Meniscus tear and cartilage injury
The meniscus is often referred to as the knee’s shock absorber and plays a crucial role in cushioning and stabilising the knee joint. A meniscus tear can occur gradually over time or as a result of sudden twisting or hyperflexion of the knee. Treatment and recovery depend on the shape, location, and duration of the tear. Additionally, factors such as your overall health, activity level, and the presence of other injuries are carefully considered when planning treatment or surgery. The ultimate goal of treatment is to preserve the meniscus and restore knee function.
Overview
The meniscus is an important component of the knee that helps absorb shock. These small ‘C’ shaped discs are prone to injury regardless of age. Meniscal damage can occur due to a major knee injury or repeatedly overloading the joint. A meniscal injury can sometimes be a precursor to knee osteoarthritis. In most cases, treatment is undertaken in accordance with ESSKA (European Society for Sports Traumatology, Knee Surgery and Arthroscopy) guidelines.
Causes
At Cabot Clinic, our medical team frequently encounters cases of both acute traumatic and chronic degenerative injuries.
People under 40 years of age are more likely to experience the acute type, which involves a large tear in an otherwise well-maintained meniscus. Reparatory surgery is typically necessary to alleviate pain and preserve the meniscus’s shock-absorbing function.
On the other hand, chronic degenerative meniscal tear is more commonly observed in older age groups. This injury develops gradually over many years and affects the entire structure, potentially leading to arthritis in the knee.
Symptoms
Meniscal tears typically happen due to sudden, intense movements or positions that put stress on the knee, like kneeling or sitting cross-legged. This can lead to significant pain and swelling. In some cases, the torn meniscus may flip over and curl up at the front of the knee, making it challenging for the patient to straighten their leg.
Diagnostics
To diagnose a meniscal injury, the doctor will review the patient’s medical history, conduct a physical examination of the knee, and order an MRI scan. The final diagnosis is typically made during keyhole surgery, which allows the surgeon to observe the meniscus using an arthroscopic camera. Meniscal injuries are classified based on their duration (acute or chronic) and morphology, as they can take on various shapes.
Treatments
Initially, treatment for an injured meniscus may involve rest, using ice packs, compression or physical therapy. However, if a patient continues to experience classic symptoms or sees no improvement in pain levels and is unable to straighten their knee, appropriate surgical procedures may be necessary to either repair or remove a part of the meniscus.
When an acute meniscal tear is present, procedures are aimed at reducing pain and preserving the meniscus’s shock-absorbing function. Cabot Clinic may recommend keyhole surgery to repair an acute meniscal tear using specialised all-inside sutures.
In rare cases where the meniscus has been repeatedly damaged, a meniscal transplant may be needed. This may be the solution if donor tissue can be obtained and put in place to replace the lost meniscus’s shock-absorbing tissue.
Recovery
Ideally, a patient will be able to walk out of the hospital on the day of surgery. A period of gentle mobilisation and physical therapy will then follow. If the meniscus cannot be repaired due to chronic tears, no knee brace will be necessary. However, if a repair is performed, the patient will typically need to use a brace for 2–3 months to allow the repair to fully integrate.
References
Are you struggling with the symptoms of a meniscus tear?
If knee pain, swelling or mechanical symptoms are affecting your mobility and quality of life, speak to a specialist about the most appropriate treatment options for your condition.