Meniscal Tear

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Meniscal Tear

• By Sarah Steski and Scott OBray

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Location of the Meniscus

• Three bones meet to form your knee joint your
  thighbone (femur), shinbone (tibia), and kneecap
  (patella).
• Two wedge-shaped pieces of cartilage act as
  "shock absorbers" between your thighbone and
  shinbone. These are called meniscus. They are
  tough and rubbery to help cushion the joint and
  keep it stable

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Types of Meniscus Tear

• Your meniscus is made up of two C shaped pieces
  of fibrocartilage. They are named by their
  position, either medial or lateral. The medial
  meniscus is closer to the inside of the body,
  while the lateral meniscus is located towards the
  outside. Depending on the force of the injury,
  several types of tears can occur. Longitudinal
  tears involve a vertical tear along the length of
  the meniscus. Longitudinal tears can also become
  "bucket handle tears", depending on the extent of
  the tear. Radial tears are another type of
  meniscus tear. These occur along the inside
  border of the meniscus. Significant radial tears
  can produce a flap tear, or "parrot beak tear",
  in which a flap of the meniscus may actually be
  moving into the joint space. This can often cause
  the catching or clicking feelings associated with
  meniscus tears.

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Causes of Meniscus Tear

• The two most common causes of a meniscus tear are
  due to traumatic injury (often seen in athletes)
  and degenerative processes (seen in older
  patients who have more brittle cartilage). The
  most common mechanism of a traumatic meniscus
  tear occurs when the knee joint is bent and the
  knee is then twisted.

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Symptoms of a Meniscus Tear

• Symptoms of a meniscus tear depend on the size
  and location of the tear and whether other knee
  injuries occurred along with it. Since there are
  no nerve endings to the meniscus, pain is due to
  swelling and injury to surrounding tissues.
• With small tears, you may have minimal pain at
  the time of the injury. Slight swelling often
  develops gradually over several days. Many times
  you can walk with only minimal pain, although
  pain increases with squatting, lifting, or rising
  from a seated position. These symptoms usually go
  away in 2 to 3 weeks although pain may recur with
  bending or twisting.

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• In a typical moderate tear, you feel pain at the
  side or in the center of the knee, depending on
  where the tear is. Often, you are still able to
  walk. Swelling usually increases gradually over 2
  to 3 days and may make the knee feel stiff and
  limit bending. There is often sharp pain when
  twisting or squatting. Symptoms may diminish in 1
  to 2 weeks but recur with activities that involve
  twisting or from overuse. The pain may come and
  go over a period of years if left untreated.

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• Larger tears usually cause more pain and
  immediate swelling and stiffness. Swelling can
  develop over 2 to 3 days. Pieces of the torn
  meniscus can float into the joint space. This can
  make the knee catch, pop, or lock. You may not be
  able to straighten your knee. The knee can also
  feel "wobbly" or unstable, or give way without
  warning. If other injuries occurred with the
  meniscus tear, especially torn ligaments, you may
  have increased pain, swelling, a feeling that the
  knee is unstable, and difficulty walking.

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Rehabilitation of the Knee

• A coordinated program of physical therapy and
  home exercises can advance healing in your knee
  and help you return to desired activities.
• Building strength and flexibility in your knee
  and legs may help prevent future degeneration in
  your knee.

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Rehab for Meniscus Tear 2

• The initial care for your torn meniscus centers
  around the R.I.C.E principles of rest, ice,
  compression, and elevation. If you have
  significant pain and swelling, you should see
  your certified athletic trainer or family
  physician for evaluation. Two common tests are
  the McMurray's test and Apley's Compression and
  Distraction tests. With a history of how you
  injured your knee, how quickly it swelled,
  location of your pain, and other symptoms they
  should be able to determine your exact injury.
  Your physician may also recommend an MRI for the
  most accurate diagnosis.

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Rehab for Meniscus Tear 3

• Treating tears in your meniscus starts with
  controlling the initial swelling and pain. This
  is best accomplished with rest, ice, compression,
  and elevation. Following an evaluation with
  your certified athletic trainer or physician, you
  can begin working on simple exercises to regain
  your range of motion and decrease swelling.
  Even with proper rehabilitation, some meniscus
  tears require arthroscopic surgery, because you
  may continue to have clicking, catching, popping,
  or swelling even after rehab. If you think you
  have suffered a meniscus tear, or have
  significant pain and swelling, talk with your
  physician or certified athletic trainer.

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Pro Athletes affected

• The Washington Wizards Gilbert Arenas has
  sustained a lateral meniscus tear in his left
  knee, and the tear was be repaired by
  arthroscopic surgery.
• Arenas averaged 28.4 points and 6.0 assists per
  game in 74 contests in 07, and made his third
  consecutive All Star appearance. Arenas will
  finish the regular season with 2,105 points
  scored, becoming the franchises first player
  since Walt Bellamy to score 2,000 points in
  three consecutive seasons.