackles) as well as sudden squats and a twist of the knee can cause a tear. In older people tears occur because of degeneration in the meniscus. The meniscus will become drier and therefore weaker with age and make individuals more at risk for tears with normal everyday activity.
Symptoms
When a meniscus tears, many people report feeling a pop. Many people continue activity for about 2 to 3 days after the initial tear, but over time the knee will become stiff and swell. Patients suffer from pain, decreased motion, locking of the knee and stiffness. Many people also report a feeling as if their knee is giving away. An effusion or swelling is typically present. There is a deep aching pain with standing or walking. Squatting or kneeling is very difficult.
Treatment
The type of treatment recommended depends on the size, type and location of the tear. A tear on the outside one-third of the meniscus can heal on its own or with surgery. The inner two thirds of the meniscus can’t heal on its own because it doesn’t have a plentiful blood supply. Tears in this area are typically trimmed away surgically. However, many centrally located meniscal tears are successfully treated with therapy and bracing. We try to avoid unnecessary for meniscal tears at Warner Orthopedics and Wellness.
Nonsurgical Treatment If the tear is small or located on the outer edge of the meniscus nonsurgical treatment may be recommended. Again, non-operative management can work for other tears and should be tried first in most cases. This kind of treatment is implemented if the symptoms don’t persist and the knee is stable. RICE (rest, ice, compression and elevation) and non-steroidal anti-inflammatory medicine will be most beneficial initially. Physician directed bracing is helpful and physical therapy is very effective.
Surgical Treatment If the patient’s symptoms persist the doctor may recommend arthroscopic surgery. During this surgery a tiny camera is inserted into the knee and the surgeon will use surgical instruments to trim or fix the meniscus. After surgery the doctor may recommend a cast or brace to stabilize the knee. Over time rehabilitation exercises can be used to restore mobility and strength. With proper treatment patients will be able to recovery and return to their regular activities.
For more information on meniscal tears visit the American Academy of Orthopaedic Surgeons.
