A tear to the semi-circular shock absorbing tissue in the knee joint, is known as a torn meniscus or a meniscal tear. Direct impact from contact sports is a common cause for this injury. Gradual degeneration can also cause meniscus tear in athletes who are older.
Meniscus Tear Symptoms
A history of knee twisting and trauma can lead to torn meniscus symptoms. The knee may swell 48 hours into the injury, and fully bending the knee will not be possible. The inner knee surface and the joint line will be painful. A severe injury will not allow for weight bearing on the affected side by the athlete.
With the McMurray’s test, which is performed by the Boulder sports medicine doctor, the leg is rotated while the knee is bent. A positive result will be indicated by either pain or a click. In the Apley’s test, also done during physical examination, the cartilage meniscus is compressed while in a prone position with a positive result predicted by the feeling of pain. Knee giving way or locking will be complained of by the athlete.
Explanation of Meniscal Tearing
There are two menisci (pleural for meniscus) in each knee joint, and these structures are formed of cartilage and are crescent shaped. They are situated on the upper surface of the shin bone or tibia on the outside, as well as the inside. Providing knee joint support and acting as a shock absorber, is the main function of the cartilage menisci. The one more prone to injury is the medial meniscus, rather than the lateral meniscus. This is due to the medial meniscus’ connection to the joint capsule and to the medial collateral ligament which renders it less mobile.
Twisting the knee while the foot is planted to the ground is the most common cause of cartilage meniscus injury. Other knee structures injuries, such as the medial collateral ligament sprain and anterior cruciate ligament injury, can occur in conjunction with this sort of cartilage injury.
Types of Cartilage Meniscus Injury
- Longitudinal length tear – A tear across the meniscus length, varying in length is a longitudinal length.
- Radial tear – This injury occurs from the edge of the cartilage inwards.
- Bucket handle tear – When the longitudinal meniscus tear is exaggerated forming a bucket handle like flap, it detaches the meniscus from the tibia.
Degenerative changes can also cause meniscus tears in older athletes, as can wear and tear in the knee joint. In this case, fraying and jagging is caused to the meniscus edges, leading to an increased risk of a meniscus tear occurring. Flap tear and horizontal cleavage tear are other types of meniscus tears.
Treatment for Meniscus Tearing
PRICE principles, as a treatment, should immediately be applied to any knee injury. This stands for protection, rest, ice, compression, and elevation. Once a cartilage meniscus injury is diagnosed the conservative treatment without surgery or the removal and repair of the injured meniscus is required.
Ice should not be applied to the skin directly. Instead, a towel should be placed between the ice and the skin to prevent any burns. The outer third of the meniscus does have a
Injections may help with pain relief. This may include steroid injections which may provide pain relief while the body has a chance to heal the injury. There are also regenerative medicine injections, which may include PRP therapy or stem cell injections. Recent small studies have showed the ability of the regenerative medicine stem cell injections to facilitate healing of meniscal injuries and helping patients avoid the need for surgery.
A number of factors influence the decision for surgery, including pain that is increasing, restricted movement, or locking knee joint and other injuries like anterior cruciate ligament tear, which could be associated with it. No improvement in symptoms in the patient six to eight weeks after starting conservative treatment may result in the option of surgery being most convenient. Surgery for a torn meniscus involves either shaving the torn piece or a repair.
The top sports medicine and pain management nonoperative doctors in Northern Colorado are at the Colorado Clinic. The doctors are Double Board Certified and offer over 25 pain treatments including medical and interventional pain management. The success rates are well over 90% at helping patients avoid the need for surgery.
With 3 locations in Northern Colorado including Boulder, Greeley and Loveland, Colorado Clinic’s sports medicine doctors can help you get back in the game. Most insurance is accepted, call the location closes to you for more information and scheduling today!
Loveland (970) 221-9451
Boulder (303) 444-4141
Greeley (970) 396-6994