Meniscus Tear Symptoms and Treatment

In orthopedics, tearing of the Meniscus can be defined as the rupturing of the fibro-cartilage strips in the knee called menisci. A Meniscus tear may result into excruciating pain and swelling of the knee joint, often accompanied by joint locking or clicking. The pain is so caused due to the motion of the knee as the meniscal fragment gets pinched, thus stretching the capsular attachment.

Some Common Causes

The meniscus is a C-shaped cartilage having a wedged profile. There are two menisci in the knee, made up of tough fibrio-cartilage sitting between the femur (thigh bone) and the tibia (shin bone). The respective ends of these two bones are covered with a soft hyaline cartilage. While one of the meniscus rests on the medial tibial plateau (medial meniscus), the other rests on the lateral tibial plateau (lateral meniscus).

These menisci function as distributors of body weight across the knee joint. The wedged profile of the meniscus aids in maintaining joint stability by keeping the rounded femur surface from sliding off the flat tibial surface.

Small blood vessels nourish the menisci. The internal area of the menisci has two parts – avascular or the area with no direct blood supply or the vascular area with ample direct blood supply.

Menisci are usually torn during physically strenuous activities such as walking or squatting, where there is excessive weight on the knee joint (mostly in the case of athletes) or due to degenerative processes (seen in elderly patients who have brittle cartilages).

Symptoms of a tear of the Meniscus

A “popping” sensation is experienced by the patient during a tear of the meniscus. While the symptoms may vary from one patient to another, some common symptoms include but are not limited to:

Stiffness and swelling

Tenderness in the joint line

Collection of fluid in the knee

Joint slipping, popping and locking: The knee gets stuck, often at an angle of 45 degree, until you move it manually.

Some common tests carried out to detect a Meniscus tear are the McMurray test, the Steinmann test and the Appley test.

Treatments of the Meniscus Tear

Tears of the meniscus can be dealt with using the conservative method or by repairing the tear surgically.

Conservative treatment: Preliminary treatment of a Meniscal tear follows the basic RICE formula, i.e. rest, ice, compression and elevation, coupled with consumption of non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain. The conservative treatment applies only in those cases of Meniscal tear where the knee is stable and does not lock.

Surgical repair: Surgical treatment only applies in cases where the meniscal tear does not heal on its own and becomes extremely painful, stiff or locked. Often depending upon the type and the nature of tear, an arthroscope may be used to trim off the damaged pieces of cartilage. A cast or brace immobilizes the knee after surgery and patient must complete a course of rehabilitation exercises before resuming daily physical activity.

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