The meniscus is a C-shaped fibrocartilaginous structure in the knee that sits on top of the tibia (shin bone). Each knee has two menisci: a medial (inner) meniscus and a lateral (outer) meniscus.
The meniscus helps distribute forces over a greater surface area of the knee, traps synovial joint fluid to help supply nutrition to the articular cartilage, and helps stabilize the knee. Meniscus tissue loses elasticity and wears with age.
What Is a Meniscus Tear?
A meniscus tear is an injury to one of the two C-shaped menisci in the knee. The meniscus is fibrocartilage, or rubbery tissue, that sits between the femur (thigh bone) and tibia (shin bone).
The meniscus functions like an adapter between the rounded femur and flat tibia. It helps distribute forces across the joint, supplies nutrition to the articular cartilage by trapping synovial joint fluid, and helps stabilize the knee.
Causes and Risk Factors
Meniscus tears may result from:
- Twisting, pivoting, or cutting
- Kneeling or squatting
- Wear and tear or degeneration
Risk factors include:
- Contact sports such as football
- Sports involving cleats and pivoting, such as soccer
- Sports requiring good shoe grip and sudden changes in direction, such as racquetball, basketball, and squash
- Previous knee injury
- Associated knee injuries, particularly ligament injuries
- Poor physical conditioning, including strength and flexibility
Symptoms
Signs and symptoms may include:
- Pain and tenderness along the knee joint, especially when standing on the affected leg and twisting or squatting
- Knee swelling, which may occur immediately or be delayed by one to two days
- Locking or catching of the knee
- Inability to completely straighten the knee
- Giving way or buckling of the knee
Treatment
Initial treatment may include medications and ice to relieve pain and reduce swelling.
Walking with crutches until the patient can walk without a limp is sometimes recommended, although full weight may be placed on the injured leg. Range-of-motion, stretching, and strengthening exercises may be performed at home, although referral to a physical therapist or athletic trainer may be recommended.
A single steroid injection can reduce swelling and pain and may assist with non-operative treatment.
Meniscal injuries do not heal on their own but may not cause symptoms. For symptomatic, painful meniscus tears, surgery is the definitive treatment. Depending on the condition of the meniscal tissue and the pattern of the tear, surgery may:
- Trim a nonrepairable tear back to stable edges
- Repair certain meniscus tears
Nonsteroidal anti-inflammatory medications such as aspirin and ibuprofen, or other minor pain relievers such as acetaminophen, are often recommended as directed by a physician. Pain relievers may also be prescribed when necessary.
Cold can be used to relieve pain and reduce inflammation. It may be applied for 15 to 20 minutes every two to three hours and immediately after activities that aggravate symptoms. Heat may be used before stretching and strengthening activities prescribed by a physician, physical therapist, or athletic trainer.
Recovery and Outcomes
Recovery depends on the surgical procedure performed.
Meniscectomy surgery to trim the meniscus generally has a recovery of less than six weeks, although recovery can sometimes take longer.
Meniscal repair is successful about 80% of the time and requires six weeks in a brace with crutches, followed by a total recovery period of approximately four to six months.
Potential complications may include recurrence of symptoms, repeated knee injury, progression of an untreated tear, and arthritis of the knee in later years.
When to See Dr. Chudik
Contact Dr. Chudik’s office for evaluation if knee pain, swelling, catching, locking, giving way, or difficulty fully straightening the knee persists following a meniscus injury.
Call 630-324-0402, request an appointment online, or email contactus@chudikmd.com.