A meniscus tear is the most common knee injury in athletes, especially those involved in contact sports. A sudden bend or twist in your knee may cause the meniscus to tear. Athletes who play sports, such as football, tennis and basketball are at a higher risk of developing meniscal tears.Elderly people are more prone to degenerative meniscal tears as the cartilage wears out and weakens with age.
The meniscus is the C-shaped cartilage located in the knee between the thigh bone and shin bone. There are 2 menisci; one on the inside or medial aspect of your knee and one on the outside or lateral side. Each meniscus lubricates the knee joint, acts as shock-absorber, and controls the flexion and extension of the joint.
A torn meniscus causes pain, swelling, stiffness, and a catching or locking sensation in your knee making you unable to move your knee through its complete range of motion. Your orthopedic surgeon will examine your knee, evaluate your symptoms and medical history before suggesting a treatment plan. The treatment depends on the type, size and location of the tear as well your age and activity level. If the tear is small with damage in only the outer edge of the meniscus, non-surgical treatment may be sufficient.
Non-surgical treatment of a meniscus tear may include rest, ice, anti-inflammatory medications, physical therapy or corticosteroid injections. If these conservative measures fail to manage your symptoms, surgery may be recommended.
Knee arthroscopy is the most commonly recommended surgical procedure for meniscal tears. The surgical treatment options include total or partial meniscus removal, meniscus repair, and meniscus replacement. Surgery can be performed using arthroscopy where a small camera is inserted through a tiny incision which enables the surgeon to view the inside of your knee on a large monitor. Through other tiny incisions, small instruments called shavers or scissors may be used to remove the torn meniscus.
In a total meniscectomy, the entire meniscus is removed. Total meniscectomy will help in relieving symptoms, but because the entire meniscus is removed, the cushioning and stability between the joints will be lost. Hence partial meniscectomy is considered.
In a partial meniscectomy, only the torn portion of the meniscus is removed.During the procedure, the torn meniscus is removed, and the remaining edges of the meniscus are smoothed so that there are no sharp ends. Any unstable fragments which are causing locking and catching sensations will also be removed.Partial meniscectomy helps in restoring or maintaining knee stability and offers faster and complete recovery.
In arthroscopic meniscus repair, the torn meniscus will be pinned or sutured depending on the extent of tear.
Meniscal replacement or transplantation involves replacement of a torn cartilage with the cartilage obtained from a donor or a cultured patch obtained from a laboratory. It is considered as a treatment option to relieve knee pain in patients who have undergone meniscectomy.
Possible risks and complications of meniscal surgery include infection, bleeding, and injury to blood vessels or nerves.
Post surgery rehabilitation exercises may help to restore knee mobility, strength and to improve range of motion.
- Normal knee with smooth meniscus and smooth cartilage covering the bone surfaces.
- Small meniscus tear with some early arthritis or frayed cartilage covering the bone surfaces.
- Very large meniscus tear with abnormal cartilage on the bony surfaces.