When Is Surgery Not Necessary
Surgery versus conservative treatment for meniscus tears has been a medical topic of controversy for many years.
Today, in general, doctors recommend conservative treatment, not surgery, when meniscus tears result from degeneration. Many recent studies have shown that theres no advantage to surgery with this type of tear, and that physical therapy works just as well.
If your symptoms persist after 3 months or your symptoms become significant, your doctor may recommend surgery to repair the tear.
Conservative treatment is also advised for smaller tears, and stable longitudinal meniscus tears that occur in the outer third of the meniscus, the red zone. This is the area of your meniscus that has some blood supply, which aids healing.
Your doctor may also recommend conservative measures as a first step if the tear is caused by injury to the knee.
as effective. Heres what it involves:
What Is A Torn Meniscus
A torn meniscus is damage from a tear in the cartilage that is positioned on top of the tibia to allows the femur to glide when the knee joint moves. Tears are usually described by where they are located anatomically in the C shape and by their appearance . While physical examination may predict whether it is the medial or lateral meniscus that is damaged, a diagnostic procedure, like an MRI or arthroscopic surgery, can locate the specific part of the cartilage anatomy that is torn and its appearance.
Because the blood supply is different to each part of the meniscus, knowing where the tear is located may help decide how easily an injury might heal . The better the blood supply, the better the potential for recovery. The outside rim of cartilage has better blood supply than the central part of the “C.” Blood supply to knee cartilage also decreases with age, and up to 20% of normal blood supply is lost by age 40.
Should I Wear A Knee Brace To Bed
Unless otherwise instructed, the knee brace should be worn at all times when you are out of bed. For the first several nights or until the discomfort begins to subside, you may choose to wear it while sleeping in your bed. Otherwise, you can take the brace off at night to minimize muscle stiffness caused by a lack of joint flexibility during the daytime.
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Nonsurgical Treatment For A Meniscus Tear
Treatment depends on the size, type, and location of the tear, but nonsurgical treatments are often used to treat the injury initially. They include the following:
Some meniscus tears improve over time with rest, activity restriction, and keeping the knee and leg elevated when possible. It is particularly important to avoid activities that involve twisting, rotating, or pivoting the knee in any way. Walking aids such as crutches may be recommended to take pressure off of the knee and to promote healing.
Using a cold compress or ice pack can help to reduce swelling and pain in the knee. Elevate the knee and leg, wrap the ice pack in a towel , and place the wrapped ice pack on top of the injured area of the knee for 15 minutes at a time. Do this four times per day.
If the ice pack is too cold to the point of causing pain, remove it right away. It should feel numbing and soothing, but not painful in any way.
Over-the-counter pain-relief medications may help to relieve the knee pain and to reduce inflammation while the cartilage heals. However, taking too much can cause liver damage, so talk to your orthopedist about which medicine would be best while your knee heals.
Nonsurgical Treatment For A Torn Meniscus
Your orthopedic doctor will consider your precise symptoms before deciding whether conservative treatment will work and will also factor in if your knee has worsening arthritis too. Symptoms can vary, and some people may start noticing that something wrong with their knee right away after an injury, or possibly not until sometime later. Patients may have a lot of swelling or none at all. Also, some patients with a meniscus tear can move their knee without pain, while others may have more symptoms when the knee is really flexed. Regardless of your symptoms or the pattern of your injury, some patients may be good candidates for nonsurgical treatment.
Initially, you will need to rest the knee and avoid participating in strenuous activities or performing movements that put a lot of stress on the joint, such as squatting, kneeling, twisting, jogging, dancing, or walking up or down the stairs. You should try to keep your knee elevated, and ice it carefully. Note: Be sure to wrap a towel around the ice pack so there is no direct contact with your skin. You may also benefit from a knee brace, special shoe inserts, and/or crutches at first.
As your knee pain begins to improve, physical therapy and therapeutic exercises will begin. Expect to do straight leg raises to strengthen the muscles that support the knee. Eventually, light weights can be added to these exercises, but follow the advice of your therapist and orthopedic doctor.
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Symptoms Of Torn Meniscus
Torn knee cartilage generally produces pain in the region of the tear and swelling in the knee joint. These symptoms are made worse with pivoting motions, squatting, and vigorous activities. Torn meniscus fragments can get caught in the knee joint and cause catching sensations. If a large enough fragment becomes lodged between the bearing surfaces, the knee may lock and become unable to be fully bent or extended.
For more detailed information on symptoms and diagnosis, please see our article on torn meniscus.
Question 7what Is The Prognosis For A Torn Meniscus
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Rehab And Physical Therapy
Most surgeons will recommend an at-home exercise regimen to help stimulate healing and get back to your normal activities. How much you do will depend on your general health and any underlying conditions you may have.
In some cases for example, if you need to return to athletics quickly physical therapy or sports medicine at a rehabilitation center may be recommended. If you are relatively young and in good shape, you may be able to return to running and walking after meniscus repair within a few weeks.
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What Happens Before Torn Meniscus Surgery
If you and your surgeon decide to move forward with surgery for a torn meniscus, you may have some tests in advance. For example, blood tests, electrocardiogram and chest X-ray can help determine whether you are healthy enough for surgery.
Someone from the anesthesia team will decide what type of anesthesia you should receive:
- Local anesthesia is a shot that numbs only your knee area.
- Regional anesthesia is a shot that numbs your body from the waist down.
- General anesthesia is medication that puts you to sleep.
If you receive local or regional anesthesia, you may also be sedated to help you relax. Most often you will have a general anesthetic for this type of procedure.
A few days before surgery, your healthcare provider will:
- Give you a prescription for medications to manage pain after the surgery.
- Make appointments for physical therapy or a fitting for crutches.
- Tell you how to prepare for surgery. You may need to stop taking certain medications and not eat or drink for several hours before the procedure.
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Question 8 Of : How Do I Know If I Have A Torn Meniscus
Meniscus Tear Treatment Options
Meniscus tear treatment options fall into two categories:
Whether you are going down the surgical or non-surgical meniscus tear treatment route, exercises are really important and here you will find a whole range of exercises that should help.
To find out more about other meniscus tear treatment options including knee braces and surgery, as well as the different types of tear, the common causes and symptoms, visit the meniscus tear overview.
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Question 1 Of : Can A Meniscus Tear Heal On Its Own
Treatment For A Meniscus Tear
Specific treatment for a meniscus tear will be determined by your doctor based on:
Your overall health and medical history
How bad your injury is
How well you can tolerate specific medications, procedures, and therapies
The length of time it will take to heal
Your opinion or preference
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Signs And Symptoms Of A Meniscus Tear
The history of a painful twist occurring on a slightly flexed knee will indicate the likelihood of a meniscus tear. You may also experience clicking, popping, or locking of the knee. These symptoms are usually accompanied by pain along the knee joint line and joint swelling.
A Meniscus rehabilitation program will help you regain as much strength and flexibility in your knee as possible. Your rehab program probably will include physical therapy and home exercises.
Here is a sample exercise program that you may be prescribed for your knee meniscus injury. These exercises focus on improving knee range of motion and strength and improving the overall function of your knee joint. Exercises should not cause any extra pain in your knee.* Before starting this, or any other knee meniscus exercise program, check in with your doctor and physical therapist to be sure exercise is safe for you to do.
Knee Rehab by @luqmanstherapy
How Do You Heal A Torn Meniscus Without Surgery
All in all, the goal of treatment, natural or otherwise, is to control both pain and inflammation, get your range of motion back to normal, and help get you stronger muscles.
If you had the injury from a certain sport, an added goal would be to improve certain mechanics that may have contributed to your meniscus injury.
All these are addressed in physical therapy but your therapist will also give you exercises and remedies to do at home, including the following:
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Tenderness At The Joint Line
The space between your shin bones and your thigh bone is considered the joint line. The border of the joint line at the sides of the kneecap and the border above and below the shin should be identified.
Find your joint line on your affected leg with your fingers and press on it.
If you feel pain when pressed, this can indicate a tear. This test can also help you determine which side the tear may be on.
When you have pain on the inside of your leg, it is most likely a medial tear. If the pain is on the outside of your leg, it is a lateral tear.
What Are The Symptoms Of A Torn Meniscus
The key symptom of a meniscus tear is pain in the knee joint. A locking or catching sensation may also be felt in the knee, and it will often become inflamed . There may also be a feeling of weakness in the leg and a sense of the knee buckling or giving way. This is because displaced, fragmented tissue from a torn meniscus and swelling in the knee can affect the thigh muscles that support knee function.
Pain is usually felt in the knee above the meniscus while bearing weight on the affected knee and/or when twisting, turning, or pivoting on the knee, such as while getting in and out of a car. Walking up or down stairs may be particularly painful, and may also cause increased swelling in the knee.
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How Is A Meniscus Tear Treated
If your MRI indicates a Grade 1 or 2 tear, but your symptoms and physical exam are inconsistent with a tear, surgery may not be needed.
Grade 3 meniscus tears usually require surgery, which may include:
- Arthroscopic repair An arthroscope is inserted into the knee to see the tear. One or two other small incisions are made for inserting instruments. Many tears are repaired with dartlike devices that are inserted and placed across the tear to hold it together. The body usually absorbs these over time. Arthroscopic meniscus repairs typically takes about 40 minutes. Usually you will be able to leave the hospital the same day.
- Arthroscopic partial meniscectomy The goal of this surgery is to remove a small piece of the torn meniscus in order to get the knee functioning normally.
- Arthroscopic total meniscectomy Occasionally, a large tear of the outer meniscus can best be treated by arthroscopic total meniscectomy, a procedure in which the entire meniscus is removed.
When Will My Knee Feel Better
Recovery time for your knee depends on a number of factors, including how severe your meniscus tear is. Full recovery from surgery may take 4 to 6 weeks, depending on the type of procedure performed as well as other factors. But keep in mind that people also heal at different rates. In most cases physical therapy is used after surgery to minimize complications and speed recovery.
If your medical team agrees, you could take up a new activity that won’t aggravate your knee pain while you recover. For instance, runners could try swimming.
Whatever you do, don’t rush things. Don’t try to return to your old level of physical activity until:
- You can fully bend and straighten your knee without pain.
- You feel no pain in your knee when you walk, jog, sprint, or jump.
- Your knee is no longer swollen.
- Your injured knee is as strong as your uninjured knee.
If you start using your knee before it’s healed, you could cause further injury.
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How Do I Know If Ive Torn My Meniscus
The symptoms of a meniscus tear have a lot to do with the type of tear and your age. The pain can be dramatic or subtle, immediate, or delayed.
You can imagine the immediate, acute pain a snow skier or football player might experience from a fall, pivot, or tackle.
However, some cases arent a result of a specific injury. You could start experiencing pain out of the blue without any warning signs. For example, if you have a degenerative tear from arthritis, you might notice a subtle increase in pain.
If youve been in a car wreck, you might not have pain in your knee until a couple of days later, once the adrenaline has stopped pumping from the excitement of the accident. Its not unusual to have delayed onset of symptoms.
Other symptoms besides pain include:
- Knee swelling
- Feeling your knee giving way when you put weight on it
- Difficulty straightening your knee fully or feeling it catch in a certain spot
- Feeling as though your knee is locked in place when you try to move it
The catching and locking sensation in the knee is the result of a little fragment of tissue that can get caught in between your two weight-bearing leg bones. And that can also cause a sharp, stabbing pain.
Arthritic pain is usually a more stiff and achy type of discomfort.
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What Foods Help Heal A Torn Meniscus
7 Foods that Aid in Cartilage Reconstruction
- Legumes. It is critical to combat inflammation whenever feasible in order to maintain good joint function since inflammation is the major source of collagen breakdown and, therefore, cartilage deterioration. Oranges, Pomegranates, Green Tea, Brown Rice, Nuts, Brussels Sprouts, and other seasonal produce
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