Mr Matthew Gee MBBS, BSC, MSC, FRCS (Tr&Orth) Consultant Orthopaedic Surgeon

Meniscal Tears

Your knee is the largest joint in your body and one of the most complex. Because you use it so much, it is vulnerable to injury. Because it is made up of so many parts, many different things can go wrong.

Meniscal tears are among the most common knee injuries. Athletes, particularly those who play contact sports, are most at risk for meniscal tears. However, anyone at any age can tear a meniscus. When people talk about torn cartilage in the knee, they are usually referring to a torn meniscus.

Description

Menisci tear in different ways. Tears are noted by how they look, as well as where the tear occurs in the meniscus. Common tears include longitudinal, parrot-beak, flap, bucket handle, and degenerative.

Sports-related meniscal tears often occur along with other knee injuries, such as anterior cruciate ligament tears.

Causes

What can cause a meniscus tear? Menisci are cartilages that provide stability, and work as shock absorbers taking in whatever pressure we put on the knee joints. Sudden turning or twisting or over-flexing the knee - especially when the knee is bent - like while playing sports or while lifting heavy objects causes meniscal tears.

Meniscal Tears - Symptoms

You might feel a "pop" when you tear a meniscus. Most people can still walk on their injured knee. Many athletes keep playing with a tear. Over 2 to 3 days, your knee will gradually become more stiff and swollen.

The most common symptoms of meniscal tear are:

  • Pain
  • Stiffness and swelling
  • Catching or locking of your knee
  • The sensation of your knee "giving way"
  • You are not able to move your knee through its full range of motion

Without treatment, a piece of meniscus may come loose and drift into the joint. This can cause your knee to slip, pop or lock.

Meniscal Tears - Treatment

How your orthopaedic surgeon treats your tear will depend on the type of tear you have, its size, and location.

The outside one-third of the meniscus has a reasonable blood supply. A tear in this "red" zone may heal on its own, or can often be repaired with surgery. In contrast, the inner two-thirds of the meniscus lacks a blood supply. Without nutrients from blood, tears in this "white" zone cannot heal. These complex tears are often in thin, worn cartilage. Because the pieces cannot grow back together, tears in this zone are usually surgically trimmed away. Most tears fall into the second group.

Along with the type of tear you have, your age, activity level, and any related injuries will factor into your treatment plan.

Meniscal Tears - Surgical Treatment

If your symptoms persist despite nonsurgical treatment, your doctor may suggest arthroscopic surgery.

Knee arthroscopy is one of the most commonly performed surgical procedures. In it, a telescope attached to a miniature camera is inserted through a small incision. This provides a clear view of the inside of the knee. Your orthopaedic surgeon inserts miniature surgical instruments through other small incisions to trim or repair the tear.

After surgery you will have a bandage on your knee but you will be able to walk either with or without a stick. You may need a course of physio to aid your rehabilitation. You should be able to walk well within 1 week and get back to all activities within 6 to 8 weeks.

Prognosis

Meniscal tears are one of the most frequent types of injuries that can occur at the knee joints. Consulting an expert orthopaedic surgeon in order to get the correct diagnosis and proper treatment, followed by rehabilitative physiotherapy can result in complete recovery and return to normal function.

meniscal-tears

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