The knee has several parts, including bones, tendons, ligaments and cartilage. All of them work together to make sure the knee functions well enough for walking, running, jumping, sitting and standing. Two C-shaped pieces of cartilage known as the medial and lateral menisci have the important job of absorbing shock between the shinbone and the thigh bone, preventing premature wear and tear. Each meniscus is prone to tearing when the knee twists, making meniscus tears one of the most common knee injuries.
Although meniscus tears can cause discomfort and make it difficult to straighten the knee, there are several treatment options. In many cases, a meniscus tear heals on its own with rest and other conservative treatments. If the pain persists, surgery can reduce pain and restore function.
Risk Factors for Meniscus Tears
Some people have a higher risk of meniscus tears than others, including athletes who play contact sports. Because meniscus tears typically occur due to forceful twisting of the knee, football players, tennis players and basketball players are especially vulnerable. All three sports require fancy footwork and quick movements to score points or prevent competitors from gaining ground. A meniscus tear is also more likely in someone who engages in frequent squatting or kneeling at work.
These factors also increase the risk of developing a meniscus tear:
- Male
- Frequent use of stairs
- Older age (60+)
- Playing soccer
- Delaying reconstructive surgery after surgery on the anterior cruciate ligament
Symptoms of a Meniscus Tear
Many people report a popping sensation as the tear occurs. Following this type of injury, you may experience pain, stiffness, swelling and reduced range of motion. Depending on the severity of the tear, some people also have difficulty straightening the affected leg or report feeling as if the injured knee is about to "give out" while walking or engaging in other types of physical activity.
How Is a Meniscus Tear Diagnosed?
A physical examination can help determine if you have a meniscus tear or a different type of knee injury. During this exam, your doctor may bend your knee, straighten it out and then try to rotate it. If this test causes clicking, pain or other symptoms, a meniscus tear is likely. Several knee injuries cause the same symptoms, so your doctor may also order an X-ray or MRI to make a definitive diagnosis.
X-rays don't show injuries to the soft tissues, but they can rule out problems with the bones of the knee. Magnetic resonance imaging (MRI) shows more detail, so your doctor may be able to use the images to diagnose a meniscus tear or another problem with the soft tissues of the knee.
Treatment Options for Meniscus Tears
Lifestyle Changes
Some meniscus tears heal on their own, so your doctor may recommend the RICE protocol before suggesting physical therapy or surgical intervention. RICE stands for rest, ice, compression and elevation. Rest is important because it reduces stress on the injured knee and gives the torn meniscus a chance to heal. If you try to resume your regular activities too soon, it may take you longer to recover.
Ice causes the blood vessels to constrict, reducing blood flow to the injured area. This reduces inflammation and swelling, giving you relief from the discomfort of a torn meniscus. If you use an ice pack, make sure you wrap it in a towel to prevent it from coming into direct contact with your skin.
Compression refers to the use of a medical bandage to reduce swelling. Be sure not to wrap the knee too tight, or you could cut off the circulation to your knee, causing numbness or tingling.
The final step, elevation, involves raising your injured leg above the level of your heart. One of the easiest ways to do this is to lie on your back in bed and use several pillows to prop up the leg. You can also lie down in your living room and put your injured leg on the arm of the couch. Elevation reduces knee pain and swelling, which promotes healing and can keep you comfortable as you recover.
Medications
Pain relievers and steroid injections are often used to reduce the pain caused by meniscus tears. Ibuprofen, naproxen and other nonsteroidal anti-inflammatory drugs (NSAIDs) work by preventing the body from making prostaglandins, which are fatty acids involved in the inflammatory response. These medications are intended for short-term use, so ask your doctor if you still have pain after a few days of taking an NSAID. You should also be aware that NSAIDs can cause nausea, vomiting, heart problems and fluid retention.
Corticosteroids also reduce inflammation, but they're not available without a prescription. Oral steroids are typically used to treat rheumatoid arthritis and other conditions characterized by systemic inflammation, but they can cause a wide range of side effects. To prevent some of these side effects, many doctors recommend corticosteroid injections instead.
During this procedure, a doctor injects corticosteroids directly into the knee after numbing the area with a local anesthetic. You may feel some pressure during the injection, but you shouldn't experience significant pain. If there's fluid around the knee, your doctor may have to drain that fluid before administering the injection.
Surgery
Arthroscopy is an exploratory procedure that involves the use of an arthroscope to examine the inside of the knee. During this procedure, a surgeon makes several small incisions in the knee, inserts the arthroscope and uses a small camera to look around. Depending on what they see, the surgeon may decide to perform a meniscus repair or partial meniscectomy.
Meniscus repair involves suturing the torn pieces of the meniscus together. Although meniscus repair is helpful for some patients, it isn't recommended for people with extensive meniscus damage. Following this type of surgery, the sutured meniscus needs several months to heal, so it takes longer to recover from meniscus repair than it does to recover from some other knee procedures.
A partial meniscectomy involves cutting away the damaged part of the meniscus. Once the damaged tissue is gone, it no longer causes pain, stiffness and other symptoms associated with a meniscus tear. As a result, it takes less time to recover from a partial meniscectomy than a meniscus repair, allowing patients to return to their normal activities much sooner.
Compassionate Care for Patients With Knee Pain
Meniscus tears and other knee injuries can cause significant discomfort, making it more difficult to do all the things you love to do. If you have knee pain, schedule an appointment with Northeast Spine and Sports Medicine. Members of our multispecialty medical group have extensive experience diagnosing meniscus tears and helping patients get relief. Call (732) 653-1000 to speak with one of our friendly staff members.
