Meniscus Tear

What is a meniscus?

There are two menisci in your knee; each rests between the thigh bone (femur) and shin bone (tibia). The menisci are made of tough cartilage and conform to the surfaces of the bones upon which they rest.

These meniscus functions to distribute your body weight across the knee joint. Without the meniscus present, the weight of your body would be unevenly applied to the bones in your legs (the femur and tibia). This uneven weight distribution would cause excessive forces in specific areas of bone leading to early arthritis of knee joint.

Therefore, the function of the meniscus is critical to the health of your knee.

What happens with a meniscus tear (torn cartilage)?

The two most common causes of a meniscus tear are due to traumatic injury (often seen in athletes) and degenerative processes (seen in older patients who have more brittle cartilage). The most common mechanism of a traumatic meniscus tear occurs when the knee joint is bent and the knee is then twisted.

It is not uncommon for the meniscus tear to occur along with injuries to the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL)-these three problems occurring together are known as the "unhappy triad," which is seen in sports such as football when the player is hit on the outside of the knee.

What are the symptoms of a meniscus tear?

Individuals who experience a meniscus tear usually experience pain and swelling as their primary symptoms. Another common complaint is joint locking, or the inability to completely straighten the joint. This is due to a piece of the torn cartilage physically impinging the joint mechanism of the knee.

How is the diagnosis of a meniscus tear made?

Any patient who has knee pain will be evaluated for a possible meniscus tear. Specific tests can be performed by your doctor to detect meniscus tears.

What treatments are available for a meniscus tear (torn cartilage)?

Almost any knee injury can initially be treated acutely with ice packs, rest, and immobilization. These simple measures will help to decrease swelling and pain in the joint.

Your physician can use information about how the injury occurred and physical examination tests to determine the likelihood of a meniscus tear.

Is surgery necessary for meniscus tears?

Many people live normal lives despite having a meniscus tear. It is only when the meniscus tear becomes symptomatic, and interferes with activities, that surgery to treat the meniscus tear should be considered.

There are generally two surgical options for treating a meniscus tear:

• Meniscus Repair
  A meniscus repair is a surgical procedure done to repair the damaged meniscus. This procedure can restore the normal anatomy of the knee, and has a better long-term prognosis when successful
• Meniscectomy
  A meniscectomy is a procedure to remove the torn portion of the meniscus. This procedure is far more commonly performed than a meniscus repair.

What is the prognosis after having sustained a meniscus tear (torn cartilage)?

With a meniscus tear (torn cartilage) in your knee, the shock absorbing capacity of the joint is threatened. Because of this, there is an increased risk of developing damage to the articular cartilage surface of the knee joint bones; this is commonly referred to as knee arthritis. Loss of the meniscus places more of a burden on the cartilage surfaces of the joint and they are more likely to develop arthritic changes. Therefore, any lifestyle changes to decrease your risk of developing arthritis can improve the prognosis after having sustained a meniscus tear. For example, weight loss, low-impact exercise, and prevention of further trauma to the joint will all improve the long-term prognosis.

If a meniscus repair is possible, the long-term prognosis, especially in younger patients, is improved due to restoration of the normal knee anatomy. However, as mentioned previously, a meniscus repair may not be possible in many patients with torn cartilage.

Arthroscopic knee surgery to remove torn cartilage

A partial meniscectomy is a surgical procedure that is performed to remove a piece of torn cartilage in the knee joint. Through one small incision (about 1 centimeter) a small camera, about the size of a pencil, is inserted into the joint. Then using one or more other small incisions, your surgeon places other instruments inside the knee to remove the torn cartilage.

Is arthroscopic knee surgery painful?

There is usually minimal pain associated with arthroscopic knee surgery. An anesthesiologist will be with you for the entire procedure to ensure you are comfortable. Following the procedure you will be given instructions on what type of medication to take if you experience discomfort. Icing the area is helpful for the first few days after surgery, as is keeping the knee elevated.

Do I need crutches after surgery?

For most arthroscopic knee procedures, crutches are given only for comfort. Once you feel steady on your feet, you can get rid of the crutches. However, there are some procedures, such as ACL reconstruction and meniscus repair, that may require longer use of crutches. Always check with your doctor before discontinuing crutch use.

When can I return to normal activities?

Patients who are undergoing arthroscopic knee surgery for treatment of a cartilage tear can usually return to normal activities quite quickly. Most patients take a few days or a long weekend off work. If the meniscus is removed (partial meniscectomy) then there are usually few activity restrictions. Patients can walk and move normally, so long as they don't have pain. Always check with your doctor before returning to high impact activities.

 

ACL reconstruction

< Back