Meniscus Tears

A meniscus tear is a common orthopedic injury that can occur in the knee joint. When someone says they have torn cartilage in the knee, it is usually a torn meniscus. Meniscus tears are the most common knee injury in athletes and non-athletes alike. More than 50% of people who experience an ACL ligament tear also have meniscus tears.  Associated meniscus tears are a strong predictor for development of knee osteoarthritis.

The meniscus is divided into three zones: The red-red zone is the outer edge of the meniscus and has a good blood supply. The white-white zone is the inner area of the meniscus and has a poor blood supply. Tears in this area are less likely to heal on their own and may require surgical intervention. This is also an intermediate zone referred to as the red-white zone that is the transition zone between the vascular periphery and the relatively avascular central inner portion of the meniscus.

Meniscus tears can occur due to various factors, including:

• Trauma: A sudden and forceful twist or rotation of the knee during activities like sports can lead to meniscus tears. Athletes, especially those involved in sports that involve cutting and pivoting motions, such as football or basketball, are at higher risk.
• Degenerative Changes: As we age, the meniscus can undergo degenerative changes, becoming more brittle and prone to tears. This is more common in older adults.
• Overuse: Repetitive activities that stress the knee joint, such as squatting or kneeling, can contribute to the development of meniscus tears over time.

• Pain: Patients typically experience pain, particularly along the joint line of the knee. The pain may be sharp or dull and may worsen during activities that involve bending or twisting the knee.
• Swelling: Swelling of the knee joint is common and may develop within hours after the injury.
• Stiffness: Patients may notice stiffness in the knee, limiting their range of motion.
• Catching or Locking: Some individuals may feel as if their knee “catches” or “locks” when attempting to move it.
• Weakness: Weakness in the knee joint or the feeling of instability can occur.

To diagnose a meniscus tear, a healthcare provider will perform a thorough examination, which may include:

• Medical History: Understanding the patient’s history of symptoms and any recent injuries or activities is crucial.
• Physical Examination: The healthcare provider will assess the knee joint’s range of motion, stability, and tenderness.
• Imaging: X-rays may be taken to rule out other potential issues, while magnetic resonance imaging (MRI) is the most effective way to visualize meniscus tears.

The choice of treatment for a meniscus tear depends on several factors, including the type, size, morphology and location of the tear, as well as the patient’s age and activity level. Common treatment options include:

• Conservative Management: Rest, ice, compression, elevation, and physical therapy (PRICE) may be recommended initially to reduce pain and swelling. Nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed to manage pain and inflammation in the short-run.
• Injections: In some cases, corticosteroid or orthobiologic injections may be administered directly into the knee joint to reduce inflammation.
• Surgery: When conservative measures are insufficient, surgical intervention may be necessary. Arthroscopic surgery, a minimally invasive procedure, is often used to repair or trim the torn meniscus.
• Meniscus Transplant: In severe cases where a large portion of the meniscus has been removed in a prior case, a meniscus transplant may be considered to restore joint function.