A meniscal tear is a common injury of the knee. The meniscus is a wedge-like, shock-absorbing piece of cartilage found within your knee joint. It is shaped like a C and curves inside and outside the joint to stabilize your knee. It also allows your thigh (the femur) and your shin (the tibia) bones to glide and twist over each other with movement, as well as provide cushioning support for the weight-bearing job of your legs.

There are two menisci in the knee: the lateral meniscus (on the outside) and the medial meniscus (on the inner side of the knee).

Meniscus tissue does not heal.

If you suspect that you have signs or symptoms of a meniscal tear, please see your doctor for further evaluation and treatment options.

Cause

As with most joints there are two mechanisms for injuring the meniscus: traumatic tear and degenerative.

Traumatic Tear

Injury to the meniscus often happens during sport activity, when a sudden twisting of the knee, pivoting, or deceleration causes a tear in your cartilage. A meniscal tear can also occur simultaneously with injury to other ligaments of the knee (in particular, the anterior cruciate ligament which helps to connect the upper and lower leg bones).

You may hear a popping sound at the time of injury to the meniscus, and you may still be able to bear weight and walk on the injured knee. Pain, swelling, and redness of the joint then develop over the next 12 to 24 hours. In some cases, a piece of cartilage can interfere with knee movement, and you may notice that your knee will “lock” or “pop” with attempted movement. Your doctor may choose to evaluate a possible tear with an MRI scan, a form of imaging that uses a large magnet to view changes in tissue.

Degenerative Tear

Over time the meniscus becomes less elastic as a natural drying out of the center of the meniscus occurs. A tear can occur with minimal trauma and sometimes there is no memorable event that can be blamed for the tear.

Symptoms

Think of a torn meniscus like a hang nail. Just as a hang nail is a fragment of nail that can cause pain at the site of the tear, a meniscus tear involves a fragment of cartilage that can cause pain at the site of the tear. Typically low-level swelling accompanied by stiffness and limping toccur the next dday after injury. Activities involving impact, twisting or squatting can cause pain.

Sometimes the knee will “lock” in a bent position. In this case the torn fragment acts like a wedge to prevent the joint from moving, and attempts at moving the knee can be painful.

Repair

Initial treatment of a meniscal tear follows basic home care management — “RICE,” which stands for Rest, Ice, Compression, and Elevation. Nonsteroidal anti-inflammatory medications (NSAIDs) are helpful to relieve pain and inflammation. This may be all that is needed for minor tears that have occurred in the outer edges of the meniscus.

In most cases, your ProSports physician will be able to diagnose a Meniscus injury with direct examination. In the likelihood that there may be additional injury to the joint, or if the swelling makes diagnosis difficult, your physician may conduct an MRI or arthroscope the fully evaluate the injury to the knee.

Surgery may be recommended for tears that are central, cause locking or instability of your knee, or for injuries that don’t heal on their own. Surgery may involve using a small, pen-sized camera (called an arthroscope) to trim torn flaps in the cartilage and repair any other damaged ligaments. Often, a brace or cast is needed after surgery, and physical therapy is an important part of recovery to relieve pain and strengthen and stabilize the muscles around your knee.

The decision whether or not to undergo meniscus surgery depends on several factors, including the extent of the injury and the expectations of the patient. Your ProSports physician will determine the degree of the injury or injuries to the knee.

For younger patients with moderate to several injuries and laxity, who want to continue with a broad range of physical activities, surgery will most likely be necessary. For older patients and others with less severe injuries, who anticipate less vigorous physical activity, a rehabilitation program will be prescribed.

Recovery

Meniscus tear rehabilitation includes exercises to restore the full range of motion to the knee, followed by a program of strengthening exercises. These programs continue until the leg strength and flexibility are nearly back to normal.

If you have undergone surgery for a Meniscus tear, the Arthroscopy protocol contains instructions and exercises to help you recover.

Meniscus Surgery

Surgery may be recommended for tears that are central, cause locking or instability of your knee, or for injuries that don’t heal on their own.

The decision whether or not to undergo meniscus surgery depends on several factors, including the extent of the injury and the expectations of the patient. Your ProSports physician will determine the degree of the injury or injuries to the knee.

For younger patients with moderate to several injuries and laxity, who want to continue with a broad range of physical activities, surgery will most likely be necessary. For older patients and others with less severe injuries, who anticipate less vigorous physical activity, a rehabilitation program will be prescribed.

Preparing for Surgery

Arthroscopy surgery is performed on an outpatient basis. If you decide to have arthroscopy, you may be asked to have a complete physical with your family physician before surgery to assess your health and to rule out any conditions that could interfere with your surgery.

Before surgery, tell your orthopaedic surgeon about any medications that you are taking. You will be informed which medications you should stop taking before surgery.

Tests, such as blood samples or a cardiogram, may be ordered by your orthopaedic surgeon to help plan your procedure. Your doctor will provide you with any specific instructions prior to your surgery.

The Surgery

Surgery usually involves using a small, pen-sized camera (called an arthroscope) which is inserted into the knee. First the doctor will inspect the entire knee to joint to see if there are any other problems contributing to the symptoms.

Next the tear itself is inspected to determine whether it should be repaired or removed. Meniscetomy involves cutting and removing the torn portions of the meniscus. The remaining cartilage is smoothed and contoured. The meniscus is an important shock-absorbing structure in the knee, therefore, the surgeon will try to leave as much cartilage in place as possible. Most meniscus tears need to be removed.

In some cases the meniscus is repaired using a technique to sew the meniscus back together.

Recovering from Meniscus Surgery

Often, a brace or cast is needed after surgery, and physical therapy is an important part of recovery to relieve pain and strengthen and stabilize the muscles around your knee. Recovering from the removal of a meniscal tear is much quicker than the time needed for a repaired meniscus.

Meniscus tear rehabilitation includes exercises to restore the full range of motion to the knee, followed by a program of strengthening exercises. These programs continue until the leg strength and flexibility are nearly back to normal.

If you have undergone surgery for a Meniscus tear, the Arthroscopy protocol contains instructions and exercises to help you recover.