Tears of the meniscus within the knee are one of the most common conditions seen by an orthopaedic surgeon. Meniscal tears can occur across the lifespan from young athletes to geriatrics.
Meniscus refers to a type of cartilage that is found in the knee joint. The menisci are C-shaped and are wedged. They can be found on both the outside (lateral) and inside (medial) of the knee. The purpose of the meniscus is to allow for distribution of weight and to allow the bones that make up the joint, to glide smoothly against each other.
Tears of the meniscus can result from a direct injury or from a degenerative nature. Squatting and twist-ing activities can cause a tear as can a blunt trauma to the knee. In older patients, the meniscus thins over time from normal daily wear and tear. This thinning leads to eventual weakening and then tearing.
An acute meniscal tear can often be noted with a sudden pop and onset of discomfort. The knee be-comes inflamed following an acute tear in which stiffness and swelling set in over the course of a few days. Some complain of a locking or inability to bend or straighten the knee. Others complain of a feel-ing of giving way.
An orthopaedic surgeon will evaluate the knee with specific examination tests to determine if a meniscal tear is likely. Further imaging studies such as x-rays and an MRI may be ordered to confirm suspicions and identify the extent of the tear.
Different types of tears involving the meniscus exist. Some of the types include a bucket handle tear, a horizontal tear, longitudinal tear, and radial tear. In some cases, a meniscal tear can occur with other internal derangement of the knee.
Treatment for a meniscal tear depends on a number of factors including age of the patient, activity lev-els, onset of problem, tear pattern, and whether other injuries exist. Non-surgical treatment including the use of NSAIDs, activity modification, and physical therapy may be utilized for smaller tears. Surgical treatment may be offered for larger tears and for those who fail to improve with non-operative treat-ments.
Surgery for a meniscal tear is commonly performed arthroscopically. In some cases, the meniscus can be repaired by suturing the defect. In other cases, a menisectomy (removal of) is performed to debride the torn edges.
Recovery is based on the extent of injuries and treatment undertaken. A few weeks up to three to four months may be needed for a full recovery.