“The meniscus is a rubbery, C-shaped disc that cushions your knee. Each knee has two menisci (one at the outer edge of the knee and one at the inner edge. The menisci keep your knee steady by balancing your weight across the knee. A torn meniscus can prevent your knee from working right. A meniscus tear is a common knee injury.
A meniscus tear is usually caused by twisting or turning quickly, often with the foot planted while the knee is bent. Meniscus tears can occur when you lift something heavy or play sports.
With a minor tear, you may have slight pain and swelling. This usually goes away in 2 or 3 weeks.
A moderate tear can cause pain at the side or center of your knee. Swelling slowly gets worse over 2 or 3 days. This may make your knee feel stiff and limit how you can bend your knee, but walking is usually possible. You might feel a sharp pain when you twist your knee or squat. These symptoms may go away in 1 or 2 weeks but can come back if you twist or overuse your knee. The pain may come and go for years if the tear isn't treated.
In severe tears, pieces of the torn meniscus can move into the joint space. This can make your knee catch, pop, or lock. You may not be able to straighten it. Your knee may feel "wobbly" or give way without warning. It may swell and become stiff right after the injury or within 2 or 3 days.
Your doctor will look at both knees and check for tenderness, range of motion, and how stable your knee is. X-rays are also usually done.
You may need to meet with an orthopedic surgeon for more testing. These tests may include an MRI, which can give a clear picture of where a tear is and how serious it is.
Treatment may include:
- Rest, ice, wrapping the knee with an elastic bandage, and propping up the leg on pillows.
- Physical therapy.
- Surgery to repair the meniscus.
- Surgery to remove part of the meniscus.”
Meniscus repair
“The treatment of a meniscus tear depends on its severity, location, and underlying disease within the knee joint. Patient circumstances also may affect the treatment options. Often it is possible to treat meniscus tears conservatively without an operation using anti-inflammatory medications and physical therapy rehabilitation to strengthen muscles around the knee to prevent joint instability. Frequently, that is all a patient needs. Patients involved in sport or whose work is physically demanding may require immediate surgery to continue their activity.
A brace is often not used initially because most hold the knee in full extension (completely straight) and this can worsen the pain by decreasing the space within the knee joint capable of accommodating any fluid or swelling. Once the injury symptoms have calmed, the health-care professional may recommend specifically guided exercise programs; physical therapists are especially helpful, to strengthen the muscles surrounding the knee and add to the stability of the joint. Maintaining an ideal body weight will also help lessen the forces that can stress the knee joint. Shoe orthotics may be useful to distribute the forces generated by walking and running.
If conservative therapy fails, surgery may be a consideration. Knee arthroscopy allows the orthopedic surgeon to assess the cartilage tear and potentially repair it. During an operation, the goal is to preserve as much cartilage as possible. Procedures include meniscal repair (sewing the torn edges together), partial meniscectomy (trimming away the torn area, and smoothing the injury site), or total meniscectomy, removing the whole meniscus if that is deemed appropriate.
Microfracture surgery is another surgical option to stimulate new cartilage growth. Small holes are drilled into the surface of the bone and this can stimulate articular but not meniscus cartilage development. The articular cartilage that grows as a result of surgery is not as thick or as strong as the original meniscus cartilage.
If knee arthroscopy is performed, the rehabilitation process balances swelling and healing. The goal is to return range of motion to the knee as soon as possible. Physical therapy is an important part of the surgery process, and most therapists work with the orthopedic surgeon to return the patient to full function as soon as possible. Since the procedure usually is planned in advance, some health-care professionals advocate pre-hab. With rehabilitation prior to the procedure, the patient begins strengthening exercises for the quadriceps and hamstring muscles before surgery to prevent the routine muscle weakness that may occur immediately after an operation.
After surgery, once the swelling in the knee joint resolves, the goal of therapy is to increase the strength of the muscles surrounding the knee, return range of motion to normal, and promote and preserve stability of the joint.
