What is a meniscus?
The meniscus is a c-shaped piece of cartilage cushioning the knee. The knee is like a hinge, and the meniscus sits between the round thigh bone (femur) and the flat shin bone (tibia).
The meniscus is a fibrocartilaginous tissue. It's shaped to fit inside the knee and damage to the meniscus is quite a common injury.
How do you get a meniscal tear?
A meniscal tear is a tear in the knee’s cartilage. Meniscal tears are generally split into two types; traumatic (acute) and degenerative (chronic).
Acute meniscal tears are frequently the result of sports injuries or trauma to the knee. Often, they are treated with keyhole surgery (arthroscopy) as they are unlikely to heal themselves.
Chronic meniscal tears are wear-and-tear injuries. Treatment depends on the severity of the symptoms and the level of arthritis (degeneration of the joint).
What are the symptoms of a meniscal tear?
- Swelling or stiffness in the knee
- A ‘locked’ or ‘catching’ feeling in the knee
- A feeling of the knee giving way / loss of stability under load
- Difficulty straightening the knee
- Pain, especially when twisting the knee
How do you diagnose a meniscal tear?
If you see or feel the symptoms of a meniscal tear, it’s best to see your GP or Physiotherapist as soon as possible. They will normally be able to identify a torn meniscus by conducting a physical examination of the knee.
Once your doctor suspects that your pain and discomfort is caused by a torn meniscus, you might be sent for x-rays or an MRI. Torn cartilage won’t show up on an x-ray, but the x-ray will eliminate other potential causes of the pain. The MRI is an effective imaging technique to confirm the presence of a meniscus tear.
Treating a meniscal tear
As is the case with most joint injuries, your doctor is likely to recommend that you rest your knee and use ice, compression and elevation to reduce the swelling and pain. They may prescribe over-the-counter medication like anti-inflammatories for pain relief.
The next step is physiotherapy to help strengthen the muscles surrounding the knee. This can help with stability and settling the symptoms.
With ongoing symptoms, your GP can refer you to Dr Ward for assessment. Dr Ward will consult with you regarding the best course of treatment.
If required, Dr Ward will discuss arthroscopy (keyhole surgery) of the knee with you. The arthroscope is a small camera with a light attached, which allows the surgeon to see inside the joint. The surgeon can often make repairs to the meniscus during this procedure, using specialised tools.
At the time of surgery, Dr Ward will make an assessment as to whether the meniscus can be sutured and repaired or whether it needs partial removal. If advanced or degenerative arthritis is the cause, and pain is the main symptom, an arthroscopy may not be suitable for treatment. In this case, Dr Ward will discuss treating the arthritis.
In rare cases with younger patients, a meniscus transplant might be an option.
Recovery after treatment of a meniscus tear
Recovery time for partial removal of the meniscus (meniscectomy) is typically 4 to 6 weeks. A repair of the meniscus often takes 8 - 12 weeks for recovery.
A knee arthroscopy is often performed as day surgery, so you don’t knee to stay in hospital overnight. Normally you will be walking unassisted after the procedure, or rarely you may need a stick or crutches. You will be given some exercises to do while recovering from the surgery.
If you are struggling with long term knee problems, or a conservative approach to treating your meniscal tear is not working, ask your GP to refer you to Dr Jason Ward’s office.