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Meniscus tear knee injury

A meniscus tear is a knee injury affecting the shock absorbing cartilage between the knee bones.

The meniscus is a piece of cartilage in your knee that cushions and stabilises the joint and protects the bones from wear and tear. However, twisting injury can tear the meniscus.

In some cases with meniscal tears, a piece of the shredded cartilage breaks loose and catches in the knee joint, causing it to lock up.

osteoarthritis_knee_injuries_revised.jpg

Meniscus tears are common in contact sports, like football, as well as in cricket, skiing and volleyball. They can happen when a person changes direction suddenly while running, and often occur at the same time as other knee injuries, like an anterior cruciate ligament (ACL) injury. Meniscus tears are a special risk for older sportspeople, since the meniscus weakens with age. More than 40% of people aged 65 or older have them.

What does a meniscus tear feel like?

Symptoms of a meniscus tear include:

  • Pain in the knee.
  • Swelling.
  • A popping sensation during the injury.
  • Difficulty bending and straightening the leg.
  • A tendency for your knee to get "stuck" or lock up.

At first, the pain may not be too bad. You might even play through the injury. However, once the inflammation sets in, your knee will probably hurt considerably.

To diagnose a meniscus tear, your doctor will examine your knee and want to hear how you got your injury. X-rays may be necessary, to rule out broken bones and other problems. You may also need an MRI (Magnetic Resonance Imaging) scan, as these can show the damage precisely.

What's the treatment for a meniscus tear?

Happily, mild-to-moderate meniscus tears may heal on their own, given time. If your doctor or specialist feels you have a relatively minor injury, you may be referred to a physiotherapist. In addition, to help speed the healing, you can:

  • Rest the knee. Try to avoid putting weight on your knee as much as possible. You may need to use crutches for a time.
  • Ice your knee to reduce pain and swelling. Do this for 20-30 minutes every 3-4 hours for 2-3 days, or until the pain and swelling is gone. Never apply ice directly to the skin, always wrap it in a cloth.
  • Compress your knee. Use an elastic bandage, straps or sleeves on your knee to control swelling.
  • Raise your knee on a pillow when you're sitting or lying down.
  • Wear a knee brace to protect your knee from getting re-injured.
  • Take anti-inflammatory painkillers. Non-steroidal anti-inflammatory drugs (NSAIDs), like aspirin or ibuprofen, will help with pain and swelling. However, these medicines can have side-effects, like an increased risk of bleeding and ulcers. They should only be used occasionally, unless your doctor specifically says otherwise.
  • Practise stretching and strengthening exercises if your doctor recommends them.

However, these conservative treatments aren't always enough. If large chunks of cartilage have been torn off, or the meniscus has split, you may need surgery to remove them. The procedure is fairly simple, and is almost always done arthroscopically. This is a form of keyhole surgery, where an arthroscope - a small, flexible tube with a camera on the end - is inserted into your knee. Through this instrument the surgeon can see the extent of the damage, remove any broken pieces of cartilage, and trim frayed areas of the meniscus. Normally you can go home on the same day. You may need a splint or brace afterwards.

For 85-90% of people who have surgery for a meniscus tear, the short-term results are excellent or good. However, in the long term, people who have the meniscus removed completely are at much greater risk of developing knee arthritis in later years.

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