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A meniscal tear is one of the most common knee injuries, particularly among athletes. The meniscus is a wedge-shaped piece of cartilage in the knee that rests between the thighbone and the shinbone. The meniscus is tough and rubbery, acting as a shock absorber to cushion the knee and keep it stable with movement.
Causes of Meniscal Tears
The meniscus most often tears during sports activity. An athlete may squat and twist the knee, which can cause a tear, as can direct contact from a tackle or collision. In some cases, a meniscal tear may occur alongside another knee injury, such as an anterior cruciate ligament (ACL) tear.
Meniscal tears aren’t just limited to athletes, however. The meniscal cartilage can weaken and thin with age, making it more prone to tears. If the cartilage is weakened, just an awkward twist of the knee can cause it to tear.
Symptoms and Diagnosis
Symptoms of a meniscal tear include pain, stiffness, swelling, and an inability to completely bend and/or straighten the knee. If the tear is sudden, you may feel a “pop” when it occurs, and it may feel as though your knee is giving out from under you. Some patients feel catching or locking when trying to move the knee. Popping, slipping, or locking may occur in the knee if a piece of the torn cartilage has drifted into the joint.
Meniscal tears are diagnosed with a combination of a physical exam and diagnostic imaging tests. Your doctor will check for tenderness in the area where the meniscus sits. He may also perform a test in which he bends the knee, straightens it, then rotates it. If the meniscus is torn, this movement will produce a clicking sound. A meniscal tear will not show up on an X-ray, but an X-ray may be used to rule out other problems like arthritis. If additional confirmation is needed, an MRI may be used to get a better image of the meniscus.
Treatment will depend on the size and location of the tear. The outside one-third of the meniscus is called the “red zone” because it has a rich blood supply. This blood supply may allow the tear to heal if surgically repaired. The inner two-thirds of the meniscus is called the “white zone” because it lacks a blood supply. Tears in the “white zone” cannot heal on their own or grow back together, and for this reason will often be trimmed away.
Small tears in the “red zone” may heal without the need for surgery, as long as the knee is stable and symptoms do not continue. The RICE protocol is often recommended for sports injuries like meniscal tears.
RICE stands for Rest, Ice, Compression, and Elevation. You may be advised to take a rest from the activity that caused the meniscal tear and avoid putting weight on the leg. Ice packs should be used several times a day for 10 minutes at a time, and a compression bandage may be recommended to help prevent additional swelling. Finally, to reduce swelling, patients are often advised to elevate the leg higher than the heart while resting. Nonsteroidal anti-inflammatory medications like ibuprofen or aspirin may be taken for pain and swelling.
If a patient’s symptoms persist after a course of conservative treatment, or if the knee is unstable, surgery may be recommended. Arthroscopy is often used for meniscal tears. With arthroscopy, a small camera is inserted through an incision in the knee, allowing the surgeon to view the inside of the joint. Small operating instruments are inserted through other small incisions to perform the procedure.
For tears in the “white zone,” meniscectomies are often performed. During a meniscectomy, the damaged meniscal cartilage is trimmed away. Some tears in the “red zone” can be sutured back together in a procedure called a meniscus repair. This type of procedure may result in a longer recovery time, because the two pieces need to heal back together.
After surgery, rehabilitation exercises are often recommended to help with flexibility and range of motion in the knee. Patients who have had a meniscus repair may need to use crutches for about a month after the procedure to keep weight off the knee as it heals.
After surgery, most patients are able to return to the activities they participated in before the injury. Full recovery from a meniscectomy typically takes about 3 to 4 weeks, while recovery from a meniscus repair takes about 3 months.
Meniscal Tear Treatment in Beaumont, TX
Our highly-skilled physicians offer both surgical and nonsurgical treatment for meniscal tears to meet the needs of our patients. If you would like to learn more about meniscal tear treatment, or would like to schedule an appointment, please contact our Beaumont office at (409) 838-0346 or our Port Arthur office at (409) 729-5633.