Meniscal tears are one of the most common orthopedic conditions. A meniscus is a c-shaped cartilage ring inside the knee joint between your tibia and femur. Each knee has 2 menisci, one lateral on the outside and one medial on the inside part of the knee. The function of this structure is to act as a shock absorber or cushion to stabilize and protect the knee joint surfaces.
Tears in the meniscus can happen from an injury, playing sports, or natural degeneration over time as we age. Often, a tear may result from squatting down and twisting at the knee.
Types of meniscal tears:
- Bucket handle tear: a lengthwise split in the meniscus that leaves a loose edge of tissue shaped like a bucket handle
- Radial tear: a sharp split from the inner edge of the meniscus aiming toward the outer edge
- Horizontal cleavage tear: a horizontal split in the body of the meniscus
- Flap tear: a horizontal tear at the top of the meniscus that can create a loose flap of cartilage
- Degenerative tear: the rim of the meniscus becomes worn and frayed
Common symptoms of a meniscus tear include: sharp pain, knee swelling, catching or locking, and a sudden “pop” sensation inside your knee.
After discussing your symptoms, the doctor will perform a physical exam and may manipulate your knee to recreate the symptoms you were having. X-rays are important to rule out problems with the bony features of the knee joint. In addition, an MRI may be ordered to view the soft tissue structures including the meniscus.
Treatment of the tear will depend on the size, type, and location of the tear.
Many people, especially with degenerative type tears, will respond to conservative treatment such as rest, ice, anti-inflammatory medications, and cortisone injections to reduce the swelling and inflammation.
Depending on the type of tear, or if conservative treatment does not relieve symptoms, your surgeon may recommend a knee arthroscopy.
Most tears are not repairable because the poor blood supply around the meniscus prevents a suitable healing environment. During a knee arthroscopy with meniscectomy, the surgeon will make tiny incisions in the knee. Using a camera, he or she will visualize the knee joint and trim out the tear, making the cartilage ring stable. You are able to put weight on your leg and walk shortly after the surgery.
Tears in the outer edge of the meniscus have a better chance of healing due to a richer blood supply. During a knee arthroscopy with meniscus repair, the surgeon will make tiny incisions in the knee. Using a camera, he or she will use fasteners or sutures to hold the tear in place, allowing the repaired edges to heal. Recovery time is often longer during this procedure. You may or may not be allowed to put weight on the affected extremity and will likely need a knee brace during the post-operative period.