Torn Meniscus

A torn meniscus is a tear in the cartilage causing pain on the inside of the knee. The functions of the meniscus are to improve the fit between the femur and the tibia, to absorb shock and distribute the load in the knee, and to help move lubricating fluid around the knee. The meniscus can tear from either trauma or injury or from degeneration. The knee is made up of the femur (thigh bone), the tibia (leg bone), and the patella (knee cap). Ligaments hold the bones of the knee together and the patella lies in the quadriceps muscle in front of the knee.

Treatment options can vary from at-home remedies to outpatient surgery, depending on the severity of your injury. You can help prevent this injury by performing exercises that will strengthen your leg muscles and by using proper techniques during contact activities or sports.

Symptoms

Initial symptoms of a torn meniscus include well-localized pain and swelling in the knee. The pain is usually either on the inner or outer side of the knee, not around the kneecap. When the patient recalls a specific injury that led to the pain and swelling, the swelling often does not occur until the day after the injury. The swelling is not necessarily in the same area as the pain.

A torn meniscus can also produce catching or locking of the knee. Sometimes the knee is stuck in midrange for days at a time. Sometimes the patient can “unlock” the knee by bending and twisting it before trying to straighten it.

Diagnosis and Treatment

A torn meniscus can often be diagnosed by a physical exam of the knee. The doctor will look for swelling, tenderness on the joint line, loss of motion and pain during specific twisting manoeuvres.

An MRI can be used to confirm the diagnosis of a torn meniscus.

A home physical therapy program or simple rest with activity modification, ice and non-steroidal anti-inflammatory drugs (NSAIDs) constitutes the non-operative management of possible meniscus tears. The physical therapy program goals are to minimize the effusion, normalize gait, normalize pain-free range of motion, prevent muscular atrophy, maintain proprioception and maintain cardiovascular fitness.

If symptoms persist, or if the patient cannot risk the delay of an inconsequential period of observation, or in cases of a locked knee, surgical treatment is indicated.

The basic principle of meniscus surgery is to save the meniscus. Tears with a high probability of healing with surgical intervention are repaired.