The diagram to the right illustrates the anatomy of the menisci of the knee joint.
The meniscus is a crescent-shaped cartilage that acts as a shock absorber between the femur (thigh bone) and tibia (shin bone). Each knee has two menisci: medial (inner) and lateral (outer). There is an additional type of cartilage in the knee joint called articular cartilage which is a smooth, white, glistening surface that covers the ends of the bones. The articular cartilage provides lubrication and as a result, there is very little friction when the joint moves. These cartilages can tear and cause pain either by degenerative wear-and-tear or an acute injury. Acute injuries resulting in meniscal tears often cause damage to other structures in the knee, such as the anterior cruciate ligament (ACL).
ACL tears are associated with squatting and twisting motions as well as direct impact to the knee. Athletes who are most susceptible to ACL tears are those who play contact sports like football, basketball, soccer, field hockey, and ice hockey.
Symptoms:
- Popping: sensation when the injury occurs
- Stiffness that increases 2 to 3 days after injury
- Swelling that increases 2 to 3 days after injury
- Catching sensation
- Weakness
- Decreased range of motion
- Pain with:
- Daily activity
- Walking
- Bending the knee
- Sleeping on the affected side
If your symptoms last longer than 2 weeks and interfere with daily activity you should consult your primary care physician for a referral.
What To Expect During Your Appointment:
During your appointment, Dr. Betz will perform a physical exam to test range of motion in the knee and the leg strength. In-office imaging may be done or an MRI may be set up to diagnose the cause of your pain. Once the results of your imaging come back, Dr. Betz will provide treatment options and help you decide the course of action that is best for you.
Treatment
Dr. Betz performs an in-office exam on the patient to test range of motion in the knee joint.
Non-Surgical Options:
Course of treatment will depend on the size, shape, and location of the meniscal tear; some tears can heal with non-surgical treatment.
- Rest
- Bracing: bracing the joint will help provide the stability that the ACL no longer provides.
- Medication: non-steroidal anti-inflammatories are often prescribed to minimize swelling and pain.
- Physical Therapy: strengthening the knee will help relieve pain and prevent further injury. Stretching is also performed to help regain mobility.
- Injections: If the other non-surgical treatments fail, Dr. Betz can use injections to help reduce pain.
- Steroid Injection (Cortisone): steroids are proven to be very effective at reducing inflammation and pain when injected directly into the joint space.
- Platelet Rich Plasma (PRP): your own blood is used to extract platelet-rich plasma, which is then injected into your knee joint. The platelets within the plasma stimulate the body to repair itself.
Surgical Options:
If non-surgical treatment methods fail to improve pain, Dr. Betz will discuss surgery as an option. Each patient and tear is different, but most tears can be treated arthroscopically. For more information on arthroscopic surgery please see “Arthroscopic Surgery”.
For postoperative patients: