Meniscus Tears
Menisci are C-shaped pads situated inside the knee between the thigh bone and the shin bone. They act as cushions and help stabilize the knee joint. The meniscus is also known as the ‘Shock Absorber’ of the knee. Each knee has two menisci: the medial meniscus sits inside the knee, and the lateral meniscus sits on the outside.
Like many knee injuries, a meniscus tear is very painful and debilitating. Unfortunately, it is one of the most frequent injuries to the knee. Commonly, a meniscus tear is a sudden, single acute injury such as a sudden twist or abnormal knee bending while playing sports. It can also happen when a person changes direction suddenly while running. All it takes is a good knee twist to tear the meniscus.
The other common cause of meniscus tears is age-related degeneration. As we age, our meniscus becomes hard and degenerate. This weak meniscus is prone to damage and tear even with daily activities.
Symptoms
People who have injuries leading to meniscus tears often experience something that has popped inside their knee during the injury. Other symptoms include:
⦁ Pain – A meniscus tear leads to pain in the knee, especially during walking, bending, and other activities. A medial meniscus tear leads to pain in the inner part of the knee, while a lateral meniscus tear causes pain in the outer part of the knee.
⦁ Swelling – The meniscus tear irritates the knee joint, which causes the joint to produce more synovial fluid. This is similar to eye irritation when some particle enters our eye. This increased fluid production causes swelling in the knee.
⦁ Difficulty in movements of the knee. Sometimes, the meniscus tear gets stuck during knee movements. This causes the knee to get ‘locked’ in that position. Some force and effort are then required to make the knee move again.
Diagnosis
Your doctor will take a detailed history of your injury and ask what activities you can and cannot do now. Then, he will physically examine your knee. He would look for signs of swelling, tenderness (pain) along the joint line, range of motion of your knee, and whether the movements are painful or not. He might also do some maneuvers to check for a meniscus tear.
The doctor would then advise some X-rays of your knee. Although X-rays do not show meniscus tears, they are done to rule out any fractures and bony injuries in and around the knee.
If your doctor suspects a meniscus tear, they will advise a knee MRI. MRI is the best investigation to confirm the tear. It also gives additional information, such as which meniscus is involved, which part of the meniscus is torn, and what the shape of the tear is.
Treatment
Initial treatment to decrease pain and swelling due to injury consists of RICE protocol.
RICE stands for Rest, Ice, Compression, and Elevation.
Rest – Take a break
from physical activities and rest your knee.
Ice – Apply cold packs for 15 minutes several
times daily.
Compression – Wear an elastic compression bandage to prevent further swelling and blood loss inside your knee.
Elevation – When you rest, keep your leg
at a higher level to reduce swelling.
Surgical Treatment
If you have pa
in and swelling in your knee and if it is locking, you may require Arthroscopy surgery. The type of arthroscopy surgery needed would depend on the patient’s age, the type of the tear, and the time since the injury.
Meniscus Repair—Some meniscus tears can be repaired by suturing the torn ends together. The success of the repair depends on the patient’s age, knee condition, meniscus condition, location, and type of meniscus tear. Recovery is longer as it takes time for the meniscus to heal.
Partial Meniscectomy – In most patients, the meniscus tear is not repairable. In these patients, the torn meniscus is trimmed. Recovery is speedy. There is no need to wear a brace after the surgery; the patient can walk from the next day.
Prevention
⦁ Maintain body flexibility
⦁ Strengthen your thigh and back muscles with exercises. These muscles support and stabilize the knee.
⦁ Wear properly fitting shoes. Ill-fitting shoes cause imbalance and increase the risk of injury. The shoes should be appropriate for the sport you’re playing.
⦁ Warm up with light activities before exercise. This increases the blood flow in the muscles and makes them active.
⦁ Never abruptly increase the intensity of your workouts.
⦁ Take rest between workouts.