What is a meniscus?
The meniscus is a disc of cartilage in a circular shape. There are 2 menisci in each knee, one on the inside of the knee and the other on the outside.
What does a meniscus do?
The meniscus functions to provide knee stability and acts as a shock absorber in all weight-bearing activities. All knee movement create great forces. The meniscus absorbs these forces to thwart wear and tear on the knee joint. This is important because wear and tear on the knee joint destroys the cartilage and results in arthritis.
What is a meniscus tear?
A meniscus tear is a tear in the cartilage.
What activity can cause a meniscus tear?
Meniscus tears are common sports injuries, caused by trauma. Any high impact sport where the knee is twisted, there is sudden stopping or a fall during play, can result in a meniscus tear.
Meniscus tears are also common in children who play sports.
Sports where meniscal tears occur:
- Any sport where the knee suffers impact on the side or front
- Sports that involve pivoting and sudden change in direction, as in soccer, basketball and football
- Sports that cause excessive force on the knee such as squatting on an uneven surface, or rapid stepping during trail running or an awkward fall in lacrosse
- Sports like basketball involving running, jumping and sudden change in direction
As we age, age-related degenerative changes in the cartilage, and the cartilage simply wears out. Then, even simple activities, like gardening, can cause a tear.
Meniscus tears often accompany other knee injuries, including ACL tears.
What happens when a meniscus is damaged?
When a meniscus is damaged the normal shock and impact forces that it absorbed, are instead displaced on to the articular cartilage that covers the ends of the femur (thigh bone) and the tibia (shin bone). Over time, the articular cartilage will break down, cause bone on bone pain and result in knee arthritis.
What are the symptoms of a torn meniscus?
- Pain is the most predominant symptom. The pain presents as a stabbing sensation on the inside or outside of the knee. It may also present as an ache or stiffness in the knee
- Tenderness along the knee joint that makes it painful and difficult to squat
- The knee swells and locks in place. This makes it impossible to straighten the knee, or creates the sensation that the knee will buckle
- If a piece of the meniscus breaks off and drifts into the joint, there will be a popping sensation, slipping or locking of the knee
Can a meniscus tear heal without surgery?
This depends on several factors including where it is torn, the size of the tear, the shape of the tear, and the cause of the tear.
Self- repair requires that the damaged meniscus has a blood supply, in order to heal itself.
Thus, tears on the outer rim can potentially heal because the outer rim is close to a blood supply. But tears on the inner aspect of the meniscus generally have no ability to self-repair.
Many degenerative tears can be managed without surgery. But where there is significant pain, and instability that affects quality of life, surgery will be recommended.
How is a meniscus tear diagnosed?
Your orthopedic surgeon at SCOS will diagnose your condition based on a description of the injury, and an MRI.
What are the treatment options?
Treatment options depend on the severity of the injury, the patient’s age and physical activity, and quality of life.
- Nonsurgical treatment. RICE and OTC pain medications
- Physical Therapy. Some small tears may respond to physical therapy. While the meniscus is a shock absorber, if the muscles around the knee are strengthened, this will reduce stresses on the knee. Your SCOS orthopedic surgeon may recommend physical therapy in some situations, before contemplating surgery. In some situations, successful knee rehabilitation can eliminate the need for surgery. When that is not the case, pre-operative physical therapy can prepare the patient for better post-op recovery
- Arthroscopic surgery may be recommended if nonsurgical treatments fail to eliminate symptoms. It is generally outpatient surgery
The procedure uses a fiber-optic camera that is inserted through a small incision in order for the surgeon to visualize the damage. Repair can be accomplished with miniature surgical instruments can trim (meniscectomy) or repair the tear.
Repair is often recommended to save as much of the meniscus as possible to retain its shock absorption capabilities, and decrease the risk of post- injury degenerative arthritis.
Meniscus tears in children are significant because of the importance of the healthy knee, so meniscus repair and preservation are essential.
When you or a loved one is suffering with pain, swelling, stiffness, clicking and popping of the knee, contact South County Orthopedic Specialists with offices in Irvine, Laguna Woods, and Fountain Valley.
Our sports medicine and knee specialists, Dr. Scott Graham, Dr. Chris Veneziano and Dr. Nimish Kadakia are experts at evaluating and treating meniscus tears. Over the years, they have provided care to thousands of athletes and active individuals, getting them back to play and back to their pre-injury activities.
