What is a Meniscus Tear?
Meniscus injuries are one of the most common injuries sustained in the knee. There are two menisci (cartilage structures) within each knee and they function as “shock absorbers” to distribute stress during weight-bearing activities. The menisci are often compared to a washer or gasket. Menisci also function to help stabilize the knee, increase the surface area and deepen the knee joint as well as aid in the fluid hinge motion of the knee joint. There are many types of meniscus tears, classified by location, shape and how they look. It is common for meniscus tears to occur alongside other sports related injuries such as anterior cruciate ligament tears.
- Often occurs during sports activities that require twisting of the knee
- Most commonly result from a twisting injury with leg planted on the ground, or twisting in a squatted position
- Direct contact to the knee
- Hyper-flexion with leg on the ground
- Degenerative meniscus tears are possible but normally occur in older individuals
Signs and Symptoms
- Feeling or hearing a “pop” at the time of injury
- Gradual knee swelling over the next 24-48 hours
- Knee pain
- Episodes of catching or locking within the knee
- Feelings of instability, ‘giving way,’ or knee buckling
- Knee stiffness and loss of normal knee range of motion
Treatment is determined by the type, location and severity of the meniscal tear. Similar to other parts of the body, the meniscus has a varying range of blood supply. The outer third portion of the meniscus has a good blood supply and may heal on its own without surgical intervention. The inner two-thirds of the meniscus has poor blood supply and will often require surgical intervention to fix or remove damaged pieces of cartilage.
If conservative treatment options are available, a period of rest is necessary to help decrease the inflammatory process occurring within the knee joint. Use of ice, compression and elevation to decrease swelling is important, especially immediately following an acute injury. Once pain and swelling are decreased, regaining normal knee strength and range of motion is necessary before considering a progression back into sport.
If it is determined that the meniscus tear will not heal conservatively, then surgery is the next step. Based on the type and location of the tear, surgical procedures either include a meniscectomy, where the damaged piece of cartilage is completely removed, or a meniscal repair, where the orthopedic surgeon sutures or stiches the tear back together. Since the meniscus has to heal back together with a meniscal repair, recovery is much longer (3-4 months depending on the person).
Following surgery for a meniscal repair, the athlete is not allowed to put weight on their injured leg for about 6 weeks to ensure proper healing. Rehabilitation through physical therapy to focus on knee range of motion and regaining strength is required following either of these surgical procedures.