The Torn Meniscus

Having a torn meniscus isn't the end of the world. However, it's an injury we must pay close attention to. Why? Because a torn meniscus left untreated can lead to painful arthritis. And arthritis can lead to abandoning some of the activities that you enjoy doing.

What is the Meniscus?

The meniscus is a wedge-shaped structure in the knee that consists of fibrocartilage, a very tough but pliable material. It is the "cushion cartilage" of our knee. 

• The medial meniscus is located on the inside of the knee (towards the middle of the body)

• The lateral meniscus is located on the outside of the knee.

Together, the medial and lateral meniscus act primarily as shock absorbers/stabilizers in the knee joint. They also help nourish the articular cartilage through their rich blood supply. This blood enhances the ability of the cartilage to repair itself.

The Meniscus is a key component to participating in most athletic pursuits, from high-intensity sports such as skiing, basketball, and soccer, or even everyday recreational activities like walking, biking, or hiking.

The Torn Meniscus - How Does it Happen?

First, let's talk about the younger athlete. In young athletes, the majority of injuries to the meniscus occur as a result of some sort of trauma to the knee.

 Vulnerability to injuries in which there is both compression and twisting applied across the knee is high.  Commonly the meniscus can also be damaged in association with injuries to the ACL.  

Now let's touch on older athletes, many of whom experience meniscal tears which are the result of more slight,  "trivial" trauma.  Some of these include:

• Twisting the knee

• Squatting

• Repetitive activities such as running

These activities can all cause major traumatic or cumulative stress upon the knee joint. These tears happen because the meniscus has a tendency to degenerate as part of the aging process.

This degeneration often takes place in conjunction with early arthritic changes in the knee joint. It is also common for the meniscus to be damaged in association with injuries to the anterior cruciate ligament. 

How Can You Tell If You Have a Torn Meniscus? #meniscustear

 A torn meniscus will often produce pain, swelling and mechanical symptoms (such as catching or locking in the knee joint).  Meniscus injuries may be diagnosed based upon:

• Patient history

• A physical examination of the knee.

Further diagnostic studies (like an MRI) may be required so we can get a three-dimensional image of the interior of the knee joint.

In some cases, we may also recommend arthroscopic inspection of the knee joint, a minimally invasive surgical procedure.

The Torn Meniscus - Levels of Severity #meniscustears

Meniscus tears symptoms are categorized into three levels of severity: minor, moderate, and severe:

1. Minor symptoms of a meniscus tear:

• Discomfort

• Slight pain

• Swelling

If you have a minor meniscus tear, these symptoms usually subside after 2-3 weeks.

2. Moderate symptoms of a meniscus tear:

• Significant swelling

• Stiffness

• Pain when moving laterally, twisting or squatting.

If you have a moderate meniscus tear, symptoms may subside after 2-3 weeks but may reoccur again when the knee is put under extra stress.

2. Severe symptoms are created when the torn meniscus folds into the joint space.

 Because of this, the knee will “lock up” or “catch”, feel wobbly or give out, and a significant amount of range of motion will be lost. 

How Is A Meniscus Tear Treated?

Certain patterns of injury, especially in younger patients, may call for repair of the meniscus. The decision to repair is based on many factors, including:

• Location and pattern of the tear

• Age of the patient

• Predictability of whether the injury will be able to heal.

Other patterns of meniscus tears, especially in older patients, are not suitable for repair.

If the patient is symptomatic and conservative treatment options like physical therapy are not working, surgery to remove the torn section is recommended.

This surgery is called arthroscopic partial meniscectomy and is usually performed on an outpatient basis, typically in one hour or less.

Recovering From A Torn Meniscus #meniscustear

Your recovery timeline in the event of a meniscus tear depends on the severity of the tear, and on whether or not surgery is necessary. Each patient is unique, but most recovery from surgery in days or weeks.

Along with surgery, there will be 4-6 months of rehab in order to regain function and strength. Meniscus tear rehab consists of exercises that strengthen the quadriceps muscle and help regain range of motion. 

Overall if you injure your knee and symptoms continue, it is important to see a specialist in order to find out if surgery is necessary.  

If it is determined that you do not need surgery, don't worry, because it isn't the end of the world. After some rest and a few months of physical therapy, we will have you up and moving at full speed, back doing the things you love.