Meniscus Tear

The menisci are critical knee structures that when injured will impact mobility. They function as shock-absorbing pads of cartilage in the knee that stabilize the knee, equally distribute one’s weight on the knee bones for balance and smooth movement, and support and protect the bones in the knee joint. There are two C – shaped menisci in each knee, one on the inner edge and the other on the outer edge of the knee.

There are two types of meniscus tears:

• Acute tears are caused by trauma. Traumatic tears may be large or unstable and can cause ongoing discomfort if not repaired. Unstable tears include radial tears, flap tears and bucket handle tears. Traumatic tears can occur in isolation or in conjunction with ligament injuries. Many meniscus tears occur in conjunction with a torn ACL. A meniscus tear alters the forces in the knee and can eventually leads to arthritis.
• Degenerative tears are common in the older population due to wear and tear over time. A degenerative tear, called a meniscus lesion, results from microtrauma which causes the cartilage to dry out and become brittle. With degenerative changes, a simple twist of the knee may result in a tear. Early knee arthritis can weaken the meniscus and increase the risk of tearing. Degenerative tears may cause pain which can eventually improve and allow return to the daily activities of life without the need for surgery.

Acute meniscus tears most often result from an athletic injury like a direct hit to the knee or as the result of twisting or over flexing the knee joint as in football tackles. However, a tear can result from any activity where the knee is twisted or rotated while carrying the full weight of the body, including pivoting and deep squatting when lifting something heavy or a fall.

Symptoms include:

• a popping sound when the meniscus tears
• sudden onset of pain and swelling on the inner or outer side of the knee
• stiffness and limited movement
• persistent pain with squatting, twisting, walking or deep bending
• catching and locking of the knee during movement
• a sense of the knee giving way
• a clicking sound with knee movements

During your consultation with Dr. Petrigliano you will discuss your symptoms and medical history and during the physical exam, he will check for tenderness which is a sign of a tear. The McMurray test is used to diagnose meniscus tears. Here the doctor will bend and straighten the knee and rotate it. If there is a tear, this will cause pain or a clicking sound.

Imaging tests may be ordered to confirm the diagnosis since the symptoms of a meniscus tear are also symptoms of other knee problems. X-rays will reveal other causes of knee pain, while an MRI will show soft tissue damage. The combination of clinical tests and MRI imaging provide precise diagnosis and indication for surgical intervention, particularly when the tear occurs in conjunction with an ACL tear.