What Is a Meniscus Tear?
A torn meniscus is a very common knee injury, especially among athletes. It occurs when there is a forceful twist or rotation of the knee. Each knee has two menisci – C- or wedge-shaped pieces of cartilage that act as shock absorbers between the thigh bone and shin bone. They cushion the joint and provide knee stability.
A meniscus can tear in various ways, and sports-related meniscus tears in about 50 percent of cases occur in conjunction with other knee injuries, like anterior cruciate ligament (ACL) tears.
Baptist Health is known for advanced, superior care for patients with orthopedic conditions and the diagnosis, treatment and management of meniscus tears. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.
Different Types of Meniscus Tears
There are six different types of meniscus tears. Each type requires a different treatment.
The six different types of meniscus tears are:
- Intrasubstance/Incomplete Tear—This is a partial tear of the meniscus at its attachment to the bone. This type rarely requires surgical intervention and usually heals itself with rest, ice, compression, and elevation.
- Bucket-Handle Tear—This is a large tear of the meniscus that is horizontal or near-horizontal.
- Horizontal Tear—This is a tear of the meniscus in a horizontal direction. It is usually caused by trauma or arthritis but can also be spontaneous, as it sometimes occurs with degenerative conditions.
- Radial Tear—This is a tear of the meniscus where one of its attachments to either bone is stretched. The result resembles a ragged edge on the meniscus.
- Complex Tear—This is a tear of the meniscus that involves more than one tear pattern.
- Flap Tear—This is a tear of the meniscus in which one part lifts and tears off.
Signs and Symptoms
Symptoms of a torn meniscus can include:
- A popping sensation/sound when the injury occurs
- Catching and/or locking of the knee
- Feeling of the knee giving out
- Pain that increases with walking
- Reduced range of motion
- Tenderness to touch
If a meniscus tear is suspected, a physical examination that includes specific questions about the mechanism of injury and symptoms will be completed. This will include a physical exam test known as McMurray’s test that starts with the knee bent. The examiner will palpate the knee joint as he slowly rotates and straightens the leg. This puts tension on a torn meniscus. This test is considered positive for a meniscus tear if a pop or a clicking sound and/or pain is produced.
Advanced diagnostic procedures and technology to effectively diagnose and determine can include:
Magnetic resonance imaging (MRI): A large magnet, radio waves and a computer are used to produce pictures of bone and soft tissues, including cartilage.
X-rays: A common imaging test of bones or joints. Cartilage doesn’t show up on X-rays, but it can show other causes of knee pain, like osteoarthritis.
A meniscus tear can be caused by:
- Injury while squatting and twisting the knee, pivoting suddenly, lifting something heavy or taking a direct hit
- An awkward twist of the knee, especially in middle-aged or older adults who have degeneration of the cartilage
Risk factors that can contribute to a meniscus tear include:
Age: The risk of developing a degenerative meniscus tear, when the cartilage has weakened and worn thin, increases with age. Most of these tears occur in people over the age of 30. Even stepping awkwardly or getting up from a chair the wrong way can lead to one of these tears.
Osteoarthritis: This common joint disorder, involving pain and stiffness caused by wear on the joints as a person ages, carries a higher risk of a meniscus tear.
Playing sports that require sudden turns and stops: These include football, basketball, soccer, tennis and many other competitive sports. These tears can occur in children, teens or adults.
There’s not much you can do to prevent a meniscus tear aside from avoiding sports and activities that require sudden turns and stops, but this is somewhat unrealistic. Performing adequate warm-up stretches prior to exercising and doing exercises to strengthen leg muscles that support the knee may provide some protection.
Treatment and Recovery
With proper diagnosis, treatment, and rehabilitation, people often return to their pre-injury abilities.
Can a Meniscus Heal Itself?
Yes, a meniscus can heal itself as long as symptoms do not persist and the knee is stable. In this case, non-surgical treatment can be utilized. Torn meniscus treatment depends on the type of tear, its size, and location. The outer third of each meniscus has a rich blood supply so blood cells can regenerate to create new meniscus tissue and can sometimes heal on its own.
Can a Partially Torn Meniscus Heal Itself?
No, a partially torn meniscus will not heal itself without surgical intervention because a tear in the inner two-thirds lacks a blood supply. Tears are typically trimmed and /or repaired during arthroscopic surgery.
Nonsurgical Treatment (for small, outer meniscus tears)
This acronym represents the recommended treatment used (at least initially) in many sports injuries. It is the recommended treatment for non-operative meniscus tears.
- P: Protect from further injuries by ceasing all sports activities and weight-bearing restrictions (as instructed by the physician). Physical therapy may also be recommended by your physician.
- R: Rest the extremity
- I: Ice 20 to 30 minutes five times per day
- C: Compression such as a brace or an ace wrap
- E: Elevate the injured area on two or three pillows when sitting or lying down
- D: Drugs such as over-the-counter non-steroidal anti-inflammatory or analgesic medications (like ibuprofen or naproxen) may be used for pain and inflammation (unless contraindications exist)
Knee surgery can be done as a minimally invasive procedure known as arthroscopy. During this procedure, a miniature camera is inserted through a small incision to give the surgeon a clear view of the inside of the knee. The surgeon then inserts miniature surgical instruments through other incisions to trim or repair the tear. Arthroscopic procedures to repair a torn meniscus include:
- Meniscus repair (outer meniscus only): Some tears can be repaired by stitching the torn pieces together. Because the meniscus must heal back together, recovery time for a repair is much longer than from a meniscectomy.
- Partial meniscectomy: During this procedure, the surgeon trims the damaged meniscus tissue away.
- Meniscus reconstruction: Severe tears might require more complex surgery. During meniscus reconstruction, your doctor may remove the torn part of the meniscus. The surgeon might insert scaffolds or replace the removed parts of your meniscus with a transplanted meniscus. This is called an allograft meniscal transplantation.
A knee cast or brace may be applied to limit post-surgical movement. After meniscus repair, patients must use crutches for about a month to keep weight off the knee.
After a healing period, the physician will prescribe rehabilitation exercises to restore knee mobility and strength. Some patients need intense physical therapy, while others can perform much of this rehabilitation at home. Rehabilitation time for a meniscus repair is about three months, while a meniscectomy requires approximately three to four weeks.
A torn meniscus can lead to complications including:
- Difficulty moving the knee: Pain, swelling, stiffness and weakness can make everyday activities difficult or impossible.
- Increased damage: Untreated tears can increase in size.
- Pain: You may experience ongoing pain in your injured knee.
- Other conditions: Individuals with a torn meniscus are more likely to develop osteoarthritis in the same knee.
Next Steps with MyChart
Discover MyChart, a free patient portal that combines your Baptist Health medical records into one location. Schedule appointments, review lab results, financials, and more! If you have questions, give us a call.