Meniscus Tears
As I mentioned in my last blog, I am going to discuss various types of knee injuries in the coming weeks. This week’s focus is on meniscus tears.
Meniscus Cartilage: The meniscus is a soft, “rubbery”, shocking absorbing cartilage disk between the thigh bone (femur) and the leg bone (tibia). There is a medial (inner) and lateral (outer) meniscus in each knee.
Articular Cartilage: Articular cartilage is the white, hard, smooth material at the ends of bones. Because it is normally very smooth the joint is able to freely glide with movement. Along with the menisci, articular cartilage also protects the joint. With injury, normal aging or rheumatalogical diseases, the cartilage can be worn away leaving bone on bone within the joint.
Meniscus Tears: Meniscus tears are very common injuries that occur from twisting, squatting or hyperextension of the knee. Meniscus tears can occur alone or in combination with ligament injuries. As one ages, the meniscus loses water content and becomes less “rubbery” and can tear with little effort.
Meniscus tears usually cause swelling, catching, giving-way and pain. Unfortunately most meniscus tears do not heal and are likely to get large in size with activity. Medications and injections can help to alleviate pain while arthroscopic surgery is needed to remove or repair the torn meniscus.
How Does Doctor Diagnose the Problem?
Knee Specialist: Although general orthopedic surgeons can diagnose and treat cartilage problems, a surgeon with fellowship training in sports medicine and arthroscopy is best able to offer the best treatment options including the latest available technology.
Office Visit: During the office visit, your knee specialist will ask about your symptoms and any injuries that occurred. He will then carefully examine the knee for a variety of different conditions. In most cases these two steps can provide the surgeon with a very good idea of your diagnosis. X-rays will also be performed. Although meniscus tears are not visible on x-rays, the x-ray can provide important information regarding arthritis.
MRI: If a meniscus tear is suspected an MRI might be ordered. An MRI can identify meniscus tears and cartilage damage but only arthroscopy can accurately determine the extent of damage and simultaneously provide treatment.
Treatment of Cartilage Problems
Removal of Torn Meniscus: Most meniscus tears do not heal without surgical treatment. However, some small tears or incomplete tears may stop hurting and not require surgery in the short-term. Repeat injury could cause the tear to become larger and ultimately require surgery. Meniscal tears can be treated with arthroscopic surgery through two small skin punctures. After surgery patients are permitted to fully move the knee and walk. Most patients do not even use crutches. Most patients require a few visits of physical therapy to regain strength and function.
Tears in the outer 1/3 have healing potential and can be repaired. These tears are much less common and usually occur with a sudden injury in young people. After meniscus repair surgery, a brace and crutches are required. Physical therapy is required for all patients. Return to twisting, pivoting, jumping and sports activities is usually permitted at 4-6 months.
As with most orthopedic injuries, early diagnosis and treatment customized for the individual patient leads to the best outcomes.
Vic Goradia, MD
Sports Medicine Specialist
Go Orthopedics
