Torn meniscus

Description

A torn meniscus is one of the most common knee injuries. Any activity that causes the force of the torsion or rotation of the knee, especially when putting your full weight on it, can lead to a torn meniscus.

Each of your knees has two C-shaped pieces of cartilage that act like a cushion between the shinbone and your thighbone. A torn meniscus causes pain, swelling, and stiffness. You also might feel a block to knee motion and have trouble extending your knee fully.

Conservative treatment — such as rest, ice and medication — is sometimes enough to relieve the pain of a torn meniscus and give the injury time to heal on its own. In other cases, however, a torn meniscus requires surgery.

Symptoms

If you have torn your meniscus, it can take 24 hours or more for the pain and the swelling to start, especially if the tear is small. You may develop the following signs and symptoms in the knee:

  • A sense of pop
  • Swelling or stiffness
  • The pain, especially when twisting or rotation of the knee
  • Difficulty straightening the knee fully
  • Feeling as if the knee is locked in place when you try to move it
  • The sensation of your knee giving way

When to see a doctor

Contact your doctor if your knee is painful or swollen, or if you can't move your knee in the usual way.

Causes

A torn meniscus can be the result of any activity that causes the force of the torsion or rotation of the knee, such as aggressiveness or pivoting, sudden stops and turns. Still kneeling, squatting deep or lifting something heavy can sometimes lead to a torn meniscus.

In older adults, degenerative changes of the knee may contribute to a torn meniscus with little or no trauma.

Risk factors

The realization of activities that involve aggressive twisting and pivoting of the knee puts you at risk of a torn meniscus. The risk is particularly high for athletes, especially those involved in contact sports, like football, or activities related to the twists, such as tennis or basketball.

The wear and tear on your knees as you age increases the risk of a torn meniscus. So does obesity.

Complications

A torn meniscus can lead to a feeling of your knee giving way, the inability to move your knee, as you usually do or persistent pain in the knee. You may be more prone to develop osteoarthritis in the injured knee.

Torn meniscus

Diagnosis

A torn meniscus often can be identified during a physical exam. Your doctor might move your knee and leg into different positions, watch you walk and ask you to squat to help pinpoint the cause of your signs and symptoms.

Imaging tests

  • The x-ray Due to a torn meniscus is made of cartilage, not show up on x-rays. But X-rays can help to rule out other problems with the knee that can cause similar symptoms.
  • Magnetic resonance imaging (MRI). This uses a strong magnetic field to produce detailed images of the soft and hard tissues inside of your knee. It is the best imaging study to detect a torn meniscus.

Arthroscopy

In some cases, your doctor may use an instrument known as an arthroscope to examine the inside of your knee. The arthroscope is inserted through a small incision near the knee.

The device contains a light and a small camera, which transmits an enlarged image of the inner part of the knee on a monitor. If necessary, surgical instruments can be inserted through the arthroscope or through additional small incisions in your knee to trim or repair of the break.

Treatment

The treatment for a torn meniscus often begins conservatively, depending on the type, size and location of the tear.

Tears associated with arthritis often improve over time with treatment of the arthritis, so surgery is usually not indicated. Many other tears that are not associated with the lock or a block of movement of the knee will be less painful over time, so that also do not require surgery.

Your doctor might recommend:

  • Rest. Avoid activities that worsen the pain of the knee, especially any activity that causes you to twist, turn, or twist of the knee. If the pain is severe, the use of crutches can take the pressure off of your knee and promote healing.
  • Of ice. Ice can reduce the knee pain and swelling. Use a bag of ice, a bag of frozen vegetables or a towel filled with ice cubes for about 15 minutes at a time, keeping the knee elevated. Do this every 4 to 6 hours for the first day or two, and then as often as necessary.
  • The medication. Over-the-counter pain relievers can also help alleviate the knee pain.

Therapy

Physical therapy can help strengthen the muscles around the knee and in their legs to help stabilize and support the knee joint.

Surgery

If your knee remains painful despite the rehabilitation therapy or if your knee is blocked, your doctor may recommend surgery. Sometimes it is possible to repair a torn meniscus, especially in children and young adults.

If the failure cannot be repaired, the meniscus can be surgically trimmed, possibly through small incisions in the use of an arthroscope. After the surgery, you will need to do exercises to increase and maintain the strength in the knee and stability.

If you has advanced degenerative arthritis, your doctor may recommend a knee replacement. For young people, who have signs and symptoms after surgery, but not the advanced arthritis, transplantation of meniscus may be appropriate. The surgery involves the transplantation of a meniscus from a cadaver.

Self-care

Avoid activities that aggravate your knee pain — especially sports that involve twisting or twisting the knee until the pain goes away. Ice and over-the-counter pain relievers can be helpful.

Preparing for your appointment

The pain and disability associated with a meniscal tear prompt many people to seek emergency care. Others make an appointment with their family doctors. Depending on the severity of your injury, you may be referred to a doctor specializing in sports medicine or a specialist in bone and joint surgery (orthopedic surgeon).

What you can do

Before an appointment, be prepared to answer the following questions:

  • When did the injury occur?
  • What were you doing at that time?
  • Did you hear a loud "pop" or feel a "popping" sensation?
  • There was a lot of swelling after?
  • You've injured your knee before?
  • The symptoms been continuous or occasional?
  • Make certain movements seem to improve or worsen your symptoms?
  • Does your knee always "lock" or feel blocked when you are trying to move it?
  • Do you ever feel that your knee is unstable, or unable to bear his weight?
Symptoms and treatment of torn meniscus