Meniscus Tear

A torn meniscus is one of the most common knee injuries. Any activity that causes you to forcefully twist or rotate your knee, especially when putting the pressure of your full weight on it, can lead to a torn meniscus.

Each of your knees has two menisci — C-shaped pieces of cartilage that act like a cushion between your shinbone and your thighbone. A torn meniscus causes pain, swelling and stiffness. Your knee might feel unstable, as if it’s going to collapse.

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For older adults, meniscus can be damaged due to “wear and tear” which is also called a degenerative tear.
Damage to cartilage in the knee at the top of the lower leg bone (tibia). Knee cartilage injuries frequently accompany ligament sprains in the knee. This is sometimes a vaguely diagnosed knee in jury that resists conservative treatment.

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 surgical repair.

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Common Sign And Symptom

  • Complaint of localized pain with a small amount of swelling after activity.
  • Pain is often aggravated by rotating or when they perform extreme motion of their leg.
  • Experience positional pain in their knee while they sleep.
  • Difficulty playing back their choice of sports but physical disability is not common.
  • Locking of the knee joint.
  • “Giving way” of the knee.
  • Water on the knee (effusion).
  • Knee pain makes the patient extremely uncomfortable while descending from a flight of stairs.

With a minor tear, you may have slight pain and swelling. This usually goes away in 2 or 3 weeks.

A moderate tear can cause pain at the side or center of your knee. Swelling slowly gets worse over 2 or 3 days. This may make your knee feel stiff and limit how you can bend your knee, but walking is usually possible. You might feel a sharp pain when you twist your knee or squat. These symptoms go away in 1 or 2 weeks but can come back if you twist or overuse your knee. The pain may come and go for years if the tear is not treated.

In severe tear, pieces of the torn meniscus can move into the joint space. This can make your knee catch, pop, or lock. You may not be able to straighten it. Your knee may feel “wobbly” or give way without warning. It may swell and become stiff right after the injury or within 2 or 3 days.

If you are older and your meniscus is worn, you may not know what you did to cause the tear. You may only remember feeling pain after you got up from a squatting position, for example. Pain and slight swelling are often the only symptoms.

Causes

-Prolonged overuse of an injured knee.
-Twisting injury to knee or violent muscle contraction.
-Landing on a very flexed knee;Kneeling or squatting.

A meniscus tear is usually caused by twisting or turning quickly, often with the foot planted while the knee is bent. These tears can occur when you lift something heavy or play sports. As you get older, your meniscus gets worn. This can make it tear more easily.

Sudden meniscal tears often happen during sports. Players may squat and twist the knee, causing a tear. Direct contact, like a tackle, is sometimes involved.

Older people are more likely to have degenerative meniscal tears. Cartilage weakens and wears thin over time. Aged, worn tissue is more prone to tears. Just an awkward twist when getting up from a chair may be enough to cause a tear, if the menisci have weakened with age.

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Risk and Complications

Anyone performing activities involving aggressive twisting and pivoting of the knee is at risk of a torn meniscus. The risk is particularly high for athletes — especially those who participate in contact sports, such as football, or activities that involve pivoting, such as tennis or basketball. The risk of a torn meniscus also increases as you get older, due to years of wear and tear on your knees.

A torn meniscus can lead to knee instability, the inability to move your knee normally, or persistent knee pain. You also may be more likely to develop osteoarthritis in the injured knee.

Treatments

Initial Treatment

Treatment for a torn meniscus often begins conservatively. Your doctor may recommend:

Rest
Avoid activities that aggravate your knee pain, especially any activity that might cause you to twist your knee. You might want to use crutches to take pressure off your knee and promote healing.
Ice
Ice can reduce knee pain and swelling. Use a cold pack, a bag of frozen vegetables or a towel filled with ice cubes for about 15 minutes at a time. Do this every four to six hours the first day or two, and then as often as needed.
Medication
Over-the-counter pain relievers also can help ease knee pain.

Therapy

Physical therapy can help you strengthen the muscles around your knee and in your legs to help stabilize and support the knee joint. Arch supports or other shoe inserts can help to distribute force more evenly around your knee or decrease stress on certain areas of your knee.

Surgery

If your knee remains painful, stiff or locked, your doctor may recommend surgery. It’s sometimes possible to repair a torn meniscus. In other cases, the meniscus is trimmed. Surgery may be done through an arthroscope.

During arthroscopic surgery, your doctor inserts an instrument called an arthroscope through a tiny incision near your knee. The arthroscope contains a light and a small camera, which projects an enlarged image of the inside of your knee onto a monitor. Surgical instruments can be inserted through the arthroscope or through additional small incisions in your knee.

Recovery time following arthroscopic surgery tends to be much faster than it is for open-knee procedures. You can often go home the same day. Full recovery may take weeks or months, however, and you will need to do exercises to optimize knee strength and stability.

As blood circulation to the menisci is often limited, biological healing for these conditions are very minimal. In most cases, the most effective treatment method would be to perform an arthroscopic surgery. During the surgery, doctors remove the least amount of meniscal tissue required to solve the problem. Success rate is quite high and recovery is swift. Most patients return to full function within six weeks. For speedy and more effective recovery, a home exercise program or supervised physical therapy is most recommended.

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Dr Kevin Yip is an orthopaedic surgeon/professor

He has more than 20 years experience in treating orthopaedic problems ranging from common orthopaedic problem, sport injuries to degenerative changes of orthopaedic problem.
Be assured that you will be receiving professional treatments that suit your needs.

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