A Publication of WTVP

Have you ever experienced a “popping” sensation, followed by pain and tightness in the knee? If so, you may have a torn meniscus. Some individuals notice stiffness, swelling, joint tenderness, fluid collection on the knee, locking of the knee and knee buckling.

So, what is a meniscus? It is a rubbery, C-shaped disk that cushions your knee, and is located where the major bones of the leg connect. Each knee has two menisci—one at the outer edge of the knee and one at the inner edge. The meniscus acts as a stabilizer and helps the knee joint carry weight, glide and turn in various directions. It also keeps your knee steady by balancing your weight across the knee.

Cause and Types of Tears

Both athletes and non-athletes can suffer from meniscal tears. They are generally caused by twisting or turning quickly, with the foot planted and the knee bent. Athletes can sometimes tear their meniscus while pivoting, cutting or decelerating during sports, or the injury may be caused in combination with another injury, such as a torn anterior cruciate ligament. The condition can also occur as a result of the knee cartilage weakening and wearing thin over time.

There are three types of meniscal tears. Minor tears cause pain and swelling which may dissipate after a few weeks. Moderate tears can cause pain at the side or center of the knee, with swelling increasing over two to three days, causing stiffness. You may still be able to walk on the knee, but may experience pain when twisting or bending it. Symptoms may go away over time, but may reappear if you overuse it. Severe tears may cause your knee to feel wobbly, and it may give way or buckle without warning. Your knee may catch, pop or lock, and you may be unable to straighten it.

Diagnosis and Treatment

If you are experiencing any of the symptoms mentioned above, see your physician or orthopedic specialist, who will be able to determine the level of your injury through an evaluation, X-rays and possibly an MRI.

A non-surgical approach is typically the initial treatment for a torn meniscus. Non-surgical treatments may include the RICE formula (Rest, Ice, Compression and Elevation) and non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen and naproxen. If your knee is stable or if there are only small tears to the meniscus, they may heal themselves with these treatments.

If the condition becomes problematic and starts to affect your everyday activities, surgery may be considered. Increasingly, physicians are opting for arthroscopic surgery, which involves inserting a thin tube (arthroscope) containing a camera and a light through small incisions near the knee. Via a video monitor, the surgeon is able to see inside the knee and make the repairs by inserting his instruments in other small incisions. Depending on the type and degree of the tear, the portion of the meniscus that is torn may be removed from the knee (partial meniscectomy) or repaired using dissolvable sutures (stitches).

This surgery can be performed under general anesthesia, regional anesthesia (spinal or epidural block), or local anesthesia with sedation. The anesthesiologist will discuss your options with you before surgery. No matter what kind of anesthesia you receive, you will need to have someone available to drive you home.

Recuperation and Healing

Most patients return home the day of surgery. Prior to your discharge, you will be given instructions on how to care for your knee and what activities to avoid. In many cases, you will see the physician on the day after surgery to begin physical therapy. You can normally return to work or school within three to five days of surgery with crutches, unless your activities require extended walking or heavy lifting. Most people are restricted from bending or squatting beyond a 90 degree angle for four to six weeks, and from returning to sports for four to eight weeks. How long you take to recover depends on your body, the degree of the tear and your commitment to rehabilitation.

After surgery, you will be instructed on exercises to perform to help restore your range of motion, strength and endurance of your knee. You will be able to perform some exercises at home or at a gym, and others will be under the care of a physical therapist in a rehabilitation facility. Following your physician-directed rehabilitation plan is crucial to an optimum recovery.

Injury Prevention

A torn meniscus is usually the result of an unnatural twist or turn while playing a sport, or in conjunction with another injury. You can, however, take precautions to lower your risk. These include stretching before and after physical activity, making sure your shoes have enough support, and by keeping your thigh and other leg muscles strong. Finally, make gradual changes to your workout program and don’t increase the intensity of any activity suddenly.

As with any injury, it’s important to seek treatment from a qualified specialist. Your primary care physician or orthopedic surgeon can provide an accurate diagnosis and recommend the most appropriate treatment protocol for your individual needs. TPW