Treating a torn meniscus

The largest joint in the body, our knees, gets a lot of wear and tear from allowing us to walk, run, bend, and even sit. They are an integral part of movement which also makes them prone to injury.  One of the most common knee injuries is a meniscus tear.  Athletes are especially at high risk for a torn meniscus but even older adults can be vulnerable as the cartilage the meniscus is made of can become thin over time.

The meniscus is essentially a shock absorber for the knee.  Within the knee are three bones – the femur, tibia and patella. To protect and stabilize our knee joint, two crescent-shaped discs (the menisci) made of thick, rubbery cartilage sitting between the bones of the knees helping cushion the lower part of the leg from the weight of the rest of the body.

What is a meniscus tear?

Anyone of us can be at risk of a torn meniscus but generally they occur during a rotating movement while bearing weight.  This is why athletes, especially football players, are more likely to have this type of injury occur – they often make a move of twisting the upper leg while the foot stays in one place during the game.  Many times a person will describe the injury as feeling a sudden popping sensation in their knee, indicating they may have caused damage to the meniscus.

Other causes of a meniscus tear can be a direct injury to the knee or aging due to regular wear and tear on the knee causing the cartilage to thin and tear.

Meniscus tears can be minor in which the meniscus stays connected to the knee or the tear could be more major with the meniscus damaged to the point of being barely attached to the knee by a cartilage thread.  Usually a person can still walk but over the next several days the symptoms can worsen.

Symptoms of a torn meniscus can include the following:

·      Knee pain, especially when holding the knee straight

·      Inability to fully extend the knee

·      Stiffness or swelling

·      Sensation of the knee “catching,” “clicking,” or “locking” in place

·      Knee may feel weak or have a feeling of “giving away”

Diagnosing a torn meniscus

Anytime a person is experiencing any of the symptoms of a torn meniscus, it is advisable to get a prompt diagnosis and treatment so as not to further injure the knee or meniscus.

The best doctor to see for such an injury is an orthopedic surgeon.  They will conduct movement tests asking you to move your knee and leg in different directions in order to help them pinpoint the location of the meniscus tear.

Most likely an imaging test of either an x-ray or magnetic resonance image (MRI) will be conducted to rule out any other conditions causing the knee pain and to be able to view detailed pictures of soft tissue like the meniscus to confirm a diagnosis.

Another possible way of diagnosing a meniscus tear is to perform an arthroscopic procedure.  This is a minimally invasive procedure that can help diagnosis a meniscus tear.  A tiny incision is made in the knee in which a thin instrument with a camera called an arthroscope can allow the doctor to see a detailed picture of the knee anatomy.

Treatment plan for a torn meniscus

Depending on the severity and location of the meniscus tear will determine what treatment plan will be recommended.  Specific treatment will also be based on a person’s age, overall health and medical history. 

If a person chooses not to treat a torn meniscus, there can be complications from that choice.  An untreated torn meniscus can result in instability of the knee, persistent pain, and an increased risk of osteoarthritis.

If the tear is noninvasive then the treatment methods recommended might include:

·      Rest – A torn meniscus needs time to heal and this means avoiding activities that cause any rotation of the knee.  If need be, using crutches to take the pressure off of the knee may help. 

·      Ice – Icing the knee can help reduce swelling and pain.  Use cold packs for 20 minutes, several times a day avoiding applying the ice directly to the skin.

·      Compression – To prevent additional swelling and blood loss, wear an elastic compression bandage.

·      Elevation – To reduce swelling, recline when you rest, and put your leg up higher than your heart.

·      Medication – Non-steroidal anti-inflammatory medication (NSAIDs) such as ibuprofuen or aspirin can reduce knee swelling and pain.

·      Physical therapy – Referral to a physical therapist for a customized physical therapy plan can restore knee strength and function.

For major meniscus tears or persistent pain, more extensive treatment such as surgery may be recommended. If so, this might include the following procedures:

·      Knee arthroscopy – This is a minimally invasive procedure in which tiny incisions are made to the knee using specialized instruments to trim or repair the meniscus.  It is a targeted surgery so there is less damage to the surrounding healthy tissue.  There is minimal scarring and this procedure has a fast recovery.

·      Meniscus transplant surgery – If the meniscus is badly damaged, it may need to be removed completely.  If the person is under the age of 55, they may be a candidate for this type of surgery. 

·      Knee replacement surgery – For older adults who need to have their meniscus completely removed, this would be the option of them.