Meniscal Tear Overview

When athletes discuss torn cartilage in the knee joint, they are commonly referring to a meniscal tear. The menisci are small “c” shaped structures that act like cartilage and “shock absorbers” when the knee is placed under stress and when in motion. Meniscus tears are among the most common knee injuries seen by the Dallas, Frisco and Fort Worth, Texas area knee specialists at Texas Sports Medicine. This injury can occur to any individual, but is most commonly found in athletes involved in contact sports.

What is a Meniscal Tear?

Each knee joint has two menisci, the medial meniscus and the lateral meniscus. The functions of the menisci are to evenly distribute stress placed on the joint, which protects the cartilage on both the tibia and femur. The medial meniscus is responsible for bearing up to 50% of the load placed on the inside (medial) of the joint, while the lateral meniscus is responsible for bearing up to 80% of the load placed on the outside (lateral) of the joint.

Both the medial meniscus and the lateral meniscus can become torn. Common causes of a meniscal tear include direct contact (like a tackle during contact sports), repeated squatting and a sudden twisting movement of the joint. Older adults are prone to degenerative meniscus tears caused by the menisci breaking down over time from the natural aging process and general wear and tear. If the menisci are weakened, anything as small as an awkward twist while standing up can cause a tear in older individuals.

Meniscal tears vary in location, size and severity. This injury is commonly connected to other knee injuries such as a ligament tear.

Meniscal Tear Symptoms

Many people who experience a meniscal tear can walk on the injured knee and can even keep engaging in athletic activities after the tear occurs. Symptoms usually begin 2-3 days following the injury. Common symptoms include:

  • Pain
  • Catching or locking of the knee joint
  • Stiffness
  • Swelling
  • Decreased range of motion
  • The sensation the knee may give out
  • A ‘popping’ sound at the time of tear

Without proper treatment from a knee specialist, a piece of meniscus may break off and drift freely in the joint, commonly known as a loose body. The drifting meniscus piece can cause the joint to lock, pop and slip.

Meniscal Tear Treatment

Treatment for a meniscus tear depends on severity, size and location of the injury. The outside one-third of the meniscus has a rich supply of blood at all times, so a tear in the “red” zone can often heal with nonoperative or operative measures. A tear in the inner two-thirds, known as the “white” zone, lacks a rich blood supply and often requires a surgical meniscus repair to properly treat the tear. Tears in the inner one-third, or “white-white” zone, do not have the capacity to heal and may necessitate a menisectomy to remove the torn portion of the meniscus.  Your physician at Texas Sports Medicine will help you determine the best treatment option

Nonoperative

  • RICE method
    • Rest, Ice, Compression, Elevation
  • Medication
    • NSAIDs such as ibuprofen and aspirin reduce pain and swelling
  • Activity Modification
    • Avoid deep bending, twisting, and pivoting activities

Operative

  • Meniscus Debridement versus Repair
    • Surgical technique: Two small incisions are created in the front of the knee to view the damage with a tiny camera called an arthroscope. The torn meniscus can be either repaired or removed. If a larger, more complex tear is present, an arthroscopic and open surgery may be utilized to bring the damaged tissue back together.

After Surgery

  • Weight bearing as tolerated with crutches after a debridement
  • Weight bearing status will be determined by your physician if you have a repair
  • Physical therapy will start immediately after surgery
  • Return to sports usually in 6-8 weeks for debridement and 3-6 months for repair

If you live in the Dallas, Frisco and Fort Worth, Texas area and would like to discuss a meniscal tear in more detail, please contact the knee specialists at Texas Sports Medicine.

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