A torn meniscus is one of the most common of all knee injuries, particularly among athletes although older people can also be susceptible. Your menisci are the two wedge-shaped sections of cartilage in between your thigh bone and your shin bone. They act as shock absorbers, helping to cushion the knee joint and keep it stable. You can tear your meniscus due to an acute trauma or because the cartilage has become worn through ageing. Treatment for a torn meniscus will depend on the extent and location of the injury, as well as your age and how active you are.
Causes of meniscal tears
During sports you may tear your meniscus as the result of a collision with another player, a heavy fall or due to rapid changes of direction when you are running. Sports-related meniscal tears can often be accompanied by other injuries, such as a torn anterior cruciate ligament. As you age, however, even simple movements – such as twisting awkwardly – may cause you to tear your meniscus.
Symptoms of meniscal tears
Some people feel a pop when the meniscus tears, but not always. You will often be able to continue to walk with a torn meniscus – and may even continue competing if it happens during a game – but swelling and stiffness will generally develop over the next few days. You may also experience a catching or locking sensation inside your knee, or you may not be able to move it properly. Sometimes it might feel like it is about to give way.
Diagnosis of meniscal tears
Your doctor will carry out an examination of your knee and ask about your medical history and how the injury occurred. A test called a McMurray test, which involves the doctor moving your knee in certain ways to check for clicking or pain within the joint, is used to aid diagnosis of a meniscal tear. You may also be sent for a diagnostic imaging tests to confirm the diagnosis or check for other causes of your symptoms. For example, an X-ray may be used to check for associated osteoarthritis and an MRI scan may be used to diagnose the meniscal tear and assess damage to the surrounding soft tissues.
Treatment of meniscal tears
The treatment recommended will depend on the size and location of the meniscal tear, as well as your age and overall level of fitness. If you tear the outer third of your meniscus, there is a chance that it could heal on its own or respond well to surgical repair as this part of the cartilage has a blood supply. However, the inner two-thirds of the meniscus lack a good blood supply so do not generally heal well. If the tear is in this area, the most appropriate treatment might be to trim the damaged tissue away.
For minor tears that don’t cause swelling or locking of the knee, your doctor is likely to recommend rest, ice (a cold pack applied for 20 minutes at a time several times a day), compression with an elastic bandage and elevating your leg above the level of your heart. We use the acronym RICE to help people remember what to do. You can also take painkillers and anti-inflammatory medication to relieve pain and swelling.
An injection of hyaluronic acid and corticosteroids into the knee joint is sometimes recommended to help relieve symptoms or platelet-rich plasma (PRP) injections, which use a concentration of your own blood, may help to promote natural healing.
In some cases, a persistent meniscal tear may require surgery. Knee arthroscopy – or keyhole surgery – uses surgical instruments inserted through two small incisions in the knee to repair or trim the damaged meniscus.
The meniscus may be repaired using stitches or the damaged meniscus tissue may be trimmed away (partial meniscectomy). Generally recovery from a partial meniscectomy is quicker (around three to six weeks) than following a meniscal repair as it can take three to six months for the stitched meniscus to fully heal.
You will need to follow a programme of exercises recommended by a physiotherapist to help your knee to rehabilitate and regain its mobility and strength. With a proper diagnosis and effective treatment and rehabilitation, most people make a good recovery from a meniscal tear injury.
For advice about meniscal injury diagnosis and treatment, contact us.
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