Introduction
Menisci are vital cartilage structures in the knee that cushion the bones and facilitate smooth movement. These structures are particularly susceptible to injury during twisting motions common in sports. While some tears may heal naturally, many require surgical intervention. Arthroscopic surgery is the standard treatment for meniscus tears, offering a quicker recovery with fewer complications compared to traditional open surgery.
Anatomy
The knee consists of three primary bones: the femur (thigh bone), the tibia (larger leg bone), and the patella (kneecap), which moves within a groove on the femur's end. The menisci are two C-shaped cartilage discs located atop the tibia. The outer regions of the menisci have a blood supply that supports healing, while the inner portions lack this supply, making those tears less likely to mend independently. These structures bear body weight and absorb shock during activities like walking and running, allowing for smooth movement of the knee bones.
Causes
Tears typically occur during intense twisting motions of the knee, especially when the foot is fixed on the ground and the knee is bent. Activities that involve pivoting, sudden changes in direction, or quick deceleration—common in sports like football, tennis, and soccer—can lead to tears. Additionally, older adults may experience tears due to natural cartilage degeneration.
Symptoms
Signs of a meniscus tear may include a popping sound at the time of injury, followed by swelling, pain, and stiffness over the ensuing days. You might find it difficult to fully extend your knee, and it could buckle or lock unexpectedly, making it painful to bear weight or walk.
Diagnosis
If you suspect a meniscus tear, it’s essential to consult your doctor. They will take a detailed medical history and perform a physical examination, which may include the McMurray and Apley tests, assessing your knee’s stability and movement. Imaging techniques such as X-rays can evaluate bone condition, while MRI scans provide detailed images of the menisci and surrounding knee structures to confirm the diagnosis.
Treatment
Minor tears, particularly in the outer regions with good blood supply, may heal independently. Initial treatment typically involves rest, ice application, and anti-inflammatory medications. Physical therapy can strengthen the muscles around the knee, and a knee brace or custom orthotics may be recommended for support during physical activities.
Surgical
For larger or inner meniscus tears, surgery is often necessary. Most meniscus surgeries are performed on an outpatient basis, under either general anesthesia or a nerve block to numb the knee area. Arthroscopic surgery is preferred due to its minimally invasive nature, resulting in less pain, swelling, and a faster recovery compared to traditional open surgery.
During the procedure, a small tube equipped with a camera (arthroscope) is inserted through tiny incisions, allowing the surgeon to view the knee joint. Additional small instruments may be used to remove or repair torn cartilage.
Recovery
After the operation, it is crucial to elevate your leg and apply ice to minimize pain and swelling. You may need to wear a knee brace or cast temporarily and use assistive devices like crutches or a walker. Your doctor will guide you on weight-bearing activities and gradually increase your activity level as healing progresses. Full recovery can vary widely, often taking several weeks to months.
Prevention
Your physician may recommend specific activity restrictions based on your injury’s severity. If part of your meniscus has been removed, you might need to avoid high-impact exercises like running or heavy lifting. Always consult your doctor before returning to intense physical activities, and adhere to any recommendations for wearing protective gear or knee braces during sports.
