What is a torn meniscus?
The ends of the three bones in the knee – the femur, tibia, and patella – are covered with cartilage (a smooth material that covers bone ends of a joint to cushion the bone and allow the joint to move easily without pain) that acts as a shock absorber. Between the bones of the knees are two crescent-shaped discs of connective tissue, called menisci, which also act as shock absorbers to cushion the lower part of the leg from the weight of the rest of the body.
Meniscus tears can occur during a rotating movement while bearing weight, such as when twisting the upper leg while the foot stays in one place during sports and other activities. Tears can be minor, with the meniscus staying connected to the knee, or major, with the meniscus barely attached to the knee by a cartilage thread.
What are the Symptoms of a Torn Meniscus?
The following are the most common symptoms of a torn meniscus. However, each individual may experience symptoms differently. Symptoms may include:
- pain, especially when holding the knee straight
- swelling and stiffness
- knee may click or lock
- knee may feel weak
The symptoms of a torn meniscus may resemble other medical conditions or problems. Always consult your physician for a diagnosis.
How is torn meniscus diagnosed?
In addition to a complete medical history and physical examination, diagnostic procedures for a torn meniscus may include the following:
- X-ray – a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
- magnetic resonance imaging (MRI) – a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body; can often determine damage or disease in a surrounding ligament or muscle.
- Computed tomography scan (Also called a CT or CAT scan.) – a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
- Arthroscopy – a minimally-invasive diagnostic and treatment procedure used for conditions of a joint. This procedure uses a small, lighted, optic tube (arthroscope) which is inserted into the joint through a small incision in the joint. Images of the inside of the joint are projected onto a screen; used to evaluate any degenerative and/or arthritic changes in the joint; to detect bone diseases and tumors; to determine the cause of bone pain and inflammation.
- Radionuclide bone scan – a nuclear imaging technique that uses a very small amount of radioactive material, which is injected into the patient’s bloodstream to be detected by a scanner. This test shows blood flow to the bone and cell activity within the bone.
What are Treatment for Options for a Torn Meniscus?
Specific treatment for a torn meniscus will be determined by your physician based on:
- your age, overall health, and medical history
- extent of the injury
- your tolerance for specific medications, procedures, and therapies
- expectation for the course of the injury
- your opinion or preference
Possible treatments include:
- Non-surgical treatments to reduce pain and swelling. These could include anti-inflammatory medication, knee braces or crutches, and rest, ice, compression, or elevation.
- Physical therapy to strengthen the leg muscles and restore movement to the knee joint.
- Meniscectomy to remove the damaged portion of the meniscus. This is often done arthroscopically, using cameras and surgical tools inserted into a tiny opening above the knee.
- Meniscus repair to suture the torn meniscus tear together or to use special anchors that connect the meniscus. This is also done using an arthroscope.
- Cartilage transplant is optimal for a patient whose meniscus is torn beyond repair. In this procedure, your surgeon replaces the torn meniscus with cartilage from a cadaver or with cartilage that has been created using the patient’s own cells.
What are the Risks of Surgery?
Meniscectomy is generally well tolerated and does not usually cause complications. But there is a risk of damaging the nerves during surgery.
There is a direct relationship between the amount of meniscus tissue that is surgically removed and the load distribution across the knee. If more tissue is removed, the knee is less able to sustain the load of walking, running, or other activities. With uneven load distribution, degeneration of the knee joint may happen at a faster pace than it would with an intact meniscus.
In any surgery, there is risk of infection or bleeding. And there are risks with general or regional anesthesia.
Rehabilitation (rehab) varies depending on the injury, the type of surgery, your orthopedic surgeon’s preference, and your age, health status, and activities. Time periods vary, but meniscus surgery is usually followed by a period of rest, walking, and selected exercises. Most people who have arthroscopic meniscectomy can bear weight a day or two after surgery and can return to full activity within 2 to 4 weeks. After the full range of motion without pain is possible, you can return to your previous activity level.
Meniscal tears are extremely common knee injuries. With proper diagnosis, treatment, and rehabilitation, patients often return to their pre-injury abilities.