The meniscus is a tough and rubbery cartilage tissue which is situated in the knee joint. The knee joint is composed of the tibia (shinbone), femur (thighbone) and the patella (knee cap). There is a wedge-shaped cartilage (meniscus) between the thighbone and the shinbone which acts as a ‘shock-absorber’ during physical activity such as walking, running, etc.
Causes of Meniscus Tear
This meniscus is tough and rubbery in texture and is excellent in reducing the impact of a shock on the leg bones. A direct trauma to the knee or even a severe injury which results in the excessive twisting, or jarring, of the knee can cause a meniscus to get damaged and torn. This results in painful symptoms as well as increasing disability due to the restricted motion of the knee joint.
A meniscus tear may also be seen as a result of degeneration due to advancing age. As time passes, the cartilage in the body, including the meniscus, begins to get worn and weakened. This type of aged tissue is more vulnerable to get torn and even a minor stretching of the meniscus can cause it to get torn.
Signs and Symptoms of Meniscus Tear
The most noticeable sign after an injury to the meniscus is the distinct ‘pop’ sound that accompanies it. Mostly, people are still able to walk on the injured knee but in case the injury is severe the knee gradually begins to get stiff and inflamed (swollen) after 2-3 days.
The other commonly seen symptoms of a meniscus tear are:
- Stiff knee joint
- Knee locking/catching
- Weakened knee
- Restricted range of knee joint’s motion
A prompt medical care by an experienced orthopedic can relieve you of the painful and disabling symptoms of a meniscus tear.
Diagnosing Meniscus Tear
The diagnosis for a meniscus tear initially involves a check of your medical history as well as a complete physical examination. The physical examination will require checking the joint line for tender (painful) spots near the meniscus.
Imaging tests are then used to determine the extent and severity of the meniscus tear using advanced imaging tests such as:
- X-ray test – An x-ray test can help reveal the meniscus tear clearly and may also show the presence of other causes of knee pain such as osteoarthritis.
- MRI – A magnetic resonance imaging (MRI) test is useful in creating a detailed view of the soft tissues of your knee joint, such as the meniscus.
Meniscus Repair treatment
There are various methods of performing a meniscus repair surgery and the specific type of repair treatment for you will depend mainly on the type of tear, the size of the tear as well as its exact location. The outer 1/3rd of the total meniscus has a rich supply of blood and a tear in this region usually heals itself naturally ir can be repaired with surgery, if too severe. A longitudinal tear is one such kind of tear.
However, the other 2/3rd parts of the meniscus lack proper blood supply and are devoid of nutrients hence, a tear in this part of the meniscus cannot heal naturally. These are mostly complex types of tears and are often found in thin and worn cartilage. As the tear cannot heal itself naturally such types of tears need surgical treatment for repair.
The doctor/orthopedic surgeon will take into consideration various factors, such as the type of tear, your age, daily activity level and any other related injuries to decide the most-suitable treatment method for you.
These are the various meniscus repair treatment methods available:
Non-surgical Treatments for Meniscus Repair
In case the tear in the meniscus is small and on the outer portion of the meniscus it may not require surgical repair. As long as the painful symptoms are not constant and the knee joint is sufficiently stable, other non-surgical treatment methods may suffice, such as the ‘RICE’ methods – Rest, Ice, Compression and Elevation.
Non-steroidal anti-inflammatory drugs (NSAIDs) are often used to control the swelling in the knee joint.
Surgical Treatments for Meniscus Repair
If your painful symptoms persist even after being treated with non-surgical treatment methods, then the damaged meniscus may be required to be treated using surgical methods.
The surgical treatment method for meniscus repair is now performed using minimally invasive arthroscopic surgical techniques. This surgery is performed under general anesthesia commonly to avoid discomfort to you during the surgical repair procedure.
The minimally invasive surgical meniscus repair procedure involves using an ‘arthroscope’, which is a thin and flexible tube initially fitted with a light-source and a video camera. This surgical method requires making a few (2-3) very small (keyhole) incisions around the damaged knee. One of these incisions is used as an entry port for the arthroscope to enter the knee joint and provide a clear and detailed view of the damaged meniscus to the surgeon.
The other incisions are used as entry points for various specialized miniature surgical instruments to be used for trimming, or repairing, the torn meniscus.
The repair procedure involves two techniques:
- Partial Meniscectomy – This procedure requires trimming away the damaged tissue only,
- Meniscus Repair – Certain severe meniscus damage can be corrected by suturing the torn pieces together. The type of tear will decide if the suture will be able to heal, and rejoin, the repaired meniscus.
Risks associated with Meniscus Repair
As is seen any type of major surgery, there are a few complications that are associated with the surgical part of the meniscus repair. These are the risks that might arise after a meniscus repair surgery:
- Anesthetic allergy
- Nerve damage
- Blood vessel damage
- Blood clots in leg
The orthopedic surgeon will take every possible precaution to prevent any of these risks from arising.