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A Torn Meniscus: The Risks, Symptoms and Repair Options

By Fitoru | 12 April 2019
lady holding knee in pain

A torn meniscus is the most common knee injury that people experience. Knee injuries can, of course, happen to anyone, but a torn meniscus is commonly seen in sports medicine, as it frequently occurs in athletes across many different sports. Read on to find out what behaviors and activities can cause a torn meniscus, and how that injured knee can be treated, with or without surgery.

Torn Meniscus vs. Torn Knee Cartilage: What’s the Difference?

Cartilage is a type of connective tissue in our bodies that comes in several different forms. In the human body, there are three types of cartilage:

  • Hyaline cartilage: A precursor to bone that is found in the nose, larynx, trachea, and ribs.
  • Fibro cartilage: Found in ligaments, joint capsules, and invertebral discs.
  • Elastic cartilage: Found in the larynx, epiglottis, and bendable external part of the ear.

The meniscus of the knee joint is a type of fibro cartilage.

Knee Cartilage

Your knee joint has two types of cartilage, one of which is the meniscus, and the other of which is called articular cartilage. The articular cartilage provides a protective layer between the thigh bone (femur) and the shin bone (tibia) by capping each one. There is also articular cartilage that covers the back of the knee cap; this cartilage is a firm and rubbery shock absorber that keeps our bones from rubbing together.

Injury to knee cartilage can result from chronic overuse, degenerative arthritis, or traumatic injury. Words commonly used to describe an injury to articular cartilage may include:

  • Thinning: Cartilage thinning can be due to arthritis of the knee, or as a result of injury. Thin cartilage is not as smooth as undamaged cartilage and will not glide as easily.
  • Fissuring: A fissure in articular cartilage is a cleavage that causes a separation in the cartilage layer, and may cause what is felt as a catching sensation.
  • Flaps: A flap in articular cartilage occurs when a piece of the cartilage layer doesn’t adhere and can be lifted up from its proper position. This, too, can bring a catching sensation.

The Meniscus

When people refer to a “tear” in knee cartilage, they are most likely referring to the meniscus. The meniscus is the other kind of cartilage in the knee, and two curved pieces of menisci act as shock absorbers between the bones but are not attached to them as the articular cartilage is. The menisci sit between the articular caps, cushioning the joint. Many people will refer to a cartilage tear and a meniscus tear interchangeably, as meniscus is indeed one of the many forms of cartilage. A torn meniscus occurs when these two pieces are damaged.

Torn meniscus: risks, symptoms, and repair options.

A Torn Meniscus: Who’s at Risk?

Those who perform activities that require the knee to twist or bend more than usual are at a higher risk of a torn meniscus, particularly athletes. Those in contact sports like football, non-contact sports like volleyball or soccer which involve jumping and cutting movements, and those who participate in dance or gymnastics could all suffer a torn meniscus due to their activity.

Sports are not the only culprit when it comes to meniscus tears, however. Those who have had a previous knee injury are more at risk, and even normal aging will sometimes cause a torn meniscus due to degeneration of the cartilage or age-related knee changes. Sometimes there will be no clear incident that causes this damage; it will only appear once the person becomes aware of a symptomatic issue with their knee.

Torn Meniscus Symptoms

Meniscus tear symptoms will alert people to seek medical attention for their injury. Knee pain is the most common symptom, and some have said that they felt a popping sensation right at the moment of injury, but the other possible symptoms of a torn meniscus may include:

  • Stiffness and swelling of the knee
  • Difficulty or inability to straighten the knee
  • Knee pain
  • Limited range of motion
  • A knee-locking sensation
  • A feeling as if the knee is “giving out”

Though people can still walk and athletes can still play through a meniscus tear, it is important to seek treatment as soon as the injury becomes clear to prevent further damage. Without medical attention, a piece of cartilage may break away and drift into the joint, where it could cause worse symptoms like a painful popping, locking knee, and slipping knee cap.

Torn Meniscus Diagnosis

Doctors may use anything from a person’s medical history, reported symptoms, a physical exam, an X-ray of the surrounding bones, or a magnetic resonance imaging (aka MRI) scan to make their diagnosis. The physical exam may include the McMurray diagnostic test in which the physician will bend and straighten the patient’s knee, listening all the while for a telltale clicking sound that indicates there’s a meniscus tear. The severity of the injury will dictate the level of treatment that will follow.

Torn Meniscus Treatment

Though treatment is often needed for this injury, torn meniscus surgery is not always necessary. In fact, most meniscus tears can be dealt with and treated using nonsurgical methods. Because many instances of torn meniscus are caused by the degenerative process, sometimes surgical treatment options will do no better than nonsurgical treatment. In these cases, a doctor may prescribe physical therapy to encourage muscle-strengthening as a more conservative approach to treatment and management. They may also recommend the utilization of anti-inflammatory medications and RICE (rest, ice, compression, elevation) to help ease pain, or suggest their patients use crutches to ease strain on the knee.

Torn Meniscus Surgery

In more severe cases, torn meniscus surgery options will be considered by you and your health care provider. Those procedures could include the following.

  • Knee arthroscopy: the surgeon will make a small incision in the knee, insert a camera to assess the damage, and then remove or repair the torn meniscus.
  • Partial meniscectomy: the surgeon will remove a portion of the meniscus.
  • Meniscus repair: the surgeon will suture together the torn part of the meniscus.

After surgery, you’ll be provided with medical advice regarding how long to rest, and possible instructions for physical therapy or to avoid certain sporting activities going forward. Recovery time will vary person-to-person, but luckily most people can make a full and complete recovery from a meniscus tear, and athletes will be able to return to their pre-injury activity level.

Wear and Tear

As far as prevention goes, the best way to avoid another meniscus injury is to not participate in exercises or movements that require bending, twisting, or rotating the knee excessively, but by no means should fear of re-injury keep you from enjoying your life or returning to beloved activities. At the end of the day, wear and tear is a part of being active and getting older, and the best course of action going forward is merely to proceed with caution and care as you resume enjoying your daily life.

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