Meniscal Injuries
There are two meniscal cartilages located inside the knee known as the medial (the inside) meniscus and the lateral (the outside) meniscus. The menisci are “C” shaped pieces of cartilage designed to act as shock absorbers and prevent the femur (thigh bone) from grinding on the tibia (shin bone). The menisci also help stabilize the knee joint because the outer rims of the cartilage are thicker than the inner rim creating a bowl- like effect for the femur to rest in. Because of the bowl-like shape the femur can glide over the tibia allowing you knee to bend and straighten.
Most meniscal injuries are due to a twisting motion about the knee joint causing the femur to grind the cartilage causing tears. Meniscal injuries also can occur in combination with other injuries of the knee usually from a traumatic event. However, people over 40 or so may develop tears of the cartilage either with minor episodes, or no injury at all. The older one gets, the cartilage can actually wear out and tear very easily.
Patients generally will report a “clicking or popping” inside the knee, and will notice swelling and stiffness around the knee. There is also tenderness over the joint lines of the knee, which is where the two bones are joined. Some people will continue to perform all their normal activities and “play though the pain.” But, if the tear actually pulls a small piece of cartilage off, the loose body can float through the joint and can become stuck causing your knee to lock with severe pain.
Initial conservative treatment of a meniscal tear is the RICE method of Rest, Ice, Compression, and Elevation along with some non-steroidal anti-inflammatory medication. Depending on the stability of the knee and severity of the tear the conservative treatment may be all a person needs because small tears along the outside ring can settle down with rest. However, meniscal injuries do not heal themselves.
If the tear is along the inner ring, where there is less blood flow and the catching and locking sensations become too painful then surgery is generally performed. Most often this surgery is performed arthroscopically through little poke holes where the surgeon can go in the knee and trim off the little flaps of cartilage. After surgery, a standard protocol of rehabilitation should been performed before returning to full activity.
Highlights
- Meniscus tears are generally associated with another injury from a traumatic event.
- Most meniscal injuries do not heal on their own.
- Minimally invasive arthroscopic surgery can help the symptoms of a torn cartilage.
