How often have you heard friends or athletes complain that they had "torn cartilage" in their knees? They are probably not talking about the cartilage that covers the end of the bone in the knee. Instead they may have another type of cartilaginous injury: a meniscal tear.
Each knee contains two menisci, one medial (Middle) and one lateral (on the side). They are disks that act as shock absorbers between the ends of the femur (thigh bone) and the tibia (shin bone). The menisci can be torn when the knee is twisted suddenly or if one becomes trapped between the femur and tibia. As we age, our menisci can lose their rubbery consistency and soften and fray.
These weakened structures can be torn more easily, even with just a misstep or
slight sprain of the knee. When the meniscus tears, you will usually feel a
sharp pain on the side of the knee that was injured. The initial pain and
swelling will go away, but you might continue to have sharp pain in the knee
when turning suddenly. The knee might catch or lock when you bend or straighten
it.
To diagnose meniscal tears, the physician performs certain tests or maneuvers and asks you to describe the injury and symptoms. X-rays of the knee are usually taken, although meniscal tears are generally diagnosed with a magnetic resonance imaging (MRI). The plain radiographs confirm or deny any degeneration or wear and tear in the knee.
Depending on the type and location of the tear and the severity of the symptoms, nonsurgical management can be tried which includes physical therapy, activity modification, and anti-inflammatory medications. Patients who do not improve with the nonsurgical management or who have significant symptoms often need surgery.
Most tears are removed or trimmed, because the menisci have no inherent blood supply. Tears that occur in the outer edge of the meniscus have a chance of healing due to proximity of the blood supply and can be repaired. An outpatient procedure can be performed to remove or repair the meniscus using an arthroscopic camera.
Recovery from surgery varies for different people and for different clinical problems. Patients who have a torn meniscus removed or trimmed can expect to use crutches for 4 to 7 days. They may have some swelling for 3 to 6 weeks and can return to their normal activities in 4 to 6 weeks, if not sooner.
If the meniscus has been repaired, weight
bearing may be limited with use of crutches for 4 to 6 weeks. This will allow
the repaired meniscus to heal. Modern arthroscopic surgery has improved the
results of surgery for meniscal injuries and has allowed a quicker return and
greater functional recovery for this bothersome condition.