What Is The Meniscus In The Knee

What Do Doctors Do

If you see a doctor about pain in your knee, he or she will ask how you injured it and what it feels like. The doc will also review your medical history to see if the pain might be caused by something other than a torn meniscus.

The doctor will examine your knee to see if you have any tenderness in the area where your meniscus sits. To see;if pain is caused by a meniscus tear, a doctor might ask you to squat. The doctor might also bend, straighten, and rotate your knee.

The doctor also might order an X-ray to check for other conditions that can cause knee pain or a magnetic resonance imaging scan to get a better look at the soft tissue of your knee. X-rays and MRIs are the best way to “look” inside the knee without doing surgery.

Treatments For A Meniscus Tear Or Strain

Treatments for a meniscus tear or strain depend on the severity of the tear or strain, the location of the tear and your age and activity level. In many cases, patients can recover with resting, icing, compressing and elevating the injured area.

You may also need physical therapy and rehabilitation to help you regain as much strength and flexibility in the knee as possible.

Work with your physical therapist to determine the best program that will allow you to reach your rehab goals at your pace.

If your symptoms do not resolve with nonsurgical treatment options, surgery may be necessary. Your orthopedic surgeon will determine what type of surgery is needed based on the size of the tear, the location of the tear, your age and activity level as well your surgeons experience.

• Arthroscopic surgery a small hole is created to allow for a camera to provide a clear view of the inside of the knee, the surgeon will insert surgical instruments into the hole and will repair the tear.
• Partial meniscectomy removal of unstable meniscal fragments and smoothing of the remaining meniscus edges to ensure there are no frayed ends.
• Total meniscetomy the entire meniscus is removed surgically

What Is A Meniscal Root Avulsion

Occasionally people can rip the meniscus off the bone where it attaches. The injury mechanism is no different to other meniscal tears, but the resulting pain and loss of function is severe. There is often significant posterior knee pain and difficulty with weight bearing. Swelling may not be significant. Occasionally these can be repaired through a specific surgical technique. If it cannot be repaired and there is underlying osteoarthritis present, the injury can be devastating. This is then managed as a severely painful osteoarthritic knee and can result in a total knee replacement if non-operative treatments are unsuccessful.

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What Is Meniscus Tear

The meniscus is a piece of cartilage that provides a cushion between your female thorn and the tibia shinbone. There are two menisci in each knee joint. They can be damaged or ruptured during activities that put pressure on or around the knee joint. Taking a hard step on the football field or a sudden pivot on a hockey field can cause meniscus tears. Depending on the severity of your injury, treatment options may vary from home remedies to outpatient surgery. You can help prevent this injury by doing exercises that will strengthen your leg muscles and use proper techniques during communication activities or sports.

You have one meniscus on each side of your knee the middle meniscus inward and the posterior meniscus outward. Your menisci act as shock absorbers, absorbing the effect of your upper leg on your lower leg. It also helps to relax your knees as well as keep the movement of your knee soft. Meniscus tears are among the most common knee injuries. Athletes, especially those who play communication games, are at risk of meniscus tears. However, anyone at any age can break the meniscus. When people talk about on the knee, they usually refer to a ruptured meniscus.

Symptoms of meniscus tear

After an injury, joint pain in the knee may subside and feel normal when the initial inflammatory response resolves. However, other symptoms may occur over time and may include any or all of the following:

Is A Torn Meniscus A Permanent Injury

Permanence of menisci injuries depend on where theyre located.

• Single-trauma injuries to the outer third can heal because it has sufficient blood supply.
• The inner third , however, will not because of the lack of circulation.
• The middle third zone can heal but it might not fully recover or take a while longer.

Damage to the inner and middle thirds of the meniscus may require surgery to reduce joint pain and swelling. Surgical options include repair or removal of all or part of the cartilage .

Degenerative meniscus tears also wont heal naturally and may develop into arthritis with age. If youre unsure, I highly recommend seeking a professionals medical advice.

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What Is The Meniscus Tear Recovery Time Without Surgery

As you aim to heal your meniscus naturally, it may be necessary to reduce sport activities or intense plyometrics that place your knee in unstable positions. This could take anywhere from 48; weeks depending on the severity and position of the tear.

During the healing process, your pain and stiffness should decrease along with any catching feeling within the joint. I recommend that you stick with the above exercises daily.

It is also important as you improve to incorporate other strengthening exercises into your routine. Try starting with some light pool exercises or begin incorporating more closed-chain exercises like in this bodyweight strengthening workout.;

What Are Recommended Exercises Once A Torn Meniscus Has Been Repaired

Rehabilitation after an operation depends upon the individual patient and the response to surgery. Specific recommendations regarding weight-bearing and exercises will be customized for the patient by the surgeon and therapist.

Usually, the goal is to return the knee to normal function within four to six weeks.

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How Is A Meniscal Tear Diagnosed

Meniscal tears are quite straightforward to diagnose. Clinical assessment has been shown to be around 80% accurate for diagnosis of meniscus tears. Your physiotherapist will carry out specific clinical tests to assess for tenderness on the joint line , your range of movement, the amount of swelling in your joint and the stability of your knee. There is a specific meniscal test called the McMurrays test that your physiotherapist may additionally carry out to help establish your diagnosis.If we are unsure of your diagnosis or we would like to understand more about the extent and type of the meniscal tear then we may refer you for an MRI scan. MRI scans are also very useful to assess for any other contributing factors such as an associated ligament tear. We can refer you directly without going to your GP.

At Complete Physio our highly experienced physiotherapists will comprehensively assess your knee joint using a series of clinical tests.Some of our clinicians are also fully qualified musculoskeletal sonographers and will carry out a diagnostic ultrasound scan of your knee.

There is no extra charge for an ultrasound scan.

Research has shown an increased risk of early onset of arthritis after damaging your meniscus and therefore an accurate diagnosis and appropriate treatment is paramount to a positive outcome .

How Do You Treat A Torn Meniscus

Gaining a correct diagnosis is of paramount importance and is the first stage of getting back on the road to recovery. Your age, mechanism of injury, location, type and size of tear will influence which treatment is required. But it is not as simple as this, as patients can present very differently with the same injury.

At Complete Physio each patient is treated as an individual. Following a comprehensive assessment your physiotherapist will present the best treatment options available to you. Most clients we see with a meniscal tear do improve with a course of physiotherapy, surgery is rare.The best solution for you will vary depending on your own individual circumstances. For example, a professional footballer is more likely to have surgery than a sedentary individual or recreational runner, as they do not have the time to wait and see whether it heals and/or the pain resolves.

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What Is A Meniscus

Have you ever wondered what makes up your knee joint? The knee is made up of the femur, tibia, and patella. Many ligamentous structures play a crucial role in providing stability of the knee joint, but there is an important piece of cartilage that sits right in the middle of it all.;

The quick answer is the meniscus is a C-shaped piece of soft and fibrous cartilage, also known as fibrocartilage, that provides shock absorption and cushion to your knee. It is also wedge-shaped which improves joint congruency, further adding to knee stability.

When Should I See My Healthcare Provider

Your healthcare provider will tell you when to schedule an appointment for follow-up. But you should call if you develop:

• Fever higher than 101 degrees Fahrenheit.
• Lots of drainage on the dressing.
• Pain or swelling that is not relieved by resting or elevating the leg.
• Pus or foul-smelling drainage from any incisions.
• Trouble breathing.

A note from Cleveland Clinic

Meniscus surgery can fix an injured or torn meniscus, a piece of cartilage in the knee joint. Talk to your healthcare professional if you have knee pain that interferes with your life, work or activities. An arthroscopic procedure can reduce pain, improve mobility and stability, and help you return to activities.

Last reviewed by a Cleveland Clinic medical professional on 04/17/2021.

References

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How To Treat Meniscus Tears In Physical Therapy:

Management of the swelling is the first step in any physical therapy program. Aggressive icing , compression and elevation along with rest are prescribed in the days following a meniscus tear and are utilized until swelling subsides. High dose fish oil is also recommended as a way to control inflammation.

We then work on restoring normal motion and strength to the muscles around the knee with meniscus tear.;In the photo to the left, the patient is working on full hyperextension of the knee. The full hyperextension is also called full straightening. Hyperextension is essential for normal function of the knee and takes a load off of your healing meniscus. Your physical therapist will also provide hands on stretches to the knee to ensure the shin bone and thigh bone are moving correctly. Once full hyperextension and motion is restored at the knee, your physical therapist will work on muscle building. Quadriceps, calf and hamstring exercises are commonly prescribed to help you heal from a torn meniscus. Typically exercises start in a non-weight bearing position and progress to standing.

Functional retraining is another key part of the physical therapy program to help you heal from a meniscus tear. Your physical therapist will make sure you stand, walk and can do functional activities like stairs, jog, and cutting/twisting motions safely before you complete PT.

What Are Causes Of Posterior Horn Medial Meniscus Tears

There are multiple different injuries that can cause tears of the posterior horn of the medial meniscus. One of the most common causes is when one tears their ACL, the knee continues to slide forward and secondarily tears the posterior horn of the medial meniscus. Deep knee flexion also places significant stress on the posterior horn of the meniscus and can result in a posterior horn meniscus radial tear, peripheral tear, or root tear. In addition, because the medial meniscus does have significant stress at the posterior horn, as one ages, degenerative tears of the posterior horn of the medial meniscus can occur due to these wear and tear changes.

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What Is A Posterior Horn Root Tear Of The Medial Meniscus

The posterior horn of the medial meniscus attaches to bone close to the center of the knee and just above the PCL.;;This attachment site is called the root. Tears of the root can cause the meniscus to slip out of the joint, also called extrusion, which can significantly overload the cartilage. It has been reported that a medial meniscus root tear is equivalent to having the whole meniscus taken out, so having a medial meniscus root tear diagnosed quickly and treated soon is imperative to prevent the development of arthritis. If one already has significant arthritis, then it may not be worth having a repair and a program of rehabilitation may be indicated.

When Should Prp Be Used For A Posterior Horn Medial Meniscus Tear

It does not appear that any of the biologic treatments that are currently available will result in a larger or complex meniscus tear to heal. Therefore, the main time to use PRP with a posterior horn medial meniscus tear would be at the time of surgery. After suturing, injection of PRP in the joint may potentially provide further biologic augmentation to increase the chances of the tear healing.

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Rehabilitation And Return To Play

If the tear is minor and the pain and other symptoms cease, a muscle-strengthening program may be recommended.; A large tear produces a flap of meniscus that may interfere with normal joint mechanics. The torn flap of meniscus can cause further damage leading to greater risk of degenerative arthritis. Due to the nature of the tear that the menisci can suffer, repair of the meniscus can be a complicated issue.

A meniscal tear that is symptomatic may need to be addressed surgically. If so, this is now done by arthroscopic surgery which allows the surgeon to remove the flap and; smooth off the surface of the meniscus, or if possible repair the torn meniscus. This will leave normal structures and decrease the likelihood of degenerative arthritic changes.

The major goal of the rehabilitation program is to normalise walking, normalise pain-free range of motion, prevent muscle wastage and maintain cardiovascular fitness.; Rehabilitation after meniscus surgery should focus on early mobilisation of the knee joint and quadriceps and hamstring strength. Weight bearing exercises should be added as directed by a sports medicine professional. Regardless of the form of surgery, rehabilitation usually includes walking, bending the legs, and doing exercises that stretch and build the leg muscles.

What Is Meniscus Surgery Recovery Like

The recovery time for meniscus surgery depends on the type of surgery you had. It takes longer for a meniscus repair to heal than a meniscectomy. Full recovery from meniscus surgery can take anywhere from six weeks to three months. Your care after surgery may involve:

• Crutches to take stress off the knee as it heals.
• Knee brace to stabilize the joint as you recover.
• Pain medications.
• Rehabilitation exercises at home to restore mobility, range of motion and strength.
• RICE .

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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.

Can A Meniscus Tear Heal On Its Own

Yes, but heres the thing: A meniscus tear will heal only if the tear is located at the part of the meniscus with blood supply .

Luckily, only 19% of the meniscus tears happen in the part with no circulation , so most tears can heal naturally to some degree.

Degenerative meniscus tears also cant heal on their own.

For the types of tears that wont naturally heal, ask your doctor to provide medical advice.

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Always Consult A Trained Professional

The information above is general in nature and is only intended to provide a summary of the subject matter covered. It is not a substitute for medical advice and you should always consult a trained professional; practising in the area of sports medicine in relation to any injury. You use or rely on the information above at your own risk and no party involved in the production of this resource accepts any responsibility for the information contained within it or your use of that information.

Treatment For A Meniscus Tear

Specific treatment for a meniscus tear will be determined by your doctor based on:

• Your age

• 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

• Arthroscopic surgery

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What Is A Meniscus Tear Or Strain

A meniscus tear or strain occurs when the meniscus is injured. Menisci are designed to help keep the knee steady and balance weight across the knee; therefore, when the meniscus is torn, it can prevent the knee from functioning properly.

Meniscus tears are a common injury to the knee. Meniscus tears are categorized as mild, moderate or severe.