MENISCUS ROOT 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

  • Meniscus root tears are unique meniscus tears that affect young athletes with traumatic injury and older patients with degenerative changes

  • Meniscus root tears lead to de-tensioning of the meniscus, increased contact forces, and cartilage damage

  • Meniscus root tears are associated with early degenerative changes and high rates of total knee replacement 

  • 80% of Meniscus root tears affect the medial (or inside) meniscus

CAUSES 

  • Meniscus root tears usually occur after a deep bending injury in young athletes

  • They can also occur in older patients with degenerative menisci after a seemingly innocuous injury such as getting up from a seated position

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 meniscus root tears depends on the type of injury and age of patient

  • Management of older patients with meniscus root tears is controversial, and the efficacy of different treatment options is unclear. 

  • For older patients with degenerative root tears, treatment involves either conservative management or surgery

  • Conservative management involves activity modification and avoidance of heavy load bearing activities. In addition, 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

  • For younger patients with traumatic meniscus root tears, surgery is usually recommended

  • Surgery consists of arthroscopic assisted meniscus root repair using either bone tunnel or all-inside suture fixation (especially in older patients with degenerative tears)

 PREVENTION

  • The best way to prevent this condition is to avoid deep bending or squatting activities 

Meniscus root tear capture 1.png