Meniscus tears can be recurrent, however a surgical treatment may help prevent the recurrence of the tears. In fact, a meniscal tear is one of the most frequently occurring cartilage injuries of the knee. Diagnosis and management of meniscal injury jacob babu, md, mha. History chief complaint age mechanism of injury location instability mechanical symptoms prior treatment. Lock the brace when walking to protect the knee in case of a fall. If you start using your knee before its healed, you could cause further injury. To ensure that this program is safe and effective for you, it should be performed under your doctors supervision. This solution will block the pain nerve fibers and local pain receptors in your knee. Pdf most of the documents on the racgp website are in portable document format pdf. An injury or tear in the meniscus can hamper normal. It can also cause a catching or locking sensation in the knee. The decision by the surgeon to repair or remove is based primarily on the location of the meniscal tear. Pain and swelling are the most common signs of an injury to your meniscus. A tear of the meniscus in the knee will irritate the joint and cause pain, swelling, and stiffness.
Does this patient have a torn meniscus or ligament of the. Meniscal tear meniscus tears are one of the most common knee injuries. Cavanaugh, pt, med, atc, scs, sports rehabilitation and performance center, hospital for special. Meniscal injuries typically occur through application of specific forces while the knee joint is in certain positions. It cushions the outer and inner edges of the knee, balancing weight across the knee. Because the meniscus must heal back together, recovery time for a repair is much longer than from a meniscectomy. Age differences in the prevalence of isolated medial and. The meniscus functions in load bearing, load transmission, shock absorption, joint sta bility, joint lubrication, and joint congruity. The meniscus is a wedge shaped cartilage ring found on both the inside and outside of the knee between the femur thigh bone and tibia shin bone. Meniscal injuries can be the result of a forceful, twisting event in a young athletes knee or it can insid.
Symptomatic meniscal tear confirmed by mri results that show a peripheral longitudinal tear in a vascular zone, associated with pain and mechanical symptoms. Tibial plateau fractures with and without meniscus tear. A tear of the meniscus is the most common injury to the knee. In many cases the injection will last 12 or more hours after surgery and significantly reduce the amount of pain medication that you will have to take. Research shows that a meniscus tear treatment with exercises is as effective as surgical treatment the recovery without exercises takes a little bit longer but comes without side effects. Patient guide to meniscus injuries what is the meniscus. An mri may be used to assist in making the diagnosis. An acute tear usually occurs when the knee is bent and forcefully twisted, while the leg is in a weight bearing position. The outer onethird of the meniscus has a rich blood supply. Rehabilitation guidelines for meniscal repair of root and.
Statistics show that about 61 of 100,000 people experience an acute tear of the meniscus. An algorithm was developed for diagnostic steps and treatment recommendations amongst patient subgroups atraumatic knee swelling and meniscal pathology in the setting of. Each knee joint has a medial meniscus and a lateral meniscus. The injury is more common with males at a ratio of 2. Anatomy, function, injury and treatment article pdf available in clinical anatomy 282. A sudden pivot or turn, deep squatting, or heavy lifting can lead to injury. The meniscus can be injured in many ways and on different locations flap tear, bucket handle tear, vertical tear, horizontal tear, complex tear, thus causing a variety of histories and different clinical findings.
Thus, most meniscus injuries affecting the inner, avascular, twothirds will not heal, as oxygen is required in the area of injury for proper healing. Tear pattern of the meniscus or the size of the articular cartilage lesion and clinical signs and symptoms have typically guided the clinical decision making of treatment interventions primarily for the type of surgical intervention. One of the following criteria i, ii, or iii is met. But some precautions might lower the risks of a knee injury. After an injury or surgery, an exercise conditioning program will help you return. Any sudden twisting or blunt forces exerted onto the meniscus can result in damage. The symptoms of a meniscal injury depend on the type and position of the meniscal tear. Different lesions reported include a folded caudal horn, longitudinal tears, fibrillation of the surface, transverse tears, buckethandle tears, and compression injuries. The lateral meniscus is smaller than the medial meniscus and covers approximately 70% of the lateral surface of the tibial plateau 11.
The knee is a hinge joint, formed by the ends of two bones. Anatomy of the knee bones ligaments meniscus articular cartilage. As we get older the meniscus weakens and tears can occur more easily, even from something as simple as. Athletes, particularly those who play contact sports, are at risk for meniscus tears. When people talk about torn cartilage in the knee, they are usually referring to a torn meniscus. Tears are described by how they look as well as where the tear occurs. Meniscectomy or repair of torn meniscus may be medically necessary when all of the following criteria a through c are met. If you do not have it you can download adobe reader free of charge. The purpose of this study was to determine what patient and injury factors are associated with the presence of a meniscus tear in tibial plateau fractures. The knee is protected by a cshaped cartilaginous disc, the meniscus.
If the force is sufficient, a meniscus tear may result. Meniscus tears are tough to prevent since theyre usually the result of an accident. Often times these tears can be diagnosed by taking a thorough history and completing a physical examination. Some meniscus tears can be repaired by suturing stitching the torn pieces together. What to order when the radiologists at radia have developed the following scanning guidelines for our referring providers to assist you in selecting the most effective imaging modality for your patients clinical presentation. The lateral meniscus is loosely attached to the joint capsule, particularly in the posterolateral corner where the posterior third attaches to. Racgp meniscal tear presentation, diagnosis and management.
Symptoms of an acute meniscus tear include swelling, pain along the joint line, catching, locking and a specific injury. New treatment breakthrough for meniscus injuries on the. Meniscus tear treatment with 4 exercises to avoid surgery. Behrens, md abstract meniscal injury is a common cause for presentation to the emergency department or primary care physicians office. Figure 5 mri images of an intact and torn meniscal root. Whether a tear can be successfully treated with repair depends upon the type of tear, as well as the overall condition of the injured meniscus. Com meniscal cartilage tear top view femur thighbone tibia shinbone medical meniscus front view of knee lateral meniscus torn what are the symptoms. If the tear is closer to the middle, there is no blood supply, so healing will not occur. Each meniscus is a roughly moonshaped pad and they lie beside each other on the top surface of the tibia shin bone. However, the meniscus also functions as a secondary stabiliser of the knee, providing joint lubrication and shock absorption. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. There are two categories of meniscal injuries acute tears and degenerative tears. Injuries to the meniscus are usually called tears and they can happen to anyone.
Injury of the knee joint meniscus is one of the most. However, anyone at any age can sustain a meniscus injury. The mechanism of injury is important as are the presence of specific symptoms after injury. Meniscal cartilage plays an essential role in the function and biomechanics of the knee joint. Acute meniscal tears occur most often from twisting injuries.
Interventions are listed by phase of rehabilitation early, early to. Common tears include longitudinal, parrotbeak, flap, bucket handle, and mixedcomplex. They are positioned on the tibial plateau top surface of the shin bone between the tibia shin bone and the femur thigh bone and are important for distributing. Your knee meniscus is fibrocartilage that separates thigh bone femur from your shin bone tibia. Tears are more common of the medial inside meniscus than the lateral outside meniscus and the medial meniscus may have better repairing qualities. Meniscal injuries can be the result of a forceful, twisting event in a young athletes knee or it can insid iously present in the older patient. This movement can produce a traction injury of the medial meniscus, tearing it from its peripheral.
Guidelines for medical necessity determination for knee. Diagnosis and management of meniscal injury rhode island. To open a pdf file you will need compatible software such as adobe reader. Knee injuries are fairly common problems, not just in athletes.
During flexion, if the tibia is rotatedinternally,theposteriorhornofthe medial meniscus is pulled toward the center of the joint. The size and location of the meniscal tear may also affect the rate of postoperative progression. Meniscus tear is a common injury that affects the knee joint. Many people have meniscal tears without any knee symptoms, especially. How to heal a meniscus tear with pictures wikihow fitness. The meniscus is also well supplied with nerve endings which explains the pain associated with meniscal injury and the role of the meniscus in proprioception. Sometimes we might not even notice that weve done anything to cause the tear. The meniscus can be torn during activities that cause direct contact or pressure from a forced twist or rotation. Rehabilitation guidelines for meniscal repair there are two types of cartilage in the knee, articular cartilage and meniscus cartilage.
Like a lot of knee injuries, a meniscus tear can be painful and debilitating. Acute meniscal tears are most often associated with a twisting. These files will have pdf in brackets along with the filesize of the download. Thats because an athlete, an older person and anyone in between can tear a meniscus. Most meniscal tears occur as a result of twisting the knee while the foot is planted on the ground. Patient demographics, laboratory data, radiologic and operative findings, treatment plan, and clinical outcomes were recorded. A meniscal tear may settle conservatively without giving many problems. Filing for a recurrence united states department of labor. Oftentimes, swelling may not appear until the day after the actual injury. They act to provide shock absorption and reduce friction between the tibia and the femur thigh bone. Rehabilitation of meniscal injury and surgery john t. Sports injury medicine department 9250 sw hall blvd. Males who are between the ages of 31 and 40 have an increased chance of a meniscal tear.
Meniscus injury is very common in knee traumatology. Recent studies have shown that this is a safe and effective way to control pain after knee surgery. Meniscus tears are among the most common knee injuries. Cavanaugh, pt, med, atc, scs1 1sports rehabilitation and performance center, hospital for special surgery,newyork,newyork j knee surg 2014. The meniscus are c shaped discs, made of tough cartilage called fibrocartilage. Axial load transferred through the joint is converted into meniscal hoop stresses load transmission tibia femur. Its a piece of cartilage in your knee that cushions and stabilizes the joint. Articular cartilage is made up of collagen, proteoglycans and water and lines the end of the bones that meet to form a joint. For people under the age of 30, the meniscus is fairly tough and rubbery.
Rehabilitation guidelines for meniscal repair uw health. Static quads sit on the floor with your legs straight out in front of you. Keep your thigh muscles strong with regular exercises. Understanding meniscal injuries changi general hospital. Meniscal injury is a common cause for presentation to the emergency department or primary care physicians office. The menisci act as shock absorbers in the knee, and provide stability to the joint.
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