What is a Meniscus Tear?
What is the Meniscus and what does it do? #meniscus
The human meniscus is a wedge shaped structure in the knee that consists of fibrocartilage, a very tough but pliable material. The medial meniscus is located on the inside of the knee (towards the middle of the body) and the lateral meniscus is located on the outside of the knee.
Together, they act primarily as shock absorbers and stabilizers in the knee joint. They also help nourish the articular cartilage through their rich blood supply. This blood enhances the ability of the cartilage to repair itself.
All in all, your Meniscus is a key component in you doing the things you love, whether it be high-intensity sports such as skiing, basketball, and soccer, or even everyday recreational activities like walking, biking, or hiking.
Is my Meniscus Torn? #Menicustear
A torn meniscus will often produce pain, swelling and mechanical symptoms like catching or locking in the knee joint. An injury to the meniscus can be diagnosed based upon the history that the patient provides and a physical examination of the knee.
Further diagnostic studies (like an MRI) may be required so we can get a three-dimensional image of the interior of the knee joint. In some cases, we may also recommend arthroscopic inspection of the knee joint, a minimally invasive surgical procedure.
Meniscus tears symptoms are categorized in three levels of severity: minor, moderate, and severe:
Minor symptoms of a meniscus tear include:
- Slight pain
These symptoms usually subside after 2-3 weeks.
Moderate symptoms of a meniscus tear include:
- Significant swelling
- Pain when moving laterally, twisting or squatting.
Symptoms may subside after 2-3 weeks, but may reoccur again when the knee is put under extra stress.
Severe symptoms are created when the torn meniscus folds into the joint space. Because of this, the knee will “lock up” or “catch”, feel wobbly or give out, and a significant amount of range of motion will be lost.
How is the Meniscus Injured? #meniscusinjury
In the younger athlete, the majority of injuries to the meniscus happen because of some sort of trauma. Vulnerability to injuries in which there is both compression and twisting applied across the knee is high. Commonly the meniscus can also be damaged in association with injuries to the ACL. (See the above video for more on this.)
Now let's touch on older athletes, many of whom experience meniscal tears which are the result of "trivial" trauma. Some of these include:
- Twisting the knee
- Repetitive activities such as running
These activities can all cause major traumatic or cumulative stress upon the knee joint. These tears happen because the meniscus has a tendency to degenerate as part of the aging process. This degeneration often takes place in conjunction with early arthritic changes in the knee joint. It is also common for the meniscus to be damaged in association with injuries to the anterior cruciate ligament.
I have some symptoms of a meniscus tear… what next? #meniscustearsymptoms
Your Meniscus tear treatment depends on your symptoms and the type of tear you have. If your symptoms don’t subside or reoccur, then I would recommend being evaluated by an orthopedic surgeon. Not all meniscus tears require surgery, but often surgery can improve the quality of your life.
How is a meniscal tear treated? #meniscusteartreatments
Certain patterns of injury, especially in younger patients, may call for repair of the meniscus. The decision to repair is based on many factors, including: location and pattern of the tear, age of the patient, and predictability of whether the injury will be able to heal.
Other patterns of tears, especially in older patients, are not suitable for repair. If the patient is symptomatic and conservative treatment options like physical therapy are not working, surgery to remove the torn section is recommended.
This surgery is called arthroscopic partial meniscectomy and is usually performed on an outpatient basis, typically in one hour or less.
Recovering from your Meniscus Tear #meniscustearrecovery
The meniscus tear recovery timeline depends on the severity of the tear, and (obviously) on whether or not surgery is necessary. Each patient is unique, but most recovery from surgery in days or weeks.
Along with surgery, there will be 4-6 months of rehab in order to regain function and strength. Meniscus tear rehab consists of exercises that strengthen the quadriceps muscle and help regain range of motion.
All in all, if you injure your knee and symptoms do not dissipate, it is important to see a specialist in order to find out if surgery is necessary.
If it is determined that you do not need surgery, good for you-- rest and a few months of physical therapy can have you up and moving at full-speed, back doing the things you love.
Dr. Bill Sterett is Board Certified by the American Board of Orthopaedic Surgery, a member of the American Orthopaedic Society for Sports Medicine, a member of the Arthroscopy Association of North America, and is one of the few physicians who have earned a Certificate of Added Qualification in Sports Medicine.