Hi everyone,
I decided to create a post on meniscus tears because I recently had my knee scoped for this particular injury. This injury is also very common amongst active people. It is possible to continue activity(up to doctor's discretion) with this injury, and I happened to play football on mine for about a year before I had the torn cartilage removed(menisectomy) from my knee. I personally experienced what doctor's refer to as "mechanical symptoms" when I had my injury. These "mechanical symptoms" are defined by a "locking" and "popping" of the knee joint. My knee would often seem to lock into place and I would have to force it out of that position. I also experienced a pop at the time of major trauma/injury to the cartilage. My symptoms became unbearable and I eventually saw several specialists and was referred to a surgeon.
Another interesting thing about this injury is that you may experience knee pain and then experience the actual tear while you are doing a simple activity such as walking. The meniscus does not always tear during strenuous activity. The majority of my tear occured while I was at work, sitting with my legs crossed...but I had knee pain for several months before this occurred.
Having the torn meniscus(cartilage) removed may lead to premature arthritis in the knee joint...so I have that to look forward to. But then again, after all of those squats that you guys/I do...we are bound to have this happen anyway!!
The torn cartilage may also be repaired(sutured) and this is what my surgeon set out to do on my knee...but could not follow through with at the time of operation(due to the location of the tear). Having the repair done requires a much longer recovery time(oddly enough), but reduces the risk of premature arthritis in the joint. As for me....I was back to light jogging about a month and a half after surgery.(I had a fast paced recovery program)
See below for detailed info on this injury.(This happens to be the site I used to diagnose my injury after the popping occurred at work
)
What is a meniscus?
There are
two menisci in your knee; each rests between the thigh bone (femur) and shin bone (tibia). The menisci are made of tough cartilage and conform to the surfaces of the bones upon which they rest. One meniscus rests on the
medial tibial plateau; this is the medial meniscus. The other meniscus rests on the
lateral tibial plateau, the lateral meniscus.
What does the meniscus do?
These meniscus functions to distribute your body weight across the knee joint. Without the meniscus present, the weight of your body would be unevenly applied to the bones in your legs (the femur and tibia). This uneven weight distribution would cause excessive forces in specific areas of bone leading to early
arthritis of knee joint. Therefore, the function of the meniscus is critical to the health of your knee.
How does the meniscus work?
The
knee joint is obviously very important in allowing people to go about performing almost any activity. The joint is made up of
three bones: the femur (thigh bone), the tibia (shin bone), and the patella (knee cap). The surfaces of these bones within the joint are covered with
articular cartilage. This important surface allows the bones to smoothly glide against each other without causing damage to the bone. The meniscus sits between the articular cartilage surfaces of the bone to distribute weight and to improve the stability of the joint.
What is knee cartilage? Is it the meniscus or the ends of the bone?
Both the covering of the bone within the joint and the meniscus are made of cartilage--this makes the issue a little confusing. People often say 'cartilage' to mean the meniscus (the wedges of cartilage between the bone) or to mean the joint surface (so-called articular cartilage which caps the ends of the bone).
When people talk about a cartilage tear, they a talking about a meniscus tear. When people talk about
arthritis and wear of cartilage, they are talking most often about the articular cartilage on the ends of the bone. Hopefully that clears up some of the confusion; look at the pictures and the links to help your understanding of the knee joint anatomy.
The meniscus is semilunar or C-shaped and has a wedged profile. The wedged profile
maintains the stability of the joint by keeping the rounded femur surface from sliding off the flat tibial surface. The meniscus is nourished by small blood vessels, but the meniscus also has a large area in the center of that has no direct blood supply (avascular). This presents a problem when there is an injury to the meniscus as the avascular areas tend not to heal. Without the essential nutrients supplied by blood vessels, healing cannot take place.
What happens with a meniscus tear (torn cartilage)?
The two most common causes of a
meniscus tear are due to traumatic injury (often seen in athletes) and degenerative processes (seen in older patients who have more brittle cartilage). The most common mechanism of a traumatic meniscus tear occurs when the knee joint is bent and the knee is then twisted.
It is not uncommon for the meniscus tear to occur along with injuries to the
anterior cruciate ligament (ACL) and the
medial collateral ligament (MCL)-these three problems occurring together are known as the "
unhappy triad," which is seen in sports such as football when the player is hit on the outside of the knee.
What are the symptoms of a meniscus tear?
Individuals who experience a meniscus tear usually experience pain and swelling as their primary symptoms. Another common complaint is joint locking, or the inability to completely straighten the joint. This is due to a piece of the torn cartilage physically impinging the joint mechanism of the knee.
The most common symptoms of a meniscus tear are:
- Knee pain
- Swelling of the knee
- Tenderness when pressing on the meniscus
- Popping or clicking within the knee
- Limited motion of the knee joint
How is the diagnosis of a meniscus tear made?
Any patient who has
knee pain will be evaluated for a possible meniscus tear. A careful history and physical examination can help differentiate patients who have a meniscus tear from patients with
knee pain from other conditions. Specific tests can be performed by your doctor to detect meniscus tears.
X-rays and
MRIs are the two tests commonly used in patients who have meniscus tears. An x-ray can be used to determine if there is evidence of
degenerative or arthritic changes to the knee joint. The MRI is helpful at actually
visualizing the meniscus. However, simply 'seeing' a torn meniscus on MRI does not mean a specific treatment is needed.
Treatment of meniscus tears depends on several factors, as not all meniscus tears require surgery.
What treatments are available for a meniscus tear (torn cartilage)? Almost any knee injury can initially be treated acutely with
ice packs, rest, and immobilization. These simple measures will help to decrease swelling and pain in the joint.
Your physician can use information about how the injury occurred and physical examination tests to determine the likelihood of a meniscus tear. While
x-rays are usually normal with an isolated meniscus tear, the
MRI evaluation will often reveal abnormalities within the meniscus.
Is surgery necessary for meniscus tears?
The next step is to determine whether or not surgery is necessary for a meniscus tear. If an individual is not a good surgical candidate or if their meniscus tear symptoms are not significant, surgery can often be delayed or avoided altogether. zSB(3,3);if(!z336){var zIsb=gEI("adsb");if(zIsb){zIsb.style.display="inli ne";zIsb.style.height="0px";zIsb.style.width="0px" ;}var zIss=gEI("adss");if(zIss){zIss.style.display="inli ne";zIss.style.height="0px";zIss.style.width="0px" ;}}
Many people live normal lives despite having a meniscus tear. It is only when the meniscus tear becomes symptomatic, and interferes with activities, that surgery to treat the meniscus tear should be considered.
There are generally two surgical options for treating a meniscus tear:
- Meniscus Repair
A meniscus repair is a surgical procedure done to repair the damaged meniscus. This procedure can restore the normal anatomy of the knee, and has a better long-term prognosis when successful. However, the meniscus repair is a more significant surgery, the recovery is longer, and, because of limited blood supply to the meniscus, it is not always possible.
- Meniscectomy
A meniscectomy is a procedure to remove the torn portion of the meniscus. This procedure is far more commonly performed than a meniscus repair. Most meniscus tears cannot be treated by a repair for a number of reasons. Often the tear is in an avascular region of the meniscus, and will not heal even if repaired. Some tears are frayed and cannot be sutured together. In these cases, the meniscectomy is done to remove the damaged portion of meniscus. The meniscectomy has a faster recovery, but it can lead to trouble years down the road because of the absence of the normal meniscus.
What is the prognosis after having sustained a meniscus tear (torn cartilage)?
With a meniscus tear (torn cartilage) in your knee, the shock absorbing capacity of the joint is threatened. Because of this, there is an increased risk of developing damage to the articular cartilage surface of the knee joint bones; this is commonly referred to as
knee arthritis. Loss of the meniscus places more of a burden on the cartilage surfaces of the joint and they are more likely to develop
arthritic changes. Therefore, any lifestyle changes to decrease your risk of developing arthritis can improve the prognosis after having sustained a meniscus tear. For example, weight loss, low-impact exercise, and prevention of further trauma to the joint will all improve the long-term prognosis.
If a
meniscus repair is possible, the long-term prognosis, especially in younger patients, is improved due to restoration of the normal knee anatomy. However, as mentioned previously, a meniscus repair may not be possible in many patients with torn cartilage.
http://orthopedics.about.com/cs/meni...meniscus_2.htm 
