One wrong turn could tear your meniscus
By PATRICK CAREY
A torn meniscus is one of the most common knee injuries. It can happen on the field, on the court or in the garden.
In other words, it could be a traumatic injury that happens during sport, or a degenerative injury after simply squatting down while working outdoors.
The knee joint is a complex mechanism that includes three bones: the thigh bone (Femur), shin bone (Tibia), and knee cap (Patella).
Two wedge-shaped menisci fill the gap between the two larger bones, acting as shock absorbers that cushion the joint and stabilize movement.
The word meniscus describes its shape and is derived from the Greek word for crescent or moon. The meniscus is a smooth, lubricated tissue made up mostly of fluid and collagen. Some refer to the meniscus as cartilage in the knee.
The menisci are designed to aid in load transmission, joint lubrication, nutrition, movement, and stability of the knee.
While almost anyone can tear a meniscus, research indicates that athletic males from their mid-teens to age 40s, as well as individuals who suddenly choose to become physically active, are at greater risk.
As people age, the meniscus loses elasticity, becomes brittle and tears more easily. Symptoms of a torn meniscus include pain, swelling, stiffness and sometimes difficulty when extending the knee. Some patients feel clicking or locking of the knee.
Meniscus tears can be connected with knee ligament injuries. About 70 percent of all anterior cruciate ligament (ACL) injuries have associated meniscus tears.
While conservative treatment for relieving knee pain includes RICE (Rest, Ice, Compression, Elevation) and anti-inflammatory medication, such as ibuprofen, a tear rarely heals on its own due the limited blood supply to the meniscus.
When a patient comes in for knee pain, the doctor performs a physical exam and notes the level of pain when pressure is applied to the knee’s joint line.
He or she will likely recommend an X-ray to rule out other knee problems before reaching a diagnosis. In addition, the doctor may order an MRI (Magnetic Resonance Imaging) to obtain a more detailed view of soft tissue in the joint.
When a meniscus tear is confirmed, the doctor determines the best treatment based on the severity of the injury.
When surgery is necessary, an arthroscopic procedure allows the orthopedic surgeon to visualize and repair the damage through several small incisions in the knee by using a fiber-optic camera and miniature surgical instruments. Patients are fully weight-bearing on crutches the day of surgery and are instructed to begin exercises to regain range of motion the day after surgery.
Physical therapy is sometimes necessary for four-to-six weeks after surgery. Recovery from surgery typically requires four-to-six weeks.
Working to strengthen the muscles in the legs, particularly the hamstrings, is one way to reduce the chance of a meniscus tear.
If your knee is sore during normal activity and you are experiencing stiffness and swelling, this may be a good time to schedule an appointment with an orthopedic specialist. Seeking treatment for a torn meniscus is important, because avoiding treatment only leads to more serious problems.
(Patrick Carey, DO, is a UPMC Susquehanna orthopedic surgeon who earned his medical degree from the Philadelphia College of Osteopathic Medicine and completed his residency and fellowship in sports medicine at Temple University Hospital. Dr. Carey has been in practice in this area for over 25 years.)