Meniscus Tears

You twisted your knee last week, there was a small “pop” at the time and now the knee is sore and slightly swollen. Every now and then when you twist the wrong way, your knee catches and feels as though it will lock up. What is wrong? Well, as most coaches and trainers will be able to tell you, you have “torn a cartilage”.

A torn cartilage refers to an injury to the meniscus of the knee. The meniscus is a C-shaped piece of cartilage that fits between the bones of the knee joint and acts as a shock absorber. Each knee has two — one on the inside and one on the outside. A twisting injury may cause one of these shock absorbers to be caught between the two bones, causing a meniscus tear. Ligamentous instability, such as a tear of the anterior cruciate ligament, increases the chances of this occurring.

What are the Symptoms of Meniscus Tears?

Meniscus tears cause irritation, leading to swelling and inflammation inside the knee. More significantly, the torn portion frequently becomes unstable and will periodically get caught in between the two bones of the knee causing a painful catching sensation. Sometimes the torn portion will get stuck in between the two bones, leading to actual locking of the knee.

The diagnosis of meniscus tears can be made based on the history and physical examination, and are often confirmed with an MRI scan. This is a new type of scan which uses a magnetic field, rather than x-rays, to look at the knee. Soft tissues, such as the meniscus, can be seen and evaluated on an MRI scan while x-rays show only the bones.

Treatment for Meniscus Tears

Treatment of meniscus tears usually requires surgery. In the past, this meant a large incision and removal of the entire meniscus. Today, the surgery can be performed arthroscopically. The arthroscope is inserted into the knee through a small stab wound, so the meniscus tear can be seen.

Through a separate stab wound, special microinstruments are inserted to remove only the torn portion of the meniscus, leaving the rest to continue absorbing shock and protecting the knee. Even more recently, it has become possible (in some cases) to repair the torn meniscus, saving it entirely. Saving all or part of the meniscus decreases the chance of developing arthritis in the future.

After surgery, the athlete undergoes a program of knee rehabilitation, followed by a return to play. With modern surgery and rehab techniques, time lost for an athlete in season can be as little as three weeks.