Meniscal Injuries - Symptoms, Risk factors and Treatment

The menisci (singularly known as meniscus), are two C-shaped, round cartilages, located in each knee joint. Menisci are present in between the bone of the thigh (femur) and the bone of the shin (tibia).  There are two menisci in each knee joint, and they act as shock absorbers and help provide the joint stability and a wide range of motion. Sometimes, the menisci may get injured. Meniscal tears are the most common form of meniscal injuries and can happen when the knee is twisted or too much weight is put on the knee.

What causes meniscus tears?

Meniscus tears can occur when the knee is subjected to trauma. It is common in athletes due to excessive movement of the knee.  Meniscus tears can be caused in different situations such as:

• Forceful rotation of the knee

• Sudden stopping after running

• Lifting heavyweights

• Squatting deeply

• Degenerative changes in older adults

Symptoms of meniscal tears:

The symptoms of meniscal tears include:

• Knee pain

• Swelling of the knee joint

• Popping sensation when moving the knee

• Trouble extending the leg fully (locking of the knee)

• Knee buckling

• Stiffness of the knee joint

Diagnosis of meniscus tears:

A torn meniscus can be diagnosed by a detailed history along with a physical exam. Your doctor may ask you questions related to any history of knee trauma. A physical examination of the knee involves looking at any swelling of the joint and assessing the motion of the joint. Your doctor may put pressure on the joint to check for any tenderness. To confirm the diagnosis, your doctor may suggest imaging tests such as:

• X-ray

• MRI

• Arthroscopy

• Arthrography (For simultaneous diagnosis and treatment)

Treatment of meniscus tears:

The treatment for a torn meniscus depends upon the location and severity of the tear. Not all meniscus tears require surgery, and treatment may be conservative. Over time, the tears may heal themselves. If the knee is not locking and the pain is not very severe, you may not require surgery, and your doctor may advise you on different treatment strategies such as:

• Applying a cold pack on the knee

• Taking pain killer medications 

• Resting well

• Elevating the knee

• Avoiding high impact movements such as squatting, jumping, or running

• Doing light stretching exercises to strengthen the muscles of the leg

If the pain does not resolve and is severe, or if your knee locks, your doctor may suggest surgery. The surgical options include:

Arthrography: 

In this procedure, minor incisions are made on the knee joint, and an instrument called an arthroscope is inserted in the knee joint. The arthroscope contains a camera that allows the doctor to view the inside of the joint. The meniscus can then be removed or repaired.

Meniscus transplant:

This procedure involves replacing the torn meniscus with a healthy meniscus from a cadaver.

Meniscus Implant:

In this procedure, the synthetic, artificial meniscus is implanted in the knee joint in place of the torn meniscus.

Post-surgical rehabilitation:

After surgery, you may need proper rehabilitation and physical therapy to start moving the joint properly again and to walk normally. It may take time, depending upon the extent of the injury.

Conclusion:

Meniscal tear is a common type of meniscus injury. It is common in athletes. The condition may be painful, but fortunately, there are a variety of treatment options available to heal a torn meniscus without affecting the quality of life. If you notice any signs and symptoms of a meniscal tear, especially if you have a history of trauma to the knee, it is advised to see your doctor.