The meniscus (cartilage) is a structure within your knee that is commonly injured. The meniscus may tear in athletes who play contact sports or can also be injured with normal daily activities. Anyone at any age can tear a meniscus. When people talk about a cartilage tear, they are usually referring to a torn meniscus
Three bones meet to form your knee joint: your thighbone (femur), shinbone (tibia), and kneecap (patella). The meniscus lies on top of the tibia and acts as a shock absorber between your femur and tibia. The meniscus are two wedge-shaped pieces of cartilage between your femur and tibia. They are tough and rubbery to help cushion the joint and keep it stable. They are much thinner and fragile deeper into the knee, thus increasing their chance of becoming injured.
Meniscus tears happen during sports activities or during an awkward twist when standing up from sitting in a chair. Athletes may incur a direct contact to the knee, squat and twist the knee, or fall in an unexpected manner causing a tear. As you age, you are more likely to have degenerative meniscus tears. This is when the meniscus weakens and wears thin over time. As the tissue ages, it is more prone to tears. An awkward movement may be enough to cause a tear as the meniscus has weakened.
Injuries to the meniscus can happen by themselves or along with other knee injuries, such as anterior cruciate ligament tears or collateral ligament injuries
Menisci tear in different ways. They are classified by how they look, as well as where the tear occurs. The meniscus is thinner and more fragile deeper into the knee, so most of the tears occur in this region.
Following the injury, you may feel a "pop" or be unable to bend your knee. The knee many times becomes swollen and stiff. Some people are still able to walk on their injured knee, and some athletes are able to continue playing with a tear in their meniscus.
The most common symptoms of meniscus tear are:
During your first visit, be prepared to explain how you hurt your knee and how it feels since the injury. The more you can explain to your provider, the more they can understand your symptoms and medical history.
At your visit, your provider will perform a physical exam and evaluate all the structures of your knee. You will receive an x ray to determine if there are any fractures present. X ray can not detect meniscus injuries but can rule out bone problems.
Many meniscus injuries can be diagnosed with a thorough physical examination of the knee, but other tests, such as a Magnetic Resonance Imaging (MRI) scan may be ordered.
The MRI creates better images of soft tissues like the meniscus. These images allow the physician to determine if this injury requires non surgical or surgical treatment.
Treatment for a meniscus tear comes down to two options:
The location of the tear, type of the tear and your age will determine if the treatment can be completed in a non-surgical or surgical manner. The physical exam and MRI results assist in determining the course of treatment.
If your tear is small and in the correct location it may not require surgical treatment. Initially, the standard treatment is the RICE protocol. This stands for:
In addition to the RICE protocol, there are many types of non-surgical treatment options for meniscus tears and all have their advantages and disadvantages. Your Orthopedic Specialist can review these options and assist you in determining which will be most effective in treating your injury:
If the symptoms persist, you may need surgical treatment to repair the torn meniscus. This is most commonly completed with arthroscopic surgery. Two to three small incisions are needed to allow a miniature camera to be inserted into your and miniature surgical instruments are used to trim or repair the tear.
Illustration and photo show the knee arthroscopy tools and the size of the incisions made to complete the procedure.
Depending upon the injury, there are different surgical procedures:
Your physician will detail the advantages of each as it pertains to your injury.
(Left): Rendering of a partial meniscectomy.
(Right): Rendering of a meniscus repair.
Whether your treatment involves surgery or not, rehabilitation plays a vital role in getting you back to your desired level of activities. A physical therapy program will guide you in regaining knee strength and function.