A meniscal tear is a common injury seen among athletes and people with active lifestyles caused by acute injuries. They can also occur in an aging knee with a lower level of trauma. Below Dr. Chris Inzerillo, sports medicine surgeon at Rothman Orthopaedic Institute, answers the most common questions asked about meniscal tears and treatment options.
What is the meniscus?
There are 2 menisci in each knee. They are “C” shaped rings of cartilage that sit in between the femur bone and the tibia bone. They act as shock absorbers in the knee, helping to cushion load that is transferred down the leg during standing, walking, and running.
How does the meniscus get injured?
The most common way the meniscus gets injured is when the knee twists and the meniscus gets caught in between the two bones and a piece of it tears off. The meniscus can also degenerate with age, and can tear with minimal trauma in an older patient
Can I prevent a meniscal injury?
The meniscus is involved with every step a patient takes, so it is frequently at risk, however there are certain activities that can be minimized or avoided:
- minimize squatting and deep knee bends;
- keep body weight to a healthy level; and
- minimize activities that require the knee to twist frequently.
What are the symptoms of a meniscal tear?
The most common symptom of a meniscal tear is pain along the side of the knee. For a medial meniscal tear, it would be along the inside of a knee (more common), and for a lateral meniscal tear, the pain would be along the outside of the knee. Pain would be worse with twisting or deep knee bending. Patients can also complain of locking, catching, popping or clicking in the same area of the knee. In certain types of tears called bucket handle tears, the meniscus can flip into the middle of the knee and cause the knee to lock up. This is a more urgent problem that requires prompt attention
How is a meniscal tear diagnosed?
The majority of patients can be diagnosed with a detailed history, physical exam and diagnostic imaging (usually MRI).Evaluation by a physician trained in musculoskeletal medicine is often necessary so that prompt diagnosis and treatment can be offered in the same clinical setting.
How do I treat my meniscal tear?
Upon first diagnosis of the tear, treatment is based upon the severity of pain and mechanical symptoms. For a patient with mild sporadic pain, the tear may be treated with a combination of rest, anti-inflammatory medicine, physical therapy, or a steroid injection.For some patients, this may be enough to control or eliminate the pain.For patients that continue to have significant pain, or symptoms that limiting their activities, surgery is recommended. This is performed arthroscopically (with a small camera) through a series of little holes around the knee, and the tear can either be repaired with sutures, or the torn part can be removed.Thankfully advanced surgical techniques, such as arthroscopy, have reduced post-operative pain, lessened scar tissue formation, and achieved high success rates.
What is the difference between a meniscal repair vs debridement?
Whether a meniscus is repaired (sew together) or debrided (trimmed) depends on several factors such as patient age, location of tear, geometry of tear, how long the tear has been there, and whether the knee has significant arthritis or not.Both treatments have advantages and disadvantages.Although a preoperative plan will be discussed, it is often determined at the time of surgery whether the meniscus is repaired or debrided.
I think I may have a meniscal tear, what’s my next step?
Make an appointment with one of our fellowship trained sports medicine surgeons! At Rothman Orthopaedics we don’t employ a one size fits all approach. Your treatment will be specifically designed for you circumstances (duration of symptoms, activity level, and your specific tear). For instance, not everyone with the same meniscal tear is treated the same way. We listen to our patients, go over their imaging in detail with them, and employ shared decision making where we come up with the best treatment plan together.
Dr. Inzerillo specializes in sports medicine and shoulder surgery with special expertise in shoulder, knee, and hip arthroscopy and reconstructive procedures.