Meniscus Tear
What Is A Meniscus Tear?
One of the most commonly occurring knee injuries is a meniscal tear. This occurs when one of the menisci within the knee become injured. Inside the knee joint there are two protective pieces of cartilage called the medial menisci. They are shaped like a “C” and are found both at the inner and outer edges of the knee.
Knee joint menisci serve several important functions, including:
• Distributing load within the knee joint
• Absorbing shock
• Aiding in stability
• Establishing limits on the degree of flexion and extension
• Supplying nutrition to the articular cartilage
• Controlling movement of the knee
When this injury occurs, many patients will report that they experienced a sharp and stabbing pain upon movement of their weight-bearing knee. This acute pain generally is reported to last several seconds and is then followed by several hours of a dull and achy pain. Patients who have sustained a meniscus tear also commonly report that they have difficulty straightening the knee completely or feeling as if the knee is locked into place.
Other common symptoms of meniscus tears include:
• Swelling of the knee area
• Knee joint stiffness
• Popping sensations in the knee
Incidence rates of meniscal tears are reported to be as high as six per every 1,000 adults. Further, males are estimated to be between 2.5 to 4 times more likely to suffer from a meniscal tear than females.
Causes of Meniscus Tears
In general, the menisci within the knee can become injured as the result of a forceful twist or when the knee is rotated while bearing weight. Younger patients tend to present with meniscal tears that occur as the result of a twisting force between the femur and the tibia of a weight-bearing flexed knee. This type of meniscal tear is termed bucket handle because it occurs in a vertical fashion along the meniscus, while remaining attached both anteriorly and posteriorly. Meniscus tears can also occur as the result of cartilage deterioration over time. This type of meniscus injury occurs more commonly among aging adults and is characterized by horizontal tears along the menisci.
In most instances, a meniscus injury can be diagnosed following a physical examination. Typically, your physician will inspect your knee joint while physically manipulating your leg bones into different positions. They will pay attention to any pain or other sensations of discomfort, redness or swelling, joint stiffness, and degree of flexion. Imaging may also be used to assist the physician in accurately diagnosing a meniscal tear. The commonly used imaging technique for diagnosing meniscal tears is magnetic resonance imaging (MRI). This technique utilizes a magnetic field and radio waves to create images of internal structures of the knee. This technique is preferred, as it can provide detailed images of both hard and soft tissues. X-rays, for example, do not allow for visual inspection of the soft tissue internally, though these techniques can be helpful in ruling out other possible sources of pain, such as a bone fracture.
In some instances, knee arthroscopy may be employed. This technique involves the use of an arthroscope instrument that is inserted into the knee through a tiny incision. The arthroscope is equipped with a small camera that allows the physician to get an accurate image of the various internal structures of the knee.
Treatments for Meniscus Tear
In most instances of meniscus tears, non-operative treatment techniques are recommended for managing symptoms.
For instance, as soon as possible following a meniscal tear injury, patients are encouraged to:
• Rest the injured knee and apply weight only as tolerated
• Utilize cold therapy by applying ice for 15 to 20 minute intervals at a time
• Wrap the affected knee tightly with a compression bandage or brace
• Elevate the affected knee as much as possible to reduce any swelling or inflammation
Patients may also wish to take non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, as needed. These will aid in reducing the patient’s pain and discomfort associated with the meniscal tear and can also help reduce swelling of the area. Physical therapy is designed to improve flexibility of the joint and increase strength. Typically, patients will visit with a physical therapist twice a week for approximately eight weeks.
In some instances, surgical repair of the meniscus may be warranted. Your physician will examine the injured area to determine if surgery is appropriate. For instance, patients presenting with moderate to severe meniscal tears that occurred along the outer edge of the meniscus are generally considered good candidates for surgery. For this arthroscopic procedure, the torn meniscus is either repaired with sutures or anchors, or the torn part is clipped away. Recovery from surgery can take between four to six weeks and many patients still undergo physical therapy to aid in recovering.
Conclusion
Meniscus tears are among the most common knee injuries to occur during adulthood. This type of injury occurs when the knee is twisted forcefully or rotated while flexed and bearing weight. Meniscal tears are generally diagnosed using visual inspection; however, an MRI may be employed in order to confirm the diagnosis. Treatment for a meniscal tear depends on the type of injury sustained. Generally, it is recommended that patients rest the affected area, apply an ice compress, utilize compression bandages, and elevate the area. Your physician may also recommend physical therapy, over-the-counter pain relievers, and in some cases, surgical repair may be warranted.
References
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