MENISCUS TEAR                                   KANDIL NOTES

INTRODUCTION

  • The Meniscus is the shock absorber of the knee with the following functions:

  • Load distribution: Cushions the knee and distribute loads with every step

  • Stabilization

  • Joint lubrication

  • Cartilage protection

  • The blood supply is tenuous for certain parts of the meniscus, and depending on location, healing may be questionable

  • Meniscus tears are the most common injuries of the knee requiring surgery

  • There are many different types of tears including different shapes, sizes, configurations. Each factor has a bearing on the treatment plan

CAUSES

  • Meniscus tears usually occur after a bending or twisting injury

  • It can occur from something as benign as standing up from a seated position to a contact twisting injury during sports

SIGNS AND SYMPTOMS

  • Pain in the inside or outer portion of the knee corresponds to location of tear

  • Mechanical symptoms such as catching, locking, giving out may be associated with meniscus tears

TREATMENT​​

  • Treatment of small, stable tears can be managed with a course of conservative management. In addition, degenerative meniscus tears associated with arthritis can also be treated without surgery

  • The first line of treatment usually involves a course of physical therapy and a home exercise program focused on knee range of motion and strengthening exercises

  • Anti-inflammatories such as ibuprofen are oftentimes helpful as an adjunct to other treatments

  • Steroid injections are not recommended for meniscus tears

  • Small, stable partial meniscus tears may be treated with Platelet Rich Plasma (PRP) as there is growing evidence that this may help improve pain and avoid surgery 

  • Surgery is reserved for cases that don’t improve after a course of conservative management if symptoms are significantly affecting activities of daily living and quality of life. Surgery is arthroscopic and minimally invasive and usually involves either partial meniscectomy composed of a cleanup or trimming of the torn meniscus or meniscus repair. If the meniscus can be repaired, that is always attempted, however in some cases it cannot be repaired due to size, location, etc. and partial meniscectomy is done

Meniscus tear capture 1.png