Meniscal Tear Treatment
The knee, the largest joint in the human body, is composed of many different components. Of all the bones, ligaments, and muscles in the knee joint, the meniscus is the most fragile. The meniscus is made of a rubbery cartilage that acts as a shock absorber between the femur and tibia. Each knee joint contains two menisci: one lining the outer side knee and another lining the inner side of the knee.
Meniscal tears are very common knee injuries; in fact, meniscus tears are one of the most commonly sustained injuries among athletes. Twisting or turning quickly usually causes a tear, typically while the foot is grounded and the knee is bent. While playing sports is the most common cause of a meniscal tear, anyone can sustain an injury to the meniscus by placing excessive weight on the knees.
Symptoms of a Meniscus Tear
Patients might feel a pop when the meniscus is torn; however, most patients are able to walk, or even keep playing sports after the injury occurs. Despite the immediate mobility the patient may have, over the next few days the knee gradually becomes stiff and swollen, limiting function and range of motion.
The most common symptoms of meniscus tears are:
- Loss of full range of motion
- Locking of the Knee
Examination of the Knee
The attending orthopaedic surgeon will examine the knee to check for soreness, and will also rotate and bend the joint, listening for a “click.” Oftentimes if an initial review of the knee joint is inconclusive, imaging tests, such as X-rays and MRI scans, will be used to confirm or dispute the existence of a meniscal tear.
Types of Meniscal Tears
There are many different types of tears. The type of tear is usually determined by appearance, as well as the location of the tear. Types of meniscal tears include:
Bucket Handle Tear
A bucket handle tear is a tear around or close to the rim of the meniscus, and typically affects younger, more active patients. Bucket handle tears cause the central part of the meniscus to displace itself into the joint. When treating this type of tear, part of the meniscus may have to be removed. If the tear is at the extreme edge, then the meniscus may be able to be repaired.
The longitudinal tear involves a vertical tear along the length of the meniscus. Depending on the extent of the tear, longitudinal tears can turn into a bucket handle tear.
The flap tear allows a flake of the meniscus to break off and fall in and out of the joint.
Transverse tears are also known as vertical tears; these tears may be repairable and do not always require total removal.
A “torn horn” meniscal tear is commonly sustained during sports. “Torn horn” indicates damage to either the posterior or anterior horn of the meniscus.
A radial tear is one that cuts across the meniscus. These cannot be repaired but can be treated by removing part of the meniscus in front and in back of the tear, and then smoothing out the edge to save as much meniscus as possible.
Meniscal Tear Treatment in Manhattan
If your symptoms persist with non-surgical treatment, such as physical therapy or corticosteroid injections, Dr Harwin suggests knee arthroscopy to repair a damaged meniscus. Dr Harwin will recommend his associate, a sports medicine specialist to treat patients' meniscal tears in a safe and comfortable environment.
Please note that Dr. Harwin’s practice, The Center for Reconstructive Joint Surgery, is now exclusively focused on hip and knee replacement surgery. He recommends his associate, Dr. Robert Ziets, as your sports medicine physician.