Meniscal tear

Meniscal Tear

A meniscal tear is a common injury to the cartilage that stabilizes and cushions the knee joint. The meniscus is a C-shaped piece of tough, rubbery cartilage that acts as a shock absorber between the shinbone (tibia) and the thighbone (femur). Each knee has two menisci, one on the outer edge (lateral meniscus) and one on the inner edge (medial meniscus). Meniscal tears can occur in people of all ages, but they are more common in athletes and older adults.

Anatomy of the Meniscus

The meniscus is composed of fibrocartilage and is crucial for the proper functioning of the knee joint. It helps to distribute body weight across the knee, provides stability, and reduces friction during movement. The meniscus is divided into three zones based on blood supply:

• Red Zone: The outer third of the meniscus, which has a good blood supply and a better potential for healing.
• Red-White Zone: The middle third, which has a moderate blood supply.
• White Zone: The inner third, which has a poor blood supply and limited healing potential.

Causes of Meniscal Tears

Meniscal tears can result from acute trauma or degenerative changes. Common causes include:

• Acute Injury: Often occurs during sports activities that involve twisting, pivoting, or sudden stops. A direct blow to the knee can also cause a tear.
• Degenerative Changes: In older adults, the meniscus can weaken and become more prone to tears due to age-related degeneration.

Symptoms

Symptoms of a meniscal tear can vary depending on the severity and location of the tear. Common symptoms include:

• Pain in the knee joint
• Swelling and stiffness
• A popping sensation during the injury
• Difficulty bending and straightening the leg
• A feeling of the knee "giving way"

Diagnosis

Diagnosis of a meniscal tear typically involves:

• Physical Examination: The doctor will check for tenderness, range of motion, and perform specific tests such as the McMurray test.
• Imaging Tests: MRI is the most effective imaging technique to visualize meniscal tears. X-rays may be used to rule out other conditions.

Treatment

Treatment options depend on the size, location, and type of tear, as well as the patient's age and activity level. Options include:

• Conservative Treatment: Rest, ice, compression, and elevation (RICE), along with physical therapy.
• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and swelling.
• Surgery: Arthroscopic surgery may be necessary to repair or remove the torn portion of the meniscus.

Prognosis

The prognosis for a meniscal tear varies. Tears in the red zone have a better chance of healing on their own or with surgical repair. Degenerative tears in older adults may require more extensive treatment.

Prevention

Preventive measures include:

• Strengthening the muscles around the knee
• Using proper techniques during sports and exercise
• Wearing appropriate footwear

Also see

• Knee joint
• Arthroscopy
• Cartilage
• Anterior cruciate ligament injury