What is a Meniscus?
The meniscus is a piece of cartilage that is present between the femur and tibia and there are two menisci are present in each knee joint. It gets torn during activities that put pressure on the knee joint or rotate it such as hard tackle on foot, a sudden pivot on the basketball court, or getting up suddenly from a squatting position. Certain sports that require sudden turns and stops increase the risk of a meniscus tear. These sports include football, soccer, tennis, and basketball.
According to the Boston Children Hospital, meniscal tears are getting more common in children as they are getting into organized sports early.(1) Also, the chances of getting a tear in the meniscus are more when a person is involved in just one sport.
Meniscus weakens with age and therefore the condition gets common in those above 30 years of age. Therefore falling on knees and injuring the meniscus is more common in the elderly and especially those with osteoarthritis. In older people, the meniscus tear is due to degeneration, as the cartilage in the knee gets weaker and gets more prone to tear.
Symptoms of Meniscus Tear
As the meniscus tears there is a popping sound which may later lead to the following symptoms:
- Pain and swelling
- Difficulty in moving the knee
- Feeling of locking and catching in the knee
- A sensation as if the knee is giving way
There is a sensation as if a piece of cartilage is loose and is blocking the knee. It is important to contact the doctor if any of the above symptoms are felt or persist a few days post-surgery.
How is Meniscus Tear Diagnosed?
The doctor performs a physical examination and tests the range of motion. He closely looks for the spot where the meniscus is. A McMurray test may be performed to look for the meniscal tear, which involves bending the knee and straightening and rotating it. A slight pop during the test may indicate a tear of the meniscus.
There are a few tests recommended by the doctor to diagnose meniscus tear:
X-ray of the Knee
This test does not diagnose meniscus tear but may help determine if there is any other reason behind the knee pain.
In an MRI, multiple images of the knee are taken, which help determine if there is any meniscus tear. A study conducted in 2008 came up with a conclusion that MRI accuracy for diagnosing meniscus tear is 77%.(2)
Ultrasound may take images inside the body and help determine if there is any loose cartilage that may be getting caught in the knee.
If the above techniques are unable to diagnose the meniscus tear, knee arthroscopy may be required.
It is done by making small incisions near the knee and inserting an arthroscope (flexible fiber-optic device). The surgical instruments are moved through the arthroscope or through other incisions in the knee.
Treatment of Meniscus tear
At first, the meniscus tear is treated with conservative techniques called the RICE method. It includes:
- Resting the knee and avoiding any activity that worsens the knee pain.
- Applying ice on the knee every three to 4 hours for 30 minutes.
- Compressor wrapping the knee in an elastic bandage to reduce inflammation.
- Elevating the knee as it helps in reducing swelling.
Medications such as nonsteroidal anti-inflammatory drugs can also be helpful in reducing pain and swelling around the knee. Physical therapy is recommended and it is advised to avoid putting weight on the knee.
If the knee does not respond to the above treatments, arthroscopic surgery of the knee is recommended. The procedure lasts for an hour and the person can go back home the same day. It involves a meniscal repair and the recovery time is about six months. The patient is advised to wear a knee brace or crutches during this time.
How to Prevent Meniscus Tear?
To avoid meniscus tears it is important to perform exercises that strengthen the leg muscles. While doing sports, protective gear can be used to support the knee during injury. Performing exercises in proper form is also necessary so that not much pressure is put on the knees.
With proper diagnosis and treatment, the knee can have proper mobility and function. The healing also depends on the location of the tear.