• Meniscal Tear

    (Torn Meniscus)

    Definition

    A meniscal tear is a tear in the meniscus. The meniscus is a shock-absorbing structure in the knee. There are two menisci (plural of meniscus) in each knee, one on the inside (medial), and one on the outside (lateral).
    Torn Meniscus
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    Causes

    Most injuries to the meniscus are caused by trauma. This usually includes compression and twisting of the knee. Movements that can cause trauma to the knee include pivoting, cutting, and slowing down. Because aging tends to break down the inner tissues of the meniscus, minor trauma (such as squatting) can injure the meniscus in an older person.

    Risk Factors

    A risk factor is something that increases your chance of getting a disease or condition. Risk factors for a meniscal tear include:

    Symptoms

    A torn meniscus may or may not cause symptoms. The ones that do not cause symptoms are usually small tears in the back of the knee.
    Symptoms may include:
    • "Popping" sound at the time of the injury
    • Pain
    • Tightness
    • Swelling within the knee, often called "water on the knee"
    • Locking up, catching, or giving way of the knee
    • Tenderness in the joint

    Diagnosis

    Your doctor will ask about your symptoms and how you injured your knee. He or she will do a physical exam. Your doctor will do physical tests to decide if there is a tear. Tests may include:
    • X-ray—A test that uses radiation to take a picture of structures inside the body. It will not show a meniscus tear, but may show some bone abnormality.
    • MRI—A test that uses magnetic radiation waves to make pictures of the inside of the knee. This is effective in diagnosing a meniscal tear.
    • Arthroscopy—A thin, lighted tube inserted through a small incision in the knee to look at the structures inside the knee. With the arthroscope, the tear will be seen and may be removed or repaired as necessary.

    Treatment

    If your knee locks up and is painful, your physician may determine that surgery is necessary to remove the damaged meniscus. For knees that are stable and are not locking, the "RICE" treatment may be all that is needed, at least for a period of time.

    RICE Therapy

    • Rest—Take a break from activities that stress the knee joint. With rest, the knee will be less painful. Some meniscal tears that occur on the outside of the meniscus will heal with time.
    • Ice—Apply ice in 15-minute periods during the first 24 hours after the injury and for several days after, if needed. This helps reduce swelling, inflammation, and pain.
    • Compression—Wrap the knee in an elastic bandage. This will help stop swelling and provide support and protection for the knee. Do not pull the elastic tightly.
    • Elevation—Keep the injured knee raised for the first 24 hours, including during sleep. This will help drain fluid and reduce swelling.

    Prevention

    To avoid tearing a meniscus:
    • Wear appropriate footwear for your sport and playing surface.
    • Strengthen and stretch the leg muscles, including:
      • Hamstrings
      • Quadriceps
      • Calf muscles
    • Learn the techniques to properly cut, pivot, slow down, and land from a jump.

    RESOURCES

    American Academy of Orthopaedic Surgeons http://www.aaos.org

    American Orthopaedic Society for Sports Medicine http://www.sportsmed.org

    CANADIAN RESOURCES

    Canadian Orthopaedic Association http://www.coa-aco.org

    Canadian Orthopaedic Foundation http://www.canorth.org

    References

    American Orthopaedic Society for Sports Medicine. Available at: http://www.sportsmed.org. Accessed July 20, 2009.

    Meniscal tears. American Academy of Orthopaedic Surgeons website. Available at: http://www.aaos.org. Updated February 2009. Accessed July 20, 2009.

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