Pikes Peak Orthopaedic Surgery and Sports Medicine

2925 Professional Place STE 110, Colorado Springs, 80904   |  P. 719-445-0344   |  F. 719-445-0357   |   Email Us

 

P. 719-445-0344     |    Email Us

Meniscus Tears

The meniscus is a small, “C-shaped” piece of cartilage in the knee. Each knee consists of two menisci, medial meniscus on the inner aspect of the knee, and the lateral meniscus on the outer aspect of the knee. The medial and lateral meniscus act as cushion between the thigh bone (femur) and shin bone (tibia). The meniscus has no direct blood supply, and for that reason, when there is an injury to the meniscus, healing cannot take place. The meniscus acts like a “shock absorber” in the knee joint.

Meniscal tears often occur during sports. These tears are usually caused by twisting motion or over flexing of the knee joint. Athletes who play sports such as football, tennis and basketball are at a higher risk of developing meniscal tears. They often occur along with injuries to the anterior cruciate ligament (ACL), a ligament that crosses from the femur (thigh bone) to the tibia (shin bone).

Various types of meniscal tears that can occur are longitudinal, bucket handle, flap, parrot-beak and mixed or complex.

Symptoms

The symptoms of a meniscal tear include:

  • Knee pain when walking
  • A “popping “or “clicking” may be felt at the time of injury
  • Tenderness when pressing on the meniscus
  • Swelling of the knee
  • Limited motion of the knee joint
  • Joint locking can occur if the torn cartilage gets caught between the femur and tibia preventing straightening of the knee

Diagnosis

A careful medical history and physical examination can help diagnose meniscal injury. The McMurray test is one of the important tests for diagnosing meniscal tears. During this test, your doctor will bend the knee, then straighten and rotate it in and out. This creates pressure on the torn meniscus. Pain or a click during this test may suggest a meniscal tear. Your doctor may order imaging tests such as knee joint X-ray and knee MRI to help confirm the diagnosis.

Treatment

The treatment depends on the type, size and location of tear as well age and activity level. If the tear is small with damage in only the outer edge of the meniscus, nonsurgical treatment may be sufficient. However, if the symptoms do not resolve with nonsurgical treatment, surgical treatment may be recommended.

Nonsurgical Treatment

  • Rest: Avoid activities that may cause injury. Your may need to use crutches temporarily to limit weight bearing.
  • Ice: Ice application to reduce swelling
  • Pain medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce swelling and pain
  • Physical Therapy: Physical therapy may be recommended for muscle and joint strengthening

If the symptoms are persisting and conservative treatment fails, you may need a and arthroscopic knee surgery to repair the torn meniscus.

Surgical Treatment

Knee arthroscopy is the commonly recommended surgical procedure for meniscal tears. The surgical treatment options include meniscus removal (meniscectomy), meniscus repair, and meniscus replacement. Surgery can be performed using arthroscopy where a tiny camera will be inserted through a tiny incision which enables the surgeon to view inside of your knee on a large screen, and through other tiny incisions, surgery will be performed. During meniscectomy, small instruments called shavers or scissors may be used to remove the torn meniscus. In arthroscopic meniscus repair, the torn meniscus will be pinned or sutured depending on the extent of tear.

Meniscus replacement or transplantation involves replacement of torn cartilage with the cartilage obtained from a donor or a cultured patch obtained from laboratory. It is considered as a treatment option to relieve knee pain in patients who have undergone meniscectomy.

Discoid Mensicus

Injury to the meniscus or a tear is usually caused by an injury, or a rare case of congenital abnormality called a discoid meniscus, which results in knee pain.

The discoid meniscus is more prone to injuries while performing twisting activities.