What Is The Meniscus?
The meniscus is a gasket-like structure in the knee that helps cushion and spread out the contact pressures during weight bearing. Each knee has both a medial (inside) and lateral (outside) meniscus that sit between the thigh bone (femur) and shin bone (tibia).
How Is The Meniscus Injured?
Meniscal injury can be broken into two general categories: acute and degenerative. Acute meniscus tears most often occur after a noticeable and definite traumatic injury to the knee. This usually involves some sort of twisting/pivoting movement or buckling of the knee. There are various tear patterns that are seen which can dictate the treatment and long-term durability of the knee. Acute tears can be isolated or associated with other injuries to the knee such as an ACL tear or cartilage injury. In contrast to acute tears, degenerative meniscal tears are usually associated with arthritis of the knee. The worn cartilage surfaces of the arthritic knee cause tearing and fraying of the meniscus, creating complex tear patterns.
What Are The Symptoms Of A Meniscal Tear?
Symptoms can range from occasional clicking or catching of the knee, occasional or constant pain with weight bearing, to a “locked” knee that won’t flex or extend.
How Are Meniscal Tears Treated?
Most meniscal tears will not heal on their own. This is due to a poor blood supply to the meniscus, as well as mechanical forces that can displace the tear. Symptomatic meniscal tears are treated with repair or debridement (trimming of the torn areas). Only a small percentage of meniscal tears can be repaired, and this depends on the tear type/pattern, the location of the tear, as well as associated injuries in the knee. The majority of meniscal tears are treated with debridement, also known as a partial meniscectomy, where the displaced, torn portion is trimmed back to a stable rim.
What Is Recovery Like After Meniscal Surgery?
Recovery after a meniscal debridement is usually quick. Most patients can return to work (aside from high physical demand jobs) in 3-5 days, and can return to athletic activity and exercise by 4 weeks. In contrast, meniscal repair requires a much longer period of recovery, with restrictions on activity, weight bearing, and brace use for up to 6 weeks. Most patients are not allowed to begin sports-related rehabilitation for at least 3 months, with full recovery expected by 5-6 months.
How Do I Know If I Need Meniscal Surgery?
If you have been diagnosed with a meniscus tear on MRI, you should have a discussion with your orthopedic surgeon regarding the optimal treatment. Plain, weight-bearing x-rays of both knees will also be required. Similar to most orthopedic injuries, if the symptoms thought to be caused by the meniscal tear are interfering with your ability to remain active and healthy, we usually recommend surgical intervention. However, in the presence of moderate and severe arthritis of the knee, the approach differs due to the fact that some or all of the symptoms may be due to arthritis and not only the meniscus injury.
