Anyone at risk of twisting the knee also risks a torn meniscus,
as tears can occur when the knee rotates while bearing weight.
Athletes are especially at risk, particularly anyone participating
in contact sports such as football or soccer, or activities
involving pivoting such as skiing or tennis. In addition, the
possibility of a meniscus injury increases with age due to
accumulated wear and tear on the knee. And since much of the
meniscus has no blood supply, when damage occurs the meniscus
cannot undergo the body's normal healing process.
Since the medial meniscus is connected to multiple
structures within the knee, it is more prone to injury than is the
lateral meniscus. However, injuries can occur in either meniscus
during twisting movements, direct impact to the knee joint or due
to general cartilage degeneration.
The meniscus can be torn in two different ways. A traumatic tear
happens suddenly, usually resulting from an atypical load being
applied to the meniscus tissue. This can take place when the knee
twists, or if there is a blow to the side of the knee. Traumatic
tears are often associated with sporting activities, and can affect
patients of all ages.
The second type of tear is referred to as a degenerate meniscal
tear. As the meniscus ages it dries, and becomes less elastic.
Therefore, with only minimal trauma the meniscus can tear in an
older patient - many times with no memorable event or violent
injury precipitating the tear.
In the case of a small tear, the meniscus stays attached to the
front and back of the knee. However if the tear is large the
meniscus may be left hanging by only a small piece of cartilage.
How do you know if you have a meniscus tear? Symptoms will vary
based on the severity of the injury.
If it is a minor tear, there will be slight pain and initial
swelling that usually dissipates in two to three weeks.
A moderate tear will be more painful, with swelling increasing
over two to three days. Although the knee may feel stiff, walking
is still possible. There may be more pain felt during twisting or
squatting movements. Symptoms may lessen over time but can easily
recur with minor impacts, twisting, or overuse of the knee
A severe tear has more noticeable and immediate symptoms. Pieces
of the torn meniscus can "float" into the joint space, causing the
knee to lock, catch, or pop. The knee may feel unstable or give out
suddenly. The knee may swell and become stiff, and not be able to
straighten immediately after the injury or within a few days.
Meniscus tears can therefore look very different, and can happen
anywhere within either meniscus in all sorts of shapes.
There are generally four surgical options available to treat
larger meniscus injuries or tears, all of which are typically done
||Common procedure Preserves some of the meniscus
||May require subsequent surgery
||Permanent loss of meniscus tissue, either partial or complete
Further joint degeneration
||Preserve meniscus tissue and function
||Availability and appropriateness of donor tissue Disease
||Preserve meniscus tissue volume and function
||Patient compliance with rehabilitation protocol