What is the Meniscus?
The meniscus is a wedge-like piece of cartilage in your knee joint, shaped like a ‘C’. It curves inside and outside the joint to stabilise your knee, and allows your thigh bone (femur) and shinbone (tibia) to glide and twist over each other with movement. It also provides cushioning support for your weight-bearing legs.
How can a meniscal tear happen?
Sports injuries account for most trauma-induced meniscal tears, most commonly caused by bend-and-twist movements, such as twisting the knee, pivoting, or slowing down quickly from a fast run. A meniscal tear can also happen through normal wear and tear of the more brittle cartilage, part of the natural ageing process. Often, meniscal tears happen at the same time as injuries to other parts of the knee.
Like ACL injuries, meniscal tears often make a popping sound. You may still be able to bear weight and walk on the injured knee initially, but pain, swelling, and redness of the joint develop over the next 12 to 24 hours. Your doctor may suggest an MRI scan to assess the extent of the tear and any other damage to the knee joint that may have happened at the same time or have caused the tear.
What are the symptoms of a meniscal tear?
As well as a popping sound, which you may hear when you injure the meniscus, you will most likely experience pain, swelling and tenderness shortly afterwards. Other symptoms include a noticeable drop in mobility of the affected knee – you may not be able to walk without pain and you may feel an uncomfortable clicking feeling. For some, the injured knee may get stuck, or lock, at a 45-degree angle temporarily. Your doctor will examine your knee in different positions and manipulate its movement, and he or she will probably recommend X-rays to check for fractures, or an MRI scan.
How is a meniscal tear treated?
Your doctor will recommend treatment options based on your symptoms and the severity of your injury. Treatments may include:
- Rest – this allows tiny blood vessels to feed the edges of the meniscus properly, so in some cases rest can let the tear heal itself naturally.
- Pain relief – anti-inflammatory medication like aspirin or ibuprofen, and cooling packs to reduce inflammation and pain in the knee.
- Physiotherapy – for minor meniscal tears, where your knee is stable during routine activities, your doctor may suggest physiotherapy to reduce pain and increase mobility in the knee joint. You should refrain completely from taking part in any high-risk sports and activities.
- Surgery – because your blood supply doesn’t feed the entire cartilage, it may not be able to heal on its own. It depends on the extent and location of the tear, but if you are still experiencing pain after trying other treatments, if your lifestyle affected, or if your tear is complicated by damage to other knee tissue, your doctor may suggest surgery to repair it. This can help relieve your pain and help restore your mobility. This can now be done with less invasive, arthroscopic surgery, using a fibre-optic scope through a small incision.
After surgery, you can usually return home the same day. You may have to wear a splint or brace for a while to help the healing process, and many people use crutches for the first few weeks following the operation. Full recovery can take a few months, and you may benefit from rehabilitative physiotherapy during this time. Your doctor will discuss with how soon after surgery you can start participating in routine, and then more demanding, activities.