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Meniscal Tear

Anatomy

The meniscus is a piece of rubbery cartilage that is located both over the end of the femur (thigh bone) and tibia (shin bone), where they meet at the knee alongside the patella (kneecap). The menisci work to absorb shock, cushion the joint, keep it stable and prevent the bone ends from wearing down through friction. Part of the meniscus has a rich blood supply, while the other part does not, making tears in this area lacking blood more difficult to treat,

 

What causes a meniscus tear?

Menisci can be torn or damaged through activities that quickly twist the knee or put great force on the knee. Many athletes sustain meniscus tears, though anyone is vulnerable to this injury. Causes and contributing factors may include:

  • Quick pivots and changes in direction during sport
  • Fast-paced sports such as soccer and basketball
  • Impact trauma from falling on the knee or being hit with a ball
  • Moving too quickly during an activity that bends and straightens the knee
  • Osteoarthritis
  • Increasing age

 

What are the symptoms?

Symptoms tend to gradually worsen in the days following the injury. Signs and symptoms can include:

  • Pain and tenderness in the knee joint
  • Inflammation
  • Stiffness in the knee
  • Pain exacerbated by bending/straightening the knee
  • Knee instability
  • A ‘popping’ sound as the injury occurs

 

How is it treated?

It is important to have your knee properly assessed to find out the extent of the injury and the type of tear present.

The first step of treatment is to reduce the painful symptoms by following the PRICE principles (protection, rest, ice, compression and elevation). Treatment then focuses on allowing the knee to heal and reducing the likelihood of re-injury in the future. This may include:

  • Off-loading the knee using a brace or crutches while it heals
  • Orthotics to increase stability in the lower limbs and  correct any alignment problems at the knees or feet
  • Footwear assessment to ensure the shoes are helping and not hindering recovery
  • Physical therapy to stretch tight muscles and strengthen weak muscles
  • Activity modification to reduce the load on the affected knee until it has healed
  • Strapping the knee to temporarily help relieve symptoms and facilitate healing and repair

If the pain persists and the knee does not respond to treatment, surgery may be indicated. This may be necessary where the tear has occurred in the part of the meniscus with a poor blood supply.