It can ruin your weekend ski trip. It can disrupt an enjoyable pickup basketball game. It can even occur when you simply step off a curb wrong. An injury to the meniscus in your knee is generally very painful and can be accompanied by a "popping" sound, swelling, and joint locking or instability. The human knee contains two semicircular pads of fibrocartilage called menisci [meniscus (singular)]. The meniscus has a vital role in knee joint stability, shock absorption, and joint lubrication. Acute injury to the meniscus often occurs with sudden knee twisting, but chronic wear can also lead to degenerative changes.
Meniscal tears are generally diagnosed by a physician. A detailed examination of the knee and surrounding structures can reveal tenderness along the joint line, decreased range of motion, and popping or locking with knee motion. Your doctor may perform a series of physical exam maneuvers in an attempt to reproduce the symptoms. Supporting evidence of a tear can also be seen on MRI or Ultrasound. If you have been diagnosed with a meniscal injury, it is important to know what type of tear is present as this may determine the best course of treatment.
Tear patterns include partial or complex; anterior, lateral, or posterior; traumatic or degenerative; and horizontal, vertical, radial, or oblique (“parrot-beak” or “bucket-handle”). Oblique and vertical longitudinal tears account for >80% of meniscal injuries. In general, larger or more unstable tears (ie, radial tears, “bucket-handle” tears, complex tears) will remain bothersome. These types of tears are more likely to require surgical intervention. In some instances the surgeon may be able to repair the damaged meniscus. If repair is not feasible, surgical removal of the damaged tissue (partial meniscectomy) is the next consideration. Meniscal injuries deemed to be small or degenerative in nature can often be managed with more conservative, non-surgical methods (rest, ice, NSAIDs, physical therapy).
If you feel you may have injured your meniscus and would like a thorough evaluation and discussion of your treatment options, we recommend you call the office to schedule an appointment.
Bryce Kirkman, MS-IV
David Carfagno, DO, CAQSM
Allen DM, Li L, Crema MD, et al. The Relationship between Meniscal Tears and Meniscal Position. Therapeutic Advances in Musculoskeletal Disease. 2010;2(6):315-323. doi:10.1177/1759720X10383198.
Maffulli N, Longo UG, et al. Meniscal tears. Open Access Journal of Sports Medicine, 2010:1:45-54.
Gimre, M. Meniscal injuries. Warthog Sports Medicine Manual, 2000:87-97.
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