Meniscus Tears of the Knee

What is the meniscus in the knee?

The meniscus is a c-shaped, thick cartilage pad in the knee that protects the lower leg from the impulses caused by body weight and movement. Often called “shock absorbers”, the menisci are located between the tibia (lower leg bone) and the femur (thigh bone). The medial meniscus is located on the inside of the knee, while the lateral meniscus is located on the outside.

What is a meniscus tear of the knee?

Meniscus tears can occur when a person abruptly changes direction while running. It is not uncommon for a meniscus to become damaged in conjunction with other knee injuries, such as an anterior cruciate ligament (ACL) injury. The meniscus can also suffer injury due to age (wear-and-tear), a severe accident, squatting or even lifting something heavy while putting strain on your knee.  Dr. Joseph Lamplot, orthopedic knee specialist, treats patients in Atlanta, Gwinnett County, Johns Creek, Gainesville, Georgia and the surrounding areas, who have experienced a torn meniscus in their knee.

Are there different types of meniscus tears in the knee?

The six most common types of meniscus tears are:

1. Intrasubstance/Incomplete Tear: Incomplete and intrasubstance meniscus tears are stable injuries that usually do not require surgical treatment. These are frequently part of early degenerative changes in the meniscus tissue.
2. Radial Tear: These tears are located within the meniscus, often in a location where there is limited blood supply, making it difficult for the tear to heal. Typically, these tears require surgical intervention.
3. Vertical Tear: A tear that may warrant a meniscal repair. Rather than removing the damaged portion of the meniscus as is done with other tear types, a vertical tear repair can often be repaired by sewing the torn pieces together.
4. Flap Tear: A flap tear results in a unique tear pattern. This tear often results in the feeling of the knee “catching” or “sticking”. The meniscus flap causing the mechanical symptoms can be trimmed out during surgery to improve symptoms.
5. Complex Tear: A complex tear is a combination of tear patterns, often involving a radial tear pattern and horizontal tear or flap tear pattern.
6. Bucket-Handle Tear: A bucket-handle tear is a large version of a vertical tear and is common in young athletes. The part of the meniscus that is torn usually blocks the knee from achieving normal movement. Bucket-handle tears occur most often require immediate intervention to improve the likelihood of a successful repair and restoration of full movement of the joint.

What are the symptoms of a torn meniscus?

• Pain
• Swelling
• Limping
• A popping sensation during the time of injury
• Catching or locking in the knee joint
• Difficulty fully extending or bending the knee
• Feeling of instability, that they knee may “give way”

How are meniscus tears diagnosed?

Doctor Lamplot will ask questions about the symptoms and the circumstances of the injury, along with performing a physical examination. Radiological imaging such as X-rays and/or magnetic resonance imaging (MRI) may be performed to examine the soft tissue of the meniscus more carefully. An MRI will allow Dr. Lamplot to determine the location, size and severity of the tear. X-rays, if indicated, will rule out fractures or other bone injuries,

What is the treatment for a torn meniscus?

The best course of treatment will be determined by the location, severity, and type of tear, as well as the patient’s age and level of activity.

Non-Surgical:

• RICE: Rest, Ice, Compression, Elevation
• Physical therapy
• Anti-inflammatory drugs (NSAIDs such as naproxen sodium or ibuprofen.)

Surgical:

Surgery is typically the best option for more severe meniscus tears. The goal of surgery is to repair or remove the torn part of the meniscus in order to preserve as much of the original tissue as possible. The procedure is usually performed arthroscopically, which means that a small camera is inserted through a small incision in the knee to guide the surgeon in repairing or removing the tear with small instruments inserted through another incision. Following surgery, physical therapy will be recommended which will aid in strengthening the knee, regaining range of motion, and resuming normal activities.

Meniscus Tear Specialist