The knee is one of the largest and most complex joints in the body and is, therefore, more susceptible to injury. Meniscal tears are among the most common injuries to the knee joint. These tears can occur at any age and can be associated with twisting injuries to the knee or “wear and tear” in older patients.
The meniscus is a small, "c" shaped piece of cartilage in the knee. Each knee consists of two menisci, the medial meniscus on the inner aspect of the knee and the lateral meniscus on the outer aspect of the knee. The medial and lateral meniscus act as cushions between the thigh bone (femur) and shin bone (tibia). The menisci have a poor blood supply and are thus less likely to heal when torn.
Meniscal tears often occur during sports. These tears are usually caused by twisting motion or over flexing of the knee joint. Athletes who play sports such as football, tennis and basketball are at a higher risk of developing meniscal tears. They often occur along with injuries to the anterior cruciate ligament, a ligament that crosses from the femur (thigh bone) to the tibia (shin bone).
In older patients, meniscal tears can occur without injury. With age, the meniscus may become more brittle and easier to tear. Many patients with arthritis will also have meniscal tears as the meniscus becomes pinched between the arthritic femur and tibia bones.
The symptoms of a meniscal tear include:
- Knee pain when walking
- A “popping “or “clicking” may be felt at the time of injury
- Tenderness when pressing on the meniscus
- Swelling of the knee
- Limited motion of the knee joint
- Catching, locking, or giving way of the knee
A careful medical history and physical examination can help diagnose meniscal injury. The McMurray test is a common test used for diagnosing meniscal tears. During this test, your doctor will bend the knee then straighten and rotate it in and out. This creates pressure on the torn meniscus. Pain or a click during this test may suggest a meniscal tear. Your doctor may order imaging tests such as knee joint X-ray and knee MRI to help confirm the diagnosis.
Treatment depends on the pattern and location of the tear. If the meniscal tear is not severe, your doctor may begin with non-surgical treatments that include:
- Rest: Avoid activities that may aggravate the injury.
- Ice: Ice application can reduce swelling
- Pain medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce swelling and pain
- Physical Therapy: Physical therapy may be recommended for muscle and joint strengthening.
If the symptoms are persisting and conservative treatment fails, your child may need a knee arthroscopic surgery to repair the torn meniscus.