Meniscal Tears

Meniscal tears are among the most common knee injuries. Athletes, particularly those who play contact sports, are at risk for meniscal tears. However, anyone at any age can tear a meniscus. When people talk about torn cartilage in the knee, they are usually referring to a torn meniscus.

Anatomy

Meniscal tears are among the most common knee injuries. Athletes, particularly those who play contact sports, are at risk for meniscal tears. However, anyone at any age can tear a meniscus. When people talk about torn cartilage in the knee, they are usually referring to a torn meniscus.


Normal Knee AnatomyNormal Knee Anatomy

Two wedge-shaped pieces of cartilage act as "shock absorbers" between your thighbone and shinbone. These are called meniscus. They are tough and rubbery to help cushion the joint and keep it stable.


Normal MeniscusNormal Meniscus

Description

Menisci tear in different ways. Tears are noted by how they look, as well as where the tear occurs in the meniscus. Common tears include longitudinal, parrot-beak, flap, bucket handle, and mixed/complex.

Sports-related meniscal tears often occur along with other knee injuries, such as anterior cruciate ligament tears.

Cause

Sudden meniscal 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 meniscal tears. Cartilage weakens and wears thin over time. Aged, worn tissue is more prone to tears. 

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 meniscal 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.

Doctor Examination

Physical Examination and Patient History

After discussing your symptoms and medical history, Dr. Wilson will examine your knee. He will check for tenderness along the joint line where the meniscus sits. This often signals a tear.

Imaging Tests

Because other knee problems cause similar symptoms, Dr. Wilson may order imaging tests to help confirm the diagnosis.

X-rays. Although x-rays do not show meniscal tears, they may show other causes of knee pain, such as osteoarthritis.

Magnetic resonance imaging (MRI). This study can create better images of the soft tissues of your knee joint, like a meniscus.  MRI is available in Dr. Wilson’s office, maximizing your convenience.

Treatment

Treatment of your tear will depend on the type of tear you have, its size, and location.  Along with the type of tear you have, your age, activity level, and any related injuries will factor into your treatment plan.

Nonsurgical Treatment

Although most meniscal tears need surgery, 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.

RICE. The RICE protocol is effective for most sports-related injuries. RICE stands for Rest, Ice, Compression, and Elevation.

  • Rest. Take a break from the activity that caused the injury. Dr. Wilson may recommend that you use crutches to avoid putting weight on your leg.
  • Ice. Use cold packs for 20 minutes at a time, several times a day. Do not apply ice directly to the skin.
  • Compression. To prevent additional swelling and blood loss, wear an elastic compression bandage.
  • Elevation. To reduce swelling, recline when you rest, and put your leg up higher than your heart.

Non-steroidal anti-inflammatory medicines. Drugs like naproxen and ibuprofen reduce pain and swelling.

Surgical Treatment

If your symptoms persist with nonsurgical treatment, Dr. Wilson may suggest arthroscopic surgery.

Procedure. Knee arthroscopy is one of the most commonly performed surgical procedures. In it, a miniature camera is inserted through a small incision. This provides a clear view of the inside of the knee. Dr. Wilson inserts miniature surgical instruments through other small incisions to trim or repair the tear.

  • Meniscectomy. In this procedure, the damaged meniscal tissue is trimmed away.
  • Meniscus repair. Some meniscal tears can be repaired by suturing (stitching) the torn pieces together. Whether a tear can be successfully treated with repair depends upon the type of tear, as well as the overall condition of the injured meniscus.
  • Meniscus Transplant.  Occasionally, the meniscus is so badly torn that trimming or repairing is not possible.  In these rare situations, meniscal transplant from a cadaveric donor is possible.  Dr. Wilson will discuss this with you if he feels you are a good candidate.  See our Meniscus Transplant page for more information.

Rehabilitation.

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.

For the most part, rehabilitation can be carried out at home, although Dr. Wilson may recommend physical therapy. Rehabilitation time for a meniscus repair is about 3 months. A meniscectomy requires less time for healing approximately 3 to 4 weeks.