*For a description of the meniscus, see the blog titled “The Knee Explained”. The menisci in the knee help to distribute weight and allow for proper mobility of the knee. Some of the outer parts of the meniscus are nourished by small blood vessels but a majority of it does not have a direct blood supply. This leads to the inability of the meniscus to heal on its own.
CAUSES: In older patients, changes in the structure of the menisci make it more brittle and susceptible to tearing over time. In younger patients, the most common type of tear comes from a traumatic event that usually involves the knee being bent, the foot planted, and then twisted.
SIGNS/SYMPTOMS: Signs and symptoms vary depending on the severity of the tear. In the older population, the pain may come without a known cause and gradually get worse over time. With mild tears, pain and swelling are minimal and may last up to about 2 weeks. Moderate tears have pain usually at the side and center of the knee. Swelling gets worse over the first few days. Pain is made worse with walking and there may be a sharp pain with twisting. Severe tears present with severe pain, potential inability to walk, joint swelling, and due to a possible piece of torn cartilage, joint locking or inability to straighten the knee may occur.
DIAGNOSIS: Physical exam, history of the injury, x-ray (to see bone changes), and MRI to see the actual menisci are the most common ways to diagnosis a meniscus tear.
TREATMENT: Rest, ice (about 15 minutes at a time), compression, and elevation (RICE), physical therapy, adjustment of the knee to align the joint for proper healing, and surgery in some cases to remove or repair the torn meniscus.
COMPLICATIONS: It is not uncommon to see meniscus tears along with other knee injuries such as MCL and ACL tears. This is called the “terrible triad” and is usually done in contact sports or with activities such as skiing.
PROGNOSIS: This depends on the age of the patient, the severity of the tear, and whether surgery is needed to repair the injury. Proper rehab is needed to ensure strengthening of surrounding musculature.