Meniscus tears are among the most common knee injury in both the athletic population and workplace. The prevalence of acute meniscus tears is 61 individuals per 100,000. Meniscus tears are primarily caused by a twisting or pivoting motion and are most prevalent in contact sports. Meniscus injuries often occur in conjunction with injuries to the ACL, articular cartilage, or other ligaments. Meniscus tears can also occur in the older population as a result of degenerative processes. Overtime, the meniscus becomes worn or weakened and thus is more susceptible to tears.
The knee joint is formed by the junction of the femur (thighbone), tibia (shinbone), and patella (kneecap). Between the femur and the tibia there are two wedge shaped pieces of cartilage known as the menisci. There are two menisci in the knee: the lateral meniscus on the outside and the medial meniscus on the inside. Together they form two C shaped rings around the upper end of the tibia to act as shock absorbers. The meniscus functions to cushion the joint by evenly distributing weight throughout the knee, reduce friction in the knee, and provide stability.
Diagnosis of meniscus injuries can be made clinically by examining the knee for joint line tenderness. X-rays and magnetic imaging studies (MRI) can be helpful in confirming the diagnosis.
Once an injury is sustained or a condition identified treatment is focused on obtaining a full range of motion of the knee and allowing the swelling to subside. Once this occurs both conservative and operative treatment options can be exercised.
Conservative treatment involves rest, physical therapy, medications, or injections that can reduce inflammation and strengthen the knee joint. Because a majority of the meniscus has no blood supply, it is harder for meniscal tears to heal on their own. That being said conservative treatment can be an effective and successful option for patients not experiencing pain and instability in normal activities or for patients who are older and less active.
Surgical management for meniscus injuries can involve multiple different treatment options. These options include: meniscus repair, meniscus resection, or meniscus transplant. A meniscus repair uses sutures to sew up the torn part of the meniscus to give it a chance to heal. A meniscus resection or partial meniscectomy is when the damaged or torn part of the meniscus is trimmed away. Lastly, a meniscus transplant, also known as meniscal allograft transplantation, is an advanced procedure performed on patients without a functioning meniscus where a new meniscus from a cadaver is transplanted into your knee. Rehabilitation timelines differ dramatically between surgical options but all surgeries can reach the same outcome in the end. The goal of these procedures is to restore function to the knee and have the patient successfully return to full activity after recovery. Treatment expectations and recovery timelines will be discussed with the surgeon prior to surgery.
Dr. Klimkiewicz discusses this topic further in his talk entitled, Meniscal Injuries: Evaluation and Treatment.