There are two menisci in each knee, one on the inner side (medial) and one on the outer side (lateral). Each knee has two menisci. A meniscal tear is a common knee injury that occurs when the cartilage is damaged by a sudden twist, a direct blow, or wear and tear over time. It is possible for meniscal tears to cause pain, swelling, stiffness, and instability in the knee. Furthermore, they can increase your chances of developing osteoarthritis.
Different factors can lead to meniscal tears, depending on the person's age and level of activity. Some of the most common causes are:
Usually, meniscal tears occur during sports involving sudden changes of direction, pivoting, or contact, such as soccer, basketball, football, or skiing. The tear usually occurs when the knee is bent and twisted while the foot is planted.
As people get older, their menisci become thinner, weaker, and more brittle. This makes them more prone to tearing from minor movements, such as squatting, kneeling, or stepping on an uneven surface. Arthritis in the knee is also linked to degenerative meniscal tears.
Meniscal tears can also be caused by obesity, previous knee injuries, genetics, and certain occupations that place stress on the knees.
Symptoms of a meniscal tear may vary depending on the type, location, and severity of the tear.
Knee pain, especially when twisting, bending, or straightening
Injuries usually cause swelling and stiffness in the knee within a few hours or days
Knee locking or difficulty moving the knee
Buckling or giving way of the knee
Knee popping or clicking
Knee range of motion is reduced
Doctors will ask about the history of the injury, the symptoms, and the activities that worsen the pain in order to diagnose a meniscal tear. In addition to examining the knee, the doctor will conduct some tests to evaluate its stability, mobility, and strength. Some of these tests include:
In the McMurray test, the doctor bends and rotates the knee while applying pressure to the joint. If there is a clicking or popping sound, there may be a meniscal tear.
A doctor will press down on the heel and rotate the lower leg while bending the knee at 90 degrees. Pain or resistance may indicate a meniscal tear.
During the Thessaly test, the doctor will ask the patient to stand on one leg and twist the knee while keeping the foot flat on the ground. Instability or pain may indicate a torn meniscus.
Some imaging tests may also be ordered by your doctor to confirm the diagnosis and rule out other possible causes of knee pain, such as fractures, ligament injuries, or arthritis.
A knee X-ray can show the bones of the knee and detect fractures or signs of arthritis, but it cannot show soft tissues like the menisci, ligaments, and tendons.
Meniscal tears can be diagnosed with an MRI by looking at the soft tissues of the knee and detecting any damage to the menisci, ligaments, or tendons.
A minimally invasive procedure called arthroscopy involves inserting a camera and instruments through tiny incisions in the knee. The camera allows the doctor to see the inside of the knee joint and assess its condition. If necessary, the doctor can repair or remove the torn meniscus with the instruments.
Meniscal tears are treated based on their type, location, severity, age, activity level, and preferences. Some of the treatment options include:
Meniscal tears that do not cause significant symptoms or interfere with daily activities are usually treated nonsurgically. Nonsurgical treatment may include:
Resting the knee and avoiding activities that cause pain or stress can help the healing process.
Pain and swelling can be reduced by applying ice to the knee for 15 to 20 minutes several times a day.
The knee can be supported and stabilized by wrapping it with an elastic bandage or wearing a knee brace.
Blood circulation can be improved by elevating the leg above the level of the heart.
Taking over-the-counter pain relievers, such as ibuprofen or naproxen, can help ease pain and inflammation. However, these medications should be used with caution as they may interact with other medications and cause side effects.
The doctor may inject a corticosteroid or hyaluronic acid into the knee joint to reduce inflammation and lubricate the joint in some cases. The injections, however, do not cure meniscal tears and may cause infection, bleeding, or nerve damage as side effects or complications.
An individualized exercise program can be designed by a physical therapist to strengthen the muscles around the knee as well as improve the joint's range of motion and function.
If a large, unstable, or symptomatic meniscal tear does not respond to nonsurgical treatment or interferes with daily activities, surgery may be considered. During surgery, the goal is to preserve as much of the healthy meniscus as possible and restore knee function and stability. It all depends on the type, location, and severity of the tear, as well as the individual's age, activity level, and preferences. Surgical options include:
The most common surgery for meniscal tears is partial meniscectomy. An arthroscopic operation is performed, in which a small incision is made into the knee to trim or remove the torn or damaged meniscus. Depending on the extent of the surgery and the rehabilitation program, recovery time is usually four to six weeks.
Meniscus repair: A meniscus repair involves stitching or suturing together the torn edges of the meniscus. The procedure is usually performed arthroscopically, but sometimes a large incision is required. As the person must limit weight-bearing and movement for several weeks to allow the meniscus to heal, the recovery time is usually longer than a partial meniscectomy. Meniscus repair success depends on several factors, including the type, location, size, and age of the tear, as well as the person's health and compliance with rehabilitation.
In a meniscus transplant, a damaged meniscus is replaced with a donor meniscus. A total meniscectomy or major meniscectomy is usually performed if a person has lost most of their meniscus due to injury or degeneration. An extensive rehabilitation program and longer recovery time are required after the surgery because it is done through a larger incision in the knee. The success rate of meniscus transplant depends on several factors, including the availability and quality of donor meniscus, the compatibility and alignment of the transplant, the patient's age and activity level, and the presence of other knee problems, such as arthritis or ligament injuries.
Despite the fact that meniscal tears cannot be completely prevented, there are a few steps that can be taken to reduce the risk of injury and protect the knee.
Before and after physical activity, warm up and stretch
Sports footwear and protective gear should be worn
Keep your knees from twisting and turning suddenly
Knees should not be subjected to excessive or repetitive stress
Eating a balanced diet and maintaining a healthy weight
Strengthening the muscles around the knee and improving its flexibility and stability
After surgery or injury to the knee, follow the doctor's advice and the rehabilitation program
