Meniscal Tears

The meniscus is a C-shaped fibrocartilaginous structure in the knee. It consists of the medial meniscus, on the inner part of the knee, and the lateral meniscus on the outer aspect of the knee.

Causes of Meniscal Tears include the following:

• Twisting motion
• Over flexing the knee joint
• Pivoting such as in sports activities
• Sudden stopping or deceleration
• Degenerative changes that occur over time can weaken and thin the menisci resulting in meniscal tears.

There are many different ways the menisci can tear. Treatment options will depend upon the type of tear, location of the tear, and the extent of the tear.

Symptoms of Meniscal Tears

Following a twisting type of injury the medial or lateral meniscus can tear. This results either from a sporting injury or may occur from a simple twisting injury when getting out of a chair or standing from a squatting position. Our cartilage becomes a little brittle as we get older and therefore can tear easier.

The symptoms of a Meniscal Tear include:

• Pain over the inner or outer side of the knee where the tear occurred.
• A “popping” may be felt at the time of injury
• Knee swelling, stiffness and tightness
• Reduced range of motion
• Locking can occur if the torn cartilage gets caught between the femur and tibia preventing straightening of the knee.

If conservative treatments options fail to relieve your knee pain, or if your knee continues to lock and is not healing, your surgeon may recommend knee surgery. Surgical treatment options will depend upon the type of tear, location of the tear, and the extent of the tear.

There are two surgical procedures for Meniscal Tears.

Meniscal Repair – This surgery is performed to repair the tear in the menisci and restore normal knee anatomy. This surgery may not be an option if the tear is located in an avascular part of the menisci. Avascular means no blood supply and therefore is unable to heal. Meniscal Repair surgery also has a longer recovery period than the alternative Meniscectomy.

Meniscectomy – This surgery is the most common procedure to repair Meniscal Tears. The surgery involves removing the torn portion of the menisci. It is usually done on an outpatient basis and is performed arthroscopically through tiny incisions with an arthroscope.

Arthroscopy is a surgical procedure in which an arthroscope, a small, soft, flexible tube with a light and video camera at the end, is inserted into a joint to evaluate and treat a variety of conditions.

The benefits of arthroscopy compared to the alternative, open knee surgery, include:

• Smaller incisions
• Minimal soft tissue trauma
• Less pain
• Faster healing time
• Lower infection rate
• Less scarring
• Earlier mobilisation
• Usually performed as outpatient day surgery

Immediate Treatment

Immediately following a knee injury and before being evaluated by a medical doctor, you should initiate the R.I.C.E. method of treatment:

Rest – Rest the knee as more damage could result from putting pressure on the injury.

Ice – Ice packs applied to the injury will help diminish swelling and pain. Ice should be applied over a towel to the affected area for 15-20 minutes four times a day for several days. Never place ice directly over the skin.

Compression – Wrapping the knee with an elastic bandage or compression stocking can help to minimize the swelling and support your knee.

Elevation – Elevating the knee above heart level will also help with swelling and pain.