Meniscal Injuries – Treatment

At the Orthopedic Center our Providers can diagnose and treat the different types of meniscal injuries. Most of the times conservative management is all that is needed.

When indicated, minimally invasive arthroscopic surgery is usually the best option. Make an appointment today for a complete evaluation of your knee.

What are Meniscal Tears?

Meniscus tears are common knee injuries. Athletes, particularly those who play contact sports, are at risk for meniscus tears. However, anyone at any age can tear a meniscus. It is often referred to as a “torn cartilage” in the knee.

Anatomically, the menisci are two wedge-shaped pieces of cartilage acting as “shock absorbers” and dispersing the joint forces between your thighbone (femur) and shinbone (tibia). They are tough and rubbery to help cushion the joint and keep it stable.

Meniscal tears are classified by location and whether they are due to sports or age-related degeneration of the tissue. Tears are also noted by how they look and their location on the meniscus. Common tear types include bucket handle, flap, and radial.

Cause

Sudden meniscus tears often happen during sports. Players may squat and twist the knee, causing a tear. Direct contact, like a tackle, is sometimes involved.

Older people are more likely to have degenerative meniscus tears. Cartilage weakens and wears thin over time. Aged, worn tissue is more prone to tears. Just an awkward twist when getting up from a chair may be enough to cause a tear, if the menisci have weakened with age.

Symptoms

You might feel a “pop” when you tear a meniscus. Most people can still walk on their injured knee. Many athletes keep playing with a tear. Over 2 to 3 days, your knee will gradually become more stiff and swollen. The most common symptoms of meniscus tear are:

• Pain
• Stiffness and swelling
• Catching or locking of your knee
• The sensation of your knee “giving way”
• You are not able to move your knee through its full range of motion

Without treatment, a piece of meniscus may come loose and drift into the joint. This can cause your knee to slip, pop, or lock.

Orthopedic Evaluation

Your orthopedic care provider at The Orthopedic Center will perform a thorough physical exam. If your provider suspects an unstable meniscal injury additional imaging tests may be obtained including X-raya and/or a magnetic Resonance scan (MRI) of your knee. These tests will confirm the diagnosis and extent of a meniscal injury since other conditions give similar symptoms.

Treatment

Treatment of your particular injury will depend on the type of tear you have, its size, and its location.

The outside one-third of the meniscus has a rich blood supply. A tear in this “red” zone may heal on its own, or can often be repaired with surgery. A longitudinal tear is an example of this kind of tear.

In contrast, the inner two-thirds of the meniscus lacks a blood supply. Without nutrients from blood, tears in this “white” zone cannot heal. These complex tears are often in thin, worn cartilage. Because the pieces cannot grow back together, tears in this zone are usually surgically trimmed away.

Along with the type of tear you have, your age, activity level, and any related injuries will factor into your treatment plan.

Nonsurgical Treatment

If your tear is small and on the outer edge of the meniscus, it may not require surgical repair. As long as your symptoms do not persist and your knee is stable, nonsurgical treatment may be all you need.

Surgical Treatment

If your symptoms include frequent locking and buckling of the knee and persist despite following the “PRICE” principle of conservative management, your doctor may suggest arthroscopic surgery.

Arthroscopic surgery is a minimally invasive technique that uses advanced, high-definition optics and specialized tools to access the knee joint. Arthroscopic knee surgery has the advantage to allow greater access and clear visualization while only using a few small incisions. These interventions are typically performed as outpatient procedures, which means you get to go home the same day. Depending on the meniscal damage your surgeon may perform:

• Partial meniscectomy. In this procedure, the damaged meniscus tissue is trimmed away and the remaining meniscal tissue is sculpted to prevent instability.
• Meniscus repair. Some meniscus tears can be repaired by suturing (stitching) the torn pieces together. Recovery time for a repair is much longer than from a meniscectomy due to the extra healing time needed.

Immediately after surgery you will be seen and evaluated by a physical therapist. Regular exercise to restore your knee mobility and strength is necessary. You will start with exercises to improve your range of motion. Strengthening exercises will gradually be added to your rehabilitation plan.

Rehabilitation time for a meniscus repair is about 3 months. A meniscectomy requires less time for healing — approximately 3 to 4 weeks.