What is a Meniscal Tear?

Meniscal tears are very common injuries and are a common cause of knee pain and dysfunction. The meniscus can tear as a result of trauma, age related wear, or a combination of both factors.

Causes of Meniscal Tears
Meniscal tears can be:

Degenerative – occur as part of the aging process due to progressive wear or as a result of habitual, prolonged activities such as squatting, kneeling twisting, etc.
Sometimes no trauma is required as the meniscus stiffens and weakens with age.
Meniscus tears are a special risk for older athletes.

Traumatic – occur in the athletic setting.
The meniscus is at risk of tearing due to constant exposure by repetitive loading as we walk, run, and perform other activities.
When the knee is partially bent under load or involved in twisting motions (pivoting during sports, squatting, heavy lifting, and changing direction) the meniscus can deform under pressure.
Higher risk sports include:

• Football
• Basketball
• Soccer
• Tennis

Meniscal tears can also occur in combination with tears of ligaments around the knee (e.g. ACL tear).

Symptoms of a Torn Meniscus?
Meniscal tears may cause some or all of the following symptoms:

• Knee pain
• Swelling
• Difficulty walking
• Loss of full range of motion
• Inability to either bend or fully straighten the knee
• Pain with walking
• Tenderness along the joint line
• A tendency for your knee to get “stuck” or lock up
• Clicking

Meniscal Tear Diagnosis
Meniscal tears are diagnosed by the following

• History of injury
• Nature of knee pain and other symptoms
• Physical examination
• Imaging tests

Imaging Tests
X-rays are useful in the diagnosis of fractures and osteoarthritis, MRI scans are useful for imaging meniscal tears, cartilage injuries, and bony abnormalities such as bone bruising and insufficiency fractures.
Treatment for a Meniscal Tear?
The treatment depends on the pattern and location of the tear. If the meniscal tear is not severe, you may begin with non-surgical treatments that may include:

• Rest: Avoid activities that may cause injury: Ice application to reduce swelling
• Pain medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce swelling and pain

Physical Therapy: physical therapy and rehabilitation to strengthen the quadriceps and hamstrings muscles to stabilise the knee and maintain range of movement.
If the symptoms are still persisting and conservative treatment fails, you will need a knee arthroscopic surgery to repair the torn meniscus.
At arthroscopy, the torn meniscus will be repaired with sutures or partly resected and reshaped to a stable configuration, depending on the site and nature of the tear.
Arthroscopy is very effective in treating the symptoms of meniscal tears.
Surgery is recommended where patients endure ongoing episodes of;

• Pain
• Instability
• Swelling and
• Locking

Certain types of meniscal tears can cause damage to the articular cartilage if left untreated. This can contribute to the development of premature osteoarthritis.

Meniscal Surgery
Patients will usually require surgery to restore function and stability if they wish to return to:

• Sports involving the cutting or pivoting movements e.g. soccer, football, netball, etc, or
• Physical jobs e.g. policeman, fireman, builders, etc).

The procedure for meniscal repair is performed via knee arthroscopy (ie. keyhole surgery) with 2 small cuts (5-7mm) on each side of the knee cap.