One of the most common knee injuries is a torn meniscus. Each knee has two C-shaped pieces of cartilage known as menisci. The menisci act as cushions between your shin bone (tibia) and your thigh bone (femur). If this cartilage tears, the result is pain, stiffness, and swelling.
Meniscus Tear Symptoms
What does a torn meniscus feel like?
The most common symptom of a torn meniscus is localized pain in the knee that worsens when rotating the leg. Other symptoms of a torn meniscus include:
- Popping sensation
- Pain, especially when rotating the knee
- Difficulty straightening the knee
- A sensation that the knee is locked in place
Can you walk with a torn meniscus?
Many people with a torn meniscus can walk, stand, sit, and sleep without pain. In cases where a torn meniscus has locked the knee, walking will be affected.
Meniscus Tear Causes
You can tear a meniscus during any activity which involves forcefully twisting or rotating the knee.
Meniscus tears can happen during physical activities, but they can also occur from:
- Deep squatting
- Lifting something heavy
Sometimes, a torn meniscus can occur due to degenerative changes in the knee, even if there is little to no trauma.
How is a meniscus tear diagnosed?
If your doctor suspects a torn meniscus, he or she will perform a physical exam. They will manipulate your leg into various positions, observe you while you walk, and bend at the knee.
X-rays and MRIs allow the doctor to evaluate the bone and soft tissue at the knee.
In some cases, your doctor may suggest an arthroscopy to examine and possibly treat your knee. The arthroscope is inserted near the knee via a tiny incision. The device is small and contains a light and a camera, which transmits images from inside the knee onto a monitor.
Meniscus Tear Risk Factors
Performing activities that involve aggressive pivoting and twisting of the knee puts you at a significantly higher risk of tearing your meniscus. This means that athletes, especially those who participate in contact sports like football, are at a higher risk of sustaining this injury.
Aging is also a risk factor due to general wear and tear of the knees.
Types of Meniscus Tears
There are numerous types of meniscus tears, including:
1. Intrasubstance/incomplete tear (top left)
This type of tear is often a sign of degenerative changes in the meniscus tissue. Seldom are they the sign of a problem. By the time people reach their twenties or thirties, intrasubstance changes of the meniscus tissue are common.
2. Radial tear (top center)
This is the most common type of meniscus tear. These tears occur within the avascular zone of the meniscus where there is no blood supply. Because there is no supply, there is little capacity for these tears to heal on their own. Surgery is typically the only option and works to trim the damaged portion of the meniscus.
3. Horizontal tear (top right)
A horizontal meniscus tear runs along the circumference of the fibers of the meniscus. Horizontal tears can be sewn together rather than removing the damaged portion. Sometimes this type of tear can heal on its own but it may require surgery if symptoms don’t subside.
4. Flap tear (bottom left)
This type of tear has an unusual pattern. In circumstances where the flap causes “catching” in the knee, the flap can simply be removed.
5. Complex tear (bottom center)
This presents with a combination of tear patterns. Typically, complex tears are not treated with meniscus repair due to their complex nature. Treatment varies on a case-by-case basis.
6. Bucket-handle tear (bottom right)
This is a large horizontal tear of the meniscus. This often causes the knee to become stuck due to a portion of the meniscus blocking the knee’s normal motion. These tears often require surgical treatment to restore the proper function of the knee.
Meniscus Tear Complications
A meniscus tear can lead to knee instability, an inability to move the knee normally, and chronic knee pain. Those with a meniscus tear are also more likely to develop osteoarthritis in the injured knee.
Meniscus Tear Treatment and Recovery Time
There are numerous treatments for meniscus tears, but treatment generally begins conservatively depending on the location, type, and size of the tear.
If the tear is associated with arthritis, it will typically improve over time as the arthritis is treated. Similarly, tears that are not associated with locking of the knee will typically become less painful over time. The majority of these types of tears do not need surgery.
If your meniscus tear is not severe, your doctor will likely recommend the following treatment:
- Rest: Avoid any activities that aggravate the knee. You should especially avoid activities that cause you to pivot, rotate, or twist the knee.
- Ice: Ice can reduce pain and swelling. Use a cold pack and ice the affected area for 15 minutes at a time while keeping your knee elevated. Repeat this every four to six hours during the first day or two of the injury.
- Medicine: Over-the-counter pain relievers can help ease the pain associated with a meniscus tear.
If you have a meniscus tear, physical therapy can help to strengthen the muscles around the knee as well as the muscles in your legs which in turn will stabilize and support the knee.
Sometimes conservative treatment doesn’t work. If the knee is still painful, or if it locks, your doctor may recommend surgery. Sometimes, it’s possible to repair a torn meniscus, especially if you are a young adult. If the tear can’t be repaired, occasionally the meniscus can be surgically trimmed. If you undergo surgery, it will likely be followed by physical therapy to optimize knee strength and stability.
Request an Appointment at The Orthopedic Clinic Today
At The Orthopedic Clinic, we want you to live your life in full motion. If you have unusual pain and discomfort in your knee, let us help you get back to doing the things you love.
Call us at (386) 255-4596 to schedule an appointment.