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Torn Meniscus

A torn meniscus is one of the most common knee injuries. Any activity that causes a person to forcefully twist or rotate his/her knee, especially when putting the pressure of full weight on it, can lead to a torn meniscus. A torn meniscus causes pain, swelling and stiffness. A person might also have trouble fully extending the knee.

Each of the knees has two menisci which are C-shaped pieces of cartilage that act as a cushion between the shinbone and the thighbone. The knee is the largest joint in the body and endures the stresses placed on it from walking, running, climbing and bending. Cartilage within the knee joint helps protect that joint from those stresses. In other words, it protects the bones from wear and tear.

Meniscus tears are common in contact sports like football as well as noncontact sports like volleyball and soccer that include jumping and cutting. The injury can happen when a person changes direction suddenly while running. Meniscus tears often occur at the same time as other knee injuries like an anterior cruciate ligament (ACL) injury. Older active people and athletes are at particular risk for meniscus tears since the meniscus weakens with age. More than 40 percent of people 65 or older have meniscus tears. It’s important to note that many of these tears can occur without any obvious mechanism of injury.

Types of Meniscal Tears

As previously mentioned, there are many different types of meniscal tears. Degenerative meniscus tears occur as a result of wear and tear, often without obvious traumatic event. Symptoms from these tears may resolve without surgery.

Acute or traumatic meniscal tears result from injury and tend to remain bothersome. Traumatic meniscal tears are characterized by various shapes and sizes:

Radial tears are short tears that extend from the inner margin of the meniscus and go towards the periphery, or outer part, of the meniscus.

Horizontal cleavage tears are common, and extend through a big portion of the meniscus, creating nearly two C-shaped discs, sitting on top of one another. Horizontal cleavage tears usually occur in older individuals.

Bucket-handle tears are the largest of all meniscal tears. These are tears around the rim of the meniscus, causing the central portion (the bucket-handle) to displace into the joint.

Symptoms of a Meniscus Tear

  • Catching or locking of the knee
  • Inability to move the knee through its full range of motion
  • Pain (from the tear itself or from swelling and injury to the surrounding tissue)
  • Stiffness and swelling
  • The sensation of the knee “giving way”

However, symptoms of a meniscus tear depend on the size and location of the tear and whether other knee injuries accompanied the tear.

With small tears, there may be minimal pain and swelling. The symptoms from these tears usually subside in 2 weeks to 3 weeks, although pain may recur with bending or twisting.

In a typical moderate tear, pain may occur at the side or center of the knee, depending on the location of the tear. While a patient is able to walk, there is still swelling and stiffness. Symptoms may diminish in 1 week to 2 weeks but recur with activities that involve twisting or overuse. If left untreated, the pain may come and go over a period of years.

Larger tears cause more pain, swelling and stiffness. Pieces of the torn meniscus can float into the joint space, causing the knee to catch, pop or lock. The knee can also feel “wobbly” or unstable, or give way without warning. Other accompanying injuries, such as torn ligaments, may cause increased pain and swelling.

Diagnosis

Often, a torn meniscus can be identified during a physical exam. This occurs when a doctor may manipulate the knee into different positions to help pinpoint the cause of whatever symptoms a patient may be experiencing.

Imaging Tests

X-rays may be indicated to rule out knee problems that may have similar symptoms to a torn meniscus. However, X-rays are not able to determine a tear, since the meniscus is made of cartilage, which doesn’t show up on X-rays.

Ultrasound allows the doctor to examine the inner structure of the knee while in motion. This can help determine if there is a loose flap of cartilage getting caught between the moving parts in the knee.

Magnetic Resonance Imaging (MRI) MRI is an imaging method for diagnosing meniscal tears with a 70 to 90 percent accuracy rate. It can create detailed images of both hard and soft tissues within the knee and produces cross-sectional images of internal structures.

Arthroscopy

In some cases, arthroscopy can be used to determine the type and extent of the injury. This is done with an arthroscope to examine the inside of your knee. The device contains a light and a small camera, which transmits an enlarged image of the inside of the knee onto a monitor. It is inserted through a tiny incision near the knee. If necessary, surgical instruments can be inserted through the arthroscope or through additional small incisions in your knee.

Treatment of a Meniscus Tear

There are many factors to consider when deciding how to treat a torn meniscus. These include the location and extent of the tear, the patient’s level of pain and activity, the patient’s age and the age of the injury, and the advice of the doctor. The level of pre-existing arthritis plays an important role in this treatment decision as well.

Treatment options include:

  • Nonsurgical treatment with rest, ice, compression, elevation, and/or physical therapy
  • Surgical repair to sew the tear together
  • Partial meniscectomy, which is surgery to remove the torn section
  • Total meniscectomy, which is surgery to remove the entire meniscus

 

University Orthopaedic Associates Care for Meniscus Tears

At University Orthopaedic Associates, we are experts in all forms of orthopaedic care including surgery. This comprises the diagnosis and treatment of meniscus tears, both non-surgical and surgical. All of our surgeons are board certified and have extensive experience with patients of all ages and profiles, including active people and athletes as well as others who may experience meniscal tears.

Physical therapy for both non-surgical and surgical treatment of meniscus tears is conducted onsite at our Somerset and Wall Township facilities, offering excellent coordination between doctors and staff. This ensures the best possible results.

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