Meniscus Tear: Surgical Options

A common but serious knee injury that athletes suffer from is the meniscus tear. These injuries are most common among athletes who play contact sports or sports that require a lot of twisting/pivoting around the knee such as basketball and soccer. The meniscus is the shock absorber of the knee and there are 2 of them in each knee (medial and lateral). These injuries can occur on their own or in association with other injuries such as an anterior cruciate ligament (ACL) tear.

Meniscus Tear

Torn Meniscus

Clinical Assessment

Physical Examination and Patient History

The common symptoms of a meniscus tear include pain along the joint line, swelling, locking (condition in which the knee is stuck in a certain position and is unable to bend or straighten) and occasionally instability if the tear is large or associated with an ACL tear. In our examination, we will palpate for joint line tenderness and look for swelling in the knee. The knee will also be stressed in certain positions and we will look for associated injuries with the knee pain.

Imaging Tests

We will order an MRI or magnetic resonance imaging scan. This will confirm the diagnosis and also help diagnose associated injuries.

Treatment

A small proportion of meniscus tears can heal on their own. They however need to occur near the outer one third area of the meniscus popularly known as the red zone (so called because it has a rich blood supply).

Most meniscus tears, however, occur in the inner two thirds of the meniscus which has poor blood supply. These tears do not heal and have to be treated surgically.

 

Surgical Treatment

Meniscus tears are treated arthroscopically (keyhole surgery). The meniscus tear is either debrided (removal of the torn portion) or repaired with sutures. The decision depends on the site and size of the tear and the chronicity of the tear. As a general rule, the longer the tear has been there, the less likely it is that a repair with sutures will be successful. In these cases, debridement or removal of the torn portion of the meniscus would be the best option.

Procedure: Knee Arthroscopy is one of the most commonly performed surgical procedures. In knee arthroplasty, a miniature camera is inserted through a small incision. This provides a clear view of the inside of the knee. We insert miniature surgical instruments through the other small incision to trim or repair the tear.

meniscus tears repair

Image (left) from AAOS.org

Rehabilitation

The procedure is usually performed as a day surgery and you can be discharged 2-4 hours post-procedure. Depending on whether a debridement or repair was done, you will either be allowed to walk with full weight on the affected limb or be told to go on crutches without putting any weight on the affected limb.

Meniscus tears are extremely common knee injuries. With proper diagnosis, treatment, and rehabilitation, patients often return to their pre-injury abilities.

 

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