Meniscal Tear
What is a meniscal tear?
A meniscal tear is an injury to one of the menisci—the crescent-shaped pieces of cartilage that act as shock absorbers in the knee joint. Each knee has two menisci: the medial meniscus (on the inner side of the knee) and the lateral meniscus (on the outer side of the knee). These structures help distribute weight across the knee joint, stabilise the joint, and reduce friction between the femur (thigh bone) and tibia (shin bone).
What causes a meniscal tear?
Meniscal tears are often caused by:
Acute Injury: This typically happens during sports or physical activities that involve twisting, pivoting, or sudden changes in direction (e.g., football, basketball, or skiing). A sharp twist or deep squat can lead to a tear.
Degeneration: As people age, the menisci may become weaker and more brittle, making them more prone to tearing even with routine activities like walking or standing.
Types of Meniscal Tears
Meniscal tears can vary in shape and severity.
Some common types include:
Horizontal Tear: A tear that runs parallel to the top and bottom edges of the meniscus.
Vertical Tear: A tear that runs from the top to the bottom of the meniscus.
Radial Tear: A tear that starts from the inner edge and radiates outward toward the outer edge of the meniscus.
Bucket Handle Tear: A type of vertical tear where a portion of the meniscus flips into the joint like a handle, often causing the knee to lock.
Complex Tear: A tear with multiple patterns and irregularities.
What are the symptoms of a meniscal tear?
Symptoms of a Meniscal Tear may include:
Pain: Typically felt on the inside or outside of the knee, depending on which meniscus is torn. The pain may be sharp, especially during twisting movements.
Swelling: Swelling often develops within 24 to 48 hours after the injury, especially if the tear causes fluid to build up in the knee joint.
Locking or Catching: In some cases, the torn meniscus can get caught in the joint, leading to a "locking" sensation where you may be unable to fully straighten or bend your knee.
Instability: The knee may feel weak or unstable, especially when bearing weight or moving.
Limited Range of Motion: The knee may feel stiff or have trouble fully bending or straightening.
Diagnosis of a Meniscal Tear
History and Physical Examination: Dr Collins will assess the knee for signs of swelling, tenderness, and range of motion. Specific tests are used to check for meniscal tears by manipulating the knee to feel for popping or clicking sensations.
Imaging:
MRI: The most common and reliable way to diagnose a meniscal tear.
X-rays: While X-rays cannot show soft tissue like the meniscus, they are helpful to rule out arthritis, and any other bony abnormalities or alignment issues.
How do you treat a meniscal tear?
Treatment depends on the type, location, and severity of the tear, as well as your age and activity level.
Non-Surgical Treatment (for minor or non-displaced tears):
Rest: Avoiding activities that stress the knee, like running or jumping, can help the meniscus heal.
Ice: Applying ice to the knee can help reduce swelling and pain.
Compression and Elevation: Using an elastic bandage or compression wrap and elevating the leg can help manage swelling.
Physical Therapy: Exercises to strengthen the muscles around the knee and improve stability can help with recovery and prevent further injury.
Medications: Anti-inflammatory medications can help relieve pain and swelling.
Injections: a trial of a steroid injection or viscosupplementation (hyaluronic acid, PRP or other) may be worthwhile in appropriate patients
Surgical Treatment:
Arthroscopic partial meniscectomy: A minimally invasive surgery where Dr Collins uses small incisions and a camera (arthroscope) to remove or trim the damaged part of the meniscus. This is often recommended for patients or those with tears that can't be repaired, if non-operative treatment has failed.
Meniscus Repair: If the tear is located in a part of the meniscus with good blood supply (which allows healing), Dr Collins may repair the tear with sutures. This is more common in younger patients who are more active, and more acute tears.
Meniscus Transplant: In rare cases, when a significant portion of the meniscus is removed, a meniscus transplant from a donor may be considered.
Your Recovery
Non-surgical Recovery: With rest, physical therapy, and proper management, minor tears may heal on their own. The recovery time can range from a few weeks to a couple of months, depending on the severity of the tear.
Surgical Recovery: If surgery is necessary, recovery time varies. Arthroscopic meniscectomy typically has a quicker recovery time (a few weeks) compared to meniscus repair, which may take several months to fully heal. Physical therapy is often recommended after surgery to restore strength and mobility.
Prognosis
The outlook for people with meniscal tears depends on the extent of the tear, the type of treatment, and the individual's activity level. Many people recover fully with appropriate treatment, while others may experience long-term knee pain or arthritis, especially if the tear is not addressed or if too much of the meniscus is removed.
If you suspect you have a meniscal tear or are experiencing knee pain, it’s important to consult with your healthcare providers for an evaluation and appropriate treatment plan. Dr Collins would be happy to see you regarding your knee issues.
Orthopaedic Surgeon Melbourne
Utilising the latest techniques and technology Kade aims to return you to your best as soon as possible with optimised recovery via a multi-disciplinary and multi-modal approach.