If you have torn your meniscus, which is a piece of fibroelastic cartilage located inside the knee joint, you might experience the following signs and symptoms in your knee: pain, swelling or stiffness with a clicking sensation, especially when twisting or rotating the knee, and difficulty straightening the knee fully as well as feeling as though the knee is locked in place when trying to move it.
A torn meniscus can not only result from accidents but also from any activity that causes the knee to forcefully twist or rotate, such as aggressive pivoting, certain sports and exercises, falls, sudden stops and turns. If a torn meniscus is overlooked, it might potentially lead to osteoarthritis in the injured knee.
Getting to know meniscus
The meniscus is a C-shaped piece of tough, rubbery fibrocartilaginous structure located in the knee joint between the femur and tibia bones (thighbone and shinbone). The meniscus acts as a shock absorber to cushion the lower part of the leg from the weight of the rest of the body during activities that cause impact to the knee, including standing, walking, running and jumping. The meniscus helps absorb the pressure exerted on the knee joint. It also provides stability and helps to distribute body weight by keeping the bones from rubbing together.
Since the meniscus is a relatively avascular structure with a limited peripheral blood supply, if a torn meniscus happens, the poor blood supply to the inner portion of the meniscus makes it difficult for the meniscus to heal. As a result, a meniscus tear can lead to an inability to move the affected knee fully and a persistent knee pain. If left untreated, it eventually causes osteoarthritis of the knee.
Signs and symptoms of torn meniscus
- Knee pain, especially when twisting or rotating the knee such as when kneeling and squatting;
- Swelling that might happen suddenly after a knee injury or appear temporarily after activity, depending on the intensity that involves knee movement;
- Knee stiffness or difficulty extending the knee fully, and;
- A clicking sensation or feeling as though your knee is locked in place when trying to move it.
Diagnosis and treatment of a torn meniscus
A torn meniscus can often be identified by sports medicine physicians during a physical exam. MRI, an imaging test, is frequently used to detect this condition by producing detailed images of both hard and soft tissues within the knee. If a meniscus tear is diagnosed, recommended treatments include:
- Rest and stop using the knee.
- Avoid activities that aggravate knee pain, especially any movement that twists, rotates or pivots the knee. If knee pain is severe, using crutches can reduce the knee loading force and prevent further damage.
- Use cold compression. A cold pack or a towel filled with ice cubes can reduce knee pain and swelling. Keeping the knee elevated and taking over-the-counter pain relievers can also help ease knee pain.
If an affected knee remains painful despite rehabilitative therapy, arthroscopic meniscus repair is highly recommended. Since this standard procedure to repair a torn meniscus is a minimally invasive surgery, it results in smaller incision, less pain, lowered postoperative complications and reduced traumatic damage to surrounding tissue such as muscles and tendons, leading to a faster recovery time and a quicker return to daily life.
Arthroscopic meniscus repair
If a major torn meniscus develops, a surgical procedure to repair a torn meniscus, known as arthroscopic meniscus repair, is vital in order to reduce knee pain and restore knee functions for daily activities, sports and exercise. More importantly, if a torn meniscus is appropriately repaired in time, it can substantially reduce the risks of developing osteoarthritis of the knee in the future. On the contrary, if a meniscus tear is left untreated or happens in a location with extremely low blood supply, repair might not be applicable. In such a case, the meniscus might be partially trimmed surgically.
Less pain with faster recovery time
Arthroscopic meniscus repair is a minimally invasive surgical approach. During this procedure, an instrument called an arthroscope is inserted through a tiny incision near the affected knee. An arthroscope contains a small and light camera that transmits enlarged images of the inside of the knee onto a monitor, enabling visualisation and therapeutic treatment of the interior of a joint. If necessary, surgical instruments can be inserted through the arthroscope or through additional small incisions in the knee to trim or repair the tear. Due to smaller incision, there is less pain and less damage to surrounding areas as well as faster recovery and fewer postoperative complications such as stiff knee syndrome (arthrofibrosis) which is the build-up of scar tissue inside the knee, causing the knee joint to shrink and tighten.
Even though a torn meniscus is not considered a life-threatening problem, it can significantly disturb daily life and activities. Untreated meniscus tear may not only impair quality of life also lead to knee osteoarthritis, which is an irreversible condition. Ensuring healthy meniscus helps prevent degenerative arthritis. If signs or symptom of a torn meniscus are indicated, immediate medical attention should be sought to receive an accurate diagnosis and effective treatments.
Source: Dr. Pakapon Issaragrisil
Sports Medicine and Orthopaedic Surgeon
Bangkok Academy of Sports and Exercise Medicine (BASEM)
FIFA Medical Centre of Excellence
Bangkok Hospital
