Some of the most common knee ailments seen in my orthopedic practice are related to the meniscus because of the role it plays in the knee joint. Just imagine your knee joint is an automobile and that automobile needs shock absorbers to support a smooth ride. Our bodies are no different. A healthy meniscus is vital to the overall health of our knees.
What is the meniscus? The meniscus is a strong, C-shaped, fibrocartilage in the knee joint that cushions the space between the femur and the tibia. Inside the knee, there are 2 menisci. One located on the inside (medial) and one on the outside (lateral).
The menisci are like suction cups and are molded to the shape of the femur and tibia joint surface. Based on their shape, menisci serve multiple purposes. Most of all, menisci allow weight to be evenly borne through the legs and down to your knees. As more weight/pressure is placed on the knee during walking, running, jumping, exercise or sport, menisci provide cushion as well as an even amount of weight distribution to keep the cartilage of the knee joint from grating one another and causing injury. This ‘buffering’ is vital to the function and health of the knee.
How do meniscal tears happen? Some are immediate and others are caused by wear and tear over time. An acute/traumatic meniscal tear can occur during many different types of activities or motion. If the knee is involved in a forceful twist, rotation, pivot, stop, turn, squat, heavy lift or random kneeling a tear can happen. Degenerative meniscal tears are non-traumatic and do not stem from a specific cause, but can be the product of an aging knee joint, onset of osteoarthritis, excessive weight on the joint, weakened thigh muscles, poor exercise fitness and more. Tears of this nature can go undetected and are not always painful.
It is more common to recognize an acute meniscal tear due to pain in the joint. You may experience a locking or catching sensation (felt) in the knee, swelling and inflammation or a sudden buckling or ‘giving way’ of the knee. This could be a sign that tissue has become fragmented due to a tear and support in the joint has been compromised.
If you are experiencing knee pain in the joint and are concerned it could be a meniscus issue, it is best to make an appointment with an orthopedic specialist. During a full physical examination, you will be asked about your symptoms, if an injury occurred, pain scale, etc. X-rays will help rule out fractures or bone injuries as the cause of pain. Magnetic Resonance Imaging (MRI) may be ordered to assess soft tissues (i.e., menisci, cartilage, tendon and ligaments) in the knee joint to confirm diagnosis.
Once a diagnosis is confirmed, a treatment plan will be developed, which may include non-surgical or surgical treatment. Non-surgical treatment may include NSAIDS (nonsteroidal anti-inflammatory drugs), RICE (rest, ice, compression, elevation), PRP (platelet-rich plasma) and steroid injections.
If surgery must be performed, an orthopedic specialist will recommend a knee arthroscopy. This procedure allows the surgeon to insert a miniature camera and other surgical instruments through small incision portals in the knee to trim or repair the meniscal tear.
Due to the frequency of meniscal tear injuries in the overall population, diagnosis, repair and rehabilitation is commonplace in orthopedic practices with positive outcomes for the majority of patients.