The meniscus is a piece of cartilage between the thighbone and the shinbone that serves as a sort of cushion or stabiliser between them. There are two menisci in each knee.
A Meniscus Tear can take place when your knee turns or twists very hard during sports or strenuous activity, particularly when your entire body weight is placed upon it at the time.
Meniscus Tears occur quite often and are described by their appearance, such as the flap tear, radial tear, and the “bucket handle”.
If a Meniscus Tear is not treated, it can cause chronic Knee Pain and prevent a person from moving the knee as usual. The knee could become unstable and more prone to Knee Osteoarthritis. And if a piece of the torn meniscus breaks off and gets stuck in the knee joint, it could even cause the knee to lock or slip.
CAUSES:
A meniscus tear occurs when the knee is subjected to pressure and rotation or twisting while the foot is firmly planted. Even simple, everyday actions such as kneeling, squatting or lifting something heavy can result in a meniscus tear.
Those at particular risk include:
- Athletes involved in contact sports or sports like tennis and basketball that require pivoting
- Persons who are overweight
- Older persons, who are more likely to have degenerative changes in the knees
SYMPTOMS:
The symptoms of a meniscal tear include:
- Pain over the inner or outer side of the knee, where the tear occurred
- A “popping “or “clicking” may be felt at the time of injury
- Catching or locking of the knee joint may occur if the torn cartilage gets caught between the femur and tibia
- Stiffness and swelling of the knee
- Inability to move your knee through its complete range of motion
- Sensation of your knee “giving way”
DIAGNOSIS:
To diagnose a meniscus tear, your doctor will need to ask about your injury and conduct a physical examination to check your knee’s range of movement. Special tests that involve bending, straightening and rotating your knee can help determine if you have a meniscus tear.
Imaging tests such as an MRI may be recommended to help your doctor evaluate the extent of injury. X-rays may be advised to eliminate other causes of knee pain.
In the event that the tests above are unable to determine the cause of your knee pain, an arthroscopy may be performed. This technique involves making small incisions that allow the doctor to insert a camera so that he or she is able to see the injury more clearly.
TREATMENT:
Treatments for a meniscus tear or strain depend on the severity of the tear or strain, the location of the tear and your age and activity level. In many cases, patients can recover with resting, icing, compressing and elevating the injured area.
You may also need physical therapy and rehabilitation to help you regain as much strength and flexibility in the knee as possible.
Work with your physical therapist to determine the best program that will allow you to reach your rehab goals at your pace.
If your symptoms do not resolve with nonsurgical treatment options, surgery may be necessary. Your orthopaedic surgeon will determine what type of surgery is needed based on the size of the tear, the location of the tear, your age and activity level as well your surgeon’s experience.
- Arthroscopic surgery — a small hole is created to allow for a camera to provide a clear view of the inside of the knee, the surgeon will insert surgical instruments into the hole and will repair the tear.
- Partial meniscectomy — removal of unstable meniscal fragments and smoothing of the remaining meniscus edges to ensure there are no frayed ends.
- Total meniscectomy — the entire meniscus is removed surgically
Nonsurgical Treatment:
If your tear is small and on the outer edge of the meniscus, it may not require surgical repair. As long as your symptoms do not persist and your knee is stable, nonsurgical treatment may be all you need.
RICE- The RICE protocol is effective for most sports-related injuries. RICE stands for Rest, Ice, Compression, and Elevation.
- Rest. Take a break from the activity that caused the injury. Your doctor may recommend that you use crutches to avoid putting weight on your leg.
- Ice. Use cold packs for 20 minutes at a time, several times a day. Do not apply ice directly to the skin.
- Compression. To prevent additional swelling and blood loss, wear an elastic compression bandage.
- Elevation. To reduce swelling, recline when you rest, and put your leg up higher than your heart.
Non-Steroidal Anti-Inflammatory Medicines
Drugs like aspirin and ibuprofen reduce pain and swelling. Other nonsurgical treatment. Biologics injections, such as platelet-rich plasma (PRP), are currently being studied and may show promise in the future for the treatment of meniscus tears.