Knee Meniscus Tear

The meniscus is a piece of cartilage that provides a cushion between your thighbone (femur) and shinbone (tibia). There are two menisci in each knee joint. They can be damaged or torn during activities that put pressure on or rotate the knee joint.

Treatment options can vary from at-home remedies to outpatient surgery, depending on the severity of your injury. You can prevent this injury by performing exercises that will strengthen the leg muscles and using proper techniques during contact activities or sports.

The meniscus can be torn during activities that cause direct contact or pressure from a forced twist or rotation. A sudden pivot or turn, deep squatting, or heavy lifting can lead to injury. Many sport athletes are at risk for tearing the meniscus. Sports that require sudden turns and stops, such as football, basketball, soccer, and tennis, may put you at higher risk for meniscus tears.

The meniscus weakens with age, and tears are more common in people over the age of 30. Movements like squatting or stepping can lead to injury in someone with weak menisci. If you have osteoarthritis, you are at higher risk of injuring your knee or tearing your meniscus. Osteoarthritis is a common joint disorder involving pain and stiffness in your joints caused by aging and wear and tear.

When a meniscus tear occurs, you may hear a popping sound around your knee joint. Afterwards, you may experience:

• pain, especially when the area is touched
• swelling
• difficulty moving your knee or inability to move it in a full range of motion
• the feeling of your knee locking or catching
• the feeling that your knee is giving away or unable to support you

You may also experience a slipping or popping sensation, which is usually an indication that a piece of cartilage has become loose and is blocking the knee joint.

You should contact your doctor if you experience any of these symptoms and they persist for more than a few days or occur after your knee has been injured. If your knee locks and you are unable to bend your knee after straightening it, you should call your doctor.

Physical Exam

After talking about your symptoms, your doctor will examine your knee and test your range of motion. He or she will look closely at the spot where the meniscus is along your joint. Your doctor also may perform a McMurry test to look for a meniscal tear. This test involves bending your knee, then straightening and rotating it. You may hear a slight pop during this test, which can indicate a meniscal tear.

Imaging Tests

Imaging tests may be ordered to confirm a meniscal tear. These include:

• Knee X-Ray: This test will not show a meniscus tear. However, it can be helpful to determine if there are any other causes of your knee pain like osteoarthritis.

• Magnetic Resonance Imaging (MRI): This machine will use a magnetic field to take multiple images of your knee. It will be able to take pictures of cartilage and ligaments to determine if there is a meniscus tear.
• Ultrasound: Ultrasound uses sound waves to take images inside the body; this will determine if you have any loose cartilage that may be getting caught in your knee.

Arthroscopy

If your doctor is unable to determine the cause of your knee pain from these techniques, he or she may suggest arthroscopy to study your knee. If you require surgery, your doctor will also most likely use an arthroscope. With arthroscopy, a small incision (cut) is made near the knee. The arthroscope is a thin and flexible fiberoptic device that can be inserted through the incision. It has a small light and camera, and surgical instruments can be moved through the arthroscope or through additional incisions in your knee. Often with arthroscopy, either for surgery or examination, you can go home the same day.

Initially, you should treat the knee injury with at-home techniques including R.I.C.E:

• Rest your knee. Use crutches to avoid any weight bearing on the joint. Avoid any activities that worsen your knee pain.
• Ice your knee every three to four hours for 30 minutes.
• Compress or wrap the knee in an elastic bandage to reduce inflammation.
• Elevate your knee to reduce swelling.

You should not put full weight on your injured knee if it is painful.

Your doctor may recommend physical therapy to strengthen the muscles surrounding the knee. This can help to reduce pain and increase your knee mobility and stability.

Surgery

If your knee is not responding to treatment, your doctor may recommend arthroscopic surgery. The surgeon makes a small incision in your knee to insert tools and a camera to repair or trim away the damaged meniscus.

You can usually go home the same day after this procedure. Full recovery will take time, but you can soon return to the level of functionality you had before surgery.

Surgery involves risks and you should talk with your doctor to determine if you are a good candidate for this procedure. The recovery period will include regular visits to the doctor, as well as physical therapy to strengthen the muscles supporting your knee.

With proper diagnosis and adherence to treatment, you can often return to preinjury knee mobility and function.

You can prevent meniscus tears by regularly performing exercises that strengthen your leg muscles. This will help stabilize your knee joint to protect it from injury. You can also use protective gear during sports or a brace to support your knee during activities that may increase your risk of injury.

Always use proper form when exercising or engaging in activities that may put pressure on your knee joint. It is a good idea to warm up and stretch prior to exercising, to use proper gear such as athletic shoes designed specifically for your activity, to lace up your footwear properly, and to learn the proper techniques for whichever activity you may be engaged in.