The knee is one of the most complex and largest joint in the body, and is more susceptible to injury. Meniscal tears are one of the common injuries to the knee joint. It can occur at any age, but are more common in athletes playing contact sports.
The meniscus is a small, "c" shaped piece of cartilage in the knee. Each knee consists of two menisci - a medial meniscus on the inner aspect of the knee and the lateral meniscus on the outer aspect of the knee. The medial and lateral menisci act as cushion between the thighbone (femur) and shinbone (tibia). The meniscus has no direct blood supply, and for that reason, when there is an injury to the meniscus, healing cannot take place.
Meniscal tears often occur during sports. These tears are usually caused by twisting motion or overflexing of the knee joint. Athletes who play sports such as football, tennis and basketball are at a higher risk of developing meniscal tears. They often occur along with injuries to the anterior cruciate ligament (ACL), a ligament that crosses from the femur to the tibia.
The various types of meniscal tears that can occur are longitudinal, bucket handle, flap, parrot-beak and mixed or complex.
The symptoms of a meniscal tear include:
- Knee pain when walking
- A “popping “or “clicking” felt at the time of injury
- Tenderness when pressing on the meniscus
- Swelling of the knee
- Limited motion of the knee joint
- Joint locking, if the torn cartilage gets caught between the femur and tibia, preventing the straightening of the knee
A careful medical history and physical examination can help diagnose meniscal injury. The McMurray test is an important test for diagnosing meniscal tears. During this test, your doctor will bend your knee, then straighten and rotate it in and out. This creates pressure on the torn meniscus. Pain or a click during this test may suggest a meniscal tear. Your doctor may order imaging tests such as X-ray and MRI to help confirm the diagnosis.
The treatment of a meniscal tear depends on the pattern and location of the tear. If the meniscal tear is not severe, your doctor may begin with nonsurgical treatments that may include:
- Rest: Avoid activities that may cause injury. You may need to use crutches temporarily to limit weightbearing.
- Ice: Ice application is recommended to reduce swelling.
- Pain medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) are usually prescribed to help reduce swelling and pain.
- Physiotherapy: Physiotherapy may be recommended for muscle and joint strengthening.
If the symptoms are persisting and conservative treatments fail, you may need a knee arthroscopic surgery to repair the torn meniscus.