What is a meniscus?
Each person has two menisci in both knees (4 total). They are C-shaped shock absorbers that are located between the tibia and femur and play a crucial role in protecting the knee joint. The menisci act as cushions between the two major leg bones and prevent grinding, distribute forces evenly and absorb shock. Their function is critical to the long term function of the knee.
How common are meniscus tears?
There are two groups of meniscal tears: acute and degenerative. Acute meniscus tears happen sudden from a single injury. They are very common knee injuries in active individuals. Degenerative meniscal tears happen gradually over time with general wear and tear. They are more common in older individuals, affecting 6 out of 10 patients over age 65.
What can cause a meniscus injury?
Acute meniscus tears are frequently the result of traumatic injuries and can occur during high-risk sports (e.g. soccer, tennis and basketball) or from a car accident. Typically, the injury is caused by an aggressive movement in which the knee twists or rotates during pivoting, kneeling, or squatting. Degenerative tears occur from chronic wear and tear of the meniscus cartilage that accumulates with age. These can be caused by everyday activities including getting in and out of a car, squatting, and heavy lifting. As patients age, the cartilage can become stiff and brittle. A damaged meniscus predisposes you to persistent pain, swelling, and arthritis.
What are the types of meniscal tears?
There are many different types of meniscal tears. Broadly, tears can be described as partial thickness, meaning they only affect one side, or full thickness, meaning the tear goes all the way through the meniscus. Tears can be further described based on their appearance. Common types of traumatic tears include bucket handle tears, flap tears, and radial tears. (Click here for a closer look at meniscal anatomy)
Can the body heal a meniscal injury?
The body is not able to heal the meniscus once it is damaged, unlike bone, which heals on its own. The meniscus does not have a good blood supply to repair itself, and damage can lead to arthritis and pain in our joints which may limit our ability to move. This is why damage to the meniscus is such a serious problem and discussion with your doctor is important.
What are the symptoms of a meniscal injury?
Common symptoms of a meniscal injury include a popping sensation, localized pain and swelling on the inside or outside of the knee (depending on the location of the tear). Other symptoms include stiffness, clicking, catching, or locking. Patients also report instability, reduced range of motion, and difficulty walking.
What is the best way to evaluate the meniscus?
A diagnosis of meniscal tear starts with a medical history followed by a physical examination of the knee and discussion of symptoms. Your doctor may also order a few imaging studies such as an X-ray and MRI scan of the knee to rule out other possible diagnoses. X-rays help to identify degenerative changes such as osteoarthritis which can cause knee pain. MRIs help to visualize the menisci and assess the location and severity of the injury. It is also common for the doctor to look in the joint with a small camera, called arthroscopy, to get the best information about injuries/damage in the knee before deciding on the best treatment.
What determines the best treatment for my meniscal injury?
Treatment of an injured meniscus is a complex decision process for doctors and many factors are considered when deciding on a treatment. Doctors consider factors outside your joint such as: your age, work and athletic activities, joint alignment, weight and overall health. Doctors also consider factors inside your joint such as: the type and severity of the meniscal tear, the location of the damage as well as the health of the surrounding cartilage and ligaments.
If surgery is recommended, how long will I be off work?
This is highly dependent on whether your job is more sedentary or requires you to be on your feet. Following surgery, you are on crutches placing no weight on the operated leg for six weeks then building up to full weight bearing by about 8 weeks. You can expect to return to desk based work around two to three weeks, prolonged standing work by 3 months, manual work with load carrying or ladder work by 4-6 months but for more active work such as police, security or military type work, we recommend nine months rehabilitation prior to a return to full duties.
If surgery is recommended, how long will I be in the hospital for?
Meniscus surgery can safely be performed as an outpatient procedure (go home the same day as surgery) or an inpatient procedure (spend one night at the surgical center). It is unlikely any additional time will be spent in the hospital.
