The knee has a medial (inner) and a lateral (outer) meniscus. These structures help to cushion the knee joint and to keep it stable.
In older patients, degeneration in the meniscus can lead to tears which frequently do not have any symptoms.
Meniscal tears usually cause pain that is often localised to one particular part of the knee. There may be swelling, catching or locking of the knee. The knee may lose its full range of motion and may feel as if it “gives way”.
Meniscal tears can usually be diagnosed by taking a history and performing a physical examination. There is often tenderness in the knee where the meniscus is torn.
An X-ray should be performed prior to any surgical procedure to rule out other conditions that may mimic a torn meniscus. An MRI scan is often performed to diagnose a meniscal tear and may also show any other damage to the knee.
The treatment of a meniscal tear depends on the size of the tear and its location. It also depends on the severity of symptoms that the patient is experiencing.
Non-operative treatment is an option for some meniscal tears. Sometimes the symptoms will subside spontaneously. The RICE protocol is very helpful immediately following the injury. This involves resting, icing, compression and elevation. Anti-inflammatory medications and strengthening exercises may be helpful.
A bucket handle tear where the knee is acutely locked requires urgent or semi-urgent knee arthroscopy.
If a meniscal tear continues to cause symptoms, then a knee arthroscopy may be recommended. During this procedure part of the meniscus may be removed. Some meniscal tears can be repaired by using special stitches to aid the healing of the meniscus.
Regular exercise and physiotherapy may help full recovery from meniscal tears.