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Meniscus Tear

A meniscus tear is a common knee injury. It affects the knee joint's cartilage, which stabilizes the knee, distributes weight, and absorbs impact.

Meniscus tears commonly occur due to forceful twisting or rotation of the knee during weight-bearing activities like sports, lifting, or squatting. Tears can also happen in older adults as part of the natural degeneration process.

Treatment for a meniscus tear depends on the tear's location, size, and severity, and your symptoms. Treatment options may include rest, physical therapy, medications, or surgery to repair or remove the damaged meniscus tissue.

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What Is a Meniscus Tear?

A meniscus tear occurs when the cartilage in the knee joint, known as the meniscus, is damaged.

The meniscus is a C-shaped piece of tough, rubbery tissue located between the thighbone (femur) and shinbone (tibia). It acts as a shock absorber and helps to distribute weight evenly across the knee joint.

A torn meniscus typically causes pain, swelling, stiffness and a catching or locking sensation in your knee.

How common is a meniscus tear?

Meniscus tears are relatively common knee injuries that affect nearly a million people each year.

Many factors affect how often they occur, including:

  • Age. As you get older, you're more likely to have meniscus tears because cartilage wears down over time.
  • Activity level. Athletes who play sports like football, basketball, soccer, and skiing often see a higher incidence of meniscus tears.

What are the types of meniscus tears? 

There are different types of meniscus tears that occur in the knee:

  • Radial tear. This type of tear starts at the inner edge of the meniscus and extends toward the outer edge in a straight line. Radial tears can make the meniscus separate into different sections, and they can be stable or unstable depending on their location and size.
  • Horizontal tear. These tears run parallel to the surface of the meniscus, dividing it into upper and lower portions. Horizontal tears are often seen in older adults due to degeneration of the meniscus.
  • Bucket handle tear. This long, vertical tear creates a flipped or displaced piece of the meniscus that resembles the handle of a bucket. It can cause the knee to lock, making it difficult to fully straighten or bend the knee.
  • Flap tear. These tears occur when a portion of the meniscus partially detaches, forming a flap-like shape. Flap tears can cause symptoms such as catching, locking, or a feeling of instability in the knee.
  • Complex tear. Complex tears involve a combination of different tear patterns, such as a radial tear with a horizontal component or a mix of radial and vertical tears. They're often more challenging to treat and may require surgery.

What causes a meniscus tear?

The most common causes of meniscus tears include:

  • Traumatic injury, such as a sudden and forceful twisting or bending of the knee joint while playing sports or during an accident.
  • Degenerative changes that happen as you age. The meniscus can become weaker and more prone to tears, even with minor activities or movements, in people over the age of 40.

What are meniscus tear risk factors and complications? 

Meniscus tear risk factors 

Your risk of having a meniscus tear varies based on your age, activity level, and overall health.

Some common risk factors include:

  • Age. The risk increases with wear and tear on the knees over time.
  • Sports and activities that involve sudden changes in direction or frequent pivoting, like soccer, basketball, football, and skiing.
  • Previous knee injuries, such as a torn ACL.
  • Obesity, as excess weight puts additional stress on the knees.
  • Occupations that require repetitive kneeling, squatting, or heavy lifting.
  • Genetics and anatomical factors, such as an abnormal knee shape or a loose connective tissue.

Meniscus tear complications

Meniscus tears can lead to complications, depending on how severe the tear is and its location.

Some possible complications include:

  • Persistent pain in the affected knee, which can be exacerbated by physical activity or certain movements.
  • Swelling and inflammation in the knee joint, which can result in stiffness, limited range of motion, and discomfort.
  • Locking or catching of the knee from a piece of the torn tissue in the joint space. This can cause sudden pain and difficulty in fully extending or bending the knee.
  • Instability and reduced knee joint function, making it difficult to bear weight or participate in activities that require balance or movement.
  • Development of osteoarthritis in the affected knee joint, if a meniscus tear is left untreated or isn't properly addressed. This degenerative condition causes joint pain, stiffness, and reduced mobility.

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What Are the Signs and Symptoms of a Meniscus Tear?

Signs and symptoms of a meniscus tear vary based on the severity and location of the tear.

Common signs and symptoms of a torn meniscus include:

  • Knee pain. A primary symptom, the pain may be sharp or aching and is often felt along the joint line of the knee. It may worsen during activities that put stress on the knee, such as running or squatting.
  • Swelling in the knee joint. The swelling may occur immediately after the injury or develop gradually over a couple of days.
  • Stiffness. The knee may feel stiff or restricted in movement, making it difficult to fully straighten or bend the knee.
  • Clicking or popping sensations during movement. This can occur when a torn portion of the meniscus moves out of place.
  • Locking or catching of the knee, leading to sudden pain and difficulty in fully extending or bending the knee.
  • Decreased range of motion, making it difficult to perform activities that require full knee movement.

When should I see a doctor about my meniscus tear symptoms?

If you have symptoms that you suspect are from a meniscus tear, you should see your doctor or an orthopaedic specialist. Many of the symptoms of a meniscus tear can also occur in other knee conditions.

Consider scheduling an appointment if you have:

  • Persistent knee pain that lasts for more than a few days or worsens over time.
  • Swelling or signs of inflammation, such as redness and warmth.
  • Difficulty putting weight on the affected leg or significant discomfort while walking or performing daily activities.
  • Locking or catching of the knee during movement, causing significant pain or difficulty in extending or bending the knee.
  • Noticeable limitations in your ability to fully straighten or bend your knee.
  • History of knee injuries or previous knee problems.

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How Do You Diagnose a Meniscal Tear? 

To diagnose a meniscus tear, your doctor will do need to do a complete evaluation.

What to expect during your visit

Your doctor will ask about your symptoms, when they started, and how they've progressed. They'll also want to know about any previous knee injuries or conditions.

Your doctor will also examine your knee for signs of a meniscus tear. They may check for tenderness along the joint line, swelling, and decreased range of motion.

Tests to diagnose a meniscus tear

If your doctor suspects that you have a meniscus tear, they'll likely order imaging tests, such as an:

  • MRI. An MRI provides detailed images of the knee joint, allowing the doctor to visualize the meniscus and identify any tears or other abnormalities.
  • X-ray. Although an x-ray cannot directly visualize the meniscus, it may be done to rule out other conditions that can cause similar symptoms, such as fractures or arthritis.
  • Ultrasound. In some cases, an ultrasound may be used to assess the meniscus and surrounding structures.

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How Do You Treat Meniscal Tears? 

The treatment for meniscus tears varies based on the severity and location of the tear, your age, activity level, and overall health.

Your doctor or an orthopaedic surgeon will determine the best treatment for a meniscus tear. They may suggest nonsurgical options such as rest, physical therapy, and medication, or in some cases, surgery.

Can a meniscus tear heal on its own?

Small tears on the outer edge of the meniscus with a good blood supply may have the potential to heal on their own. However, larger tears or tears in the inner portion of the meniscus, which has limited blood supply, are less likely to heal without medical treatment.

Nonsurgical meniscus tear treatment

For minor tears, your doctor may suggest:

  • Rest. Avoid activities that aggravate your knee and allow time for healing.
  • Ice. Apply ice packs to the affected knee to reduce swelling and pain.
  • Compression. Use a compression bandage or knee brace to provide support and reduce swelling.
  • Elevation. Elevate the leg to help reduce swelling.
  • Physical therapy. Exercises and stretches can help strengthen the muscles around the knee, improve stability, and restore function.
  • Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation.

Meniscus tear surgery

Some meniscus tears, especially those that are larger or more complex, may require surgery.

Types of meniscus tear repair surgery include:

  • Arthroscopic surgery. Your orthopaedic surgeon uses a small camera and surgical instruments inserted through small incisions to trim or repair the torn meniscus.
  • Partial meniscectomy. Your orthopaedic surgeon removes the torn section of the meniscus.
  • Total meniscectomy. Your orthopaedic surgeon removes the entire meniscus. In most cases, doctors avoid this type of surgery because it increases the risk for osteoarthritis in the knee.

How effective is meniscus tear surgery?

Meniscus tear surgery can be an effective treatment option for certain types of meniscus tears. How effective the meniscus tear surgery is depends on several factors, including the size, location, and stability of the tear, as well as your overall health and activity level.

Arthroscopic surgery for meniscus tears has been shown to provide positive outcomes and relieve symptoms in many cases.

It can help to:

  • Reduce pain.
  • Restore or improve knee function, range of motion, and stability.
  • Prevent further damage and potentially delay the progression of osteoarthritis.

For the best outcome, you'll need to go through rehab and physical therapy after surgery.

How long does it take to recover from meniscus tear surgery?

Recovery time from meniscus tear repair surgery varies based on the severity of the tear, the type of surgery performed, and your overall health.

The initial recovery phase after meniscus surgery takes about four to six weeks. During this time, you'll use crutches, limit weight-bearing activities, and undergo physical therapy to regain strength and mobility.

Full recovery and return to normal activities or sports may take longer, usually ranging from three to six months.

It's important to follow the post-operative rehabilitation plan from your orthopaedic surgeon and physical therapist to optimize the healing process and regain full function of the knee.

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