The term "torn meniscus” usually refers to the damage of meniscus of the knee joint.
Presentation
- Mild to moderate pain in the knee
- Swelling of the knee joint (intermittent, knee joint feels “tight”)
- Knee “pop”
- Skin over the involved knee is red, warm and tender
- Restriction of movements at the knee joint
- Knee “lock” (fixation of knee joint in semi-flexed position between 15° to 30° and cannot be moved from this position)
Entire Body System
- Pain
IS THE TEAR CAUSING THE PAIN…OR NOT? So what the heck is going on? When a patient has knee pain, his doctor typically orders an MRI…and if the MRI shows that the meniscus is torn, the pain is generally assumed to be attributable to the tear. [bottomlineinc.com]
When you tear your meniscus, you may experience a popping or tearing sensation in the knee, followed by joint pain that may be moderate or severe. [livestrong.com]
The catch is that while some people don’t experience pain at all; others can have problems with mobility and flexibility, accompanied by very significant pain. [wrvo.org]
Knee pain is all too common. | Source Knee Pain Knee pain is a very common ailment. If you’re active in sports, or if you live long enough, you’ll probably experience knee pain at some point in your life. [healdove.com]
See your doctor or a primary care sports medicine doctor if you have these symptoms after a knee injury: A “pop” at the time of injury (also a symptom of an ACL tear) Knee joint pain when walking Knee pain in the space between the bones that gets worse [rush.edu]
- Swelling
When the patient recalls a specific injury that led to the pain and swelling, the swelling often does not occur until the day after the injury. The swelling is not necessarily in the same area as the pain. [orthop.washington.edu]
Work out and then (the knee) swells up a little bit, and then I got to slow it down. It’s all about patience.” [derekbodner.com]
Inflammation and swelling of the knee joint are common symptoms of the disease. Conservative treatment modalities are employed for the relief of symptoms and surgical interventions are used for repair. [symptoma.com]
Joint Swelling – Some patients may experience swelling in the involved joint line, occurring as a delayed symptom. Others may not display this symptom all. [exercisesforinjuries.com]
Frequently, there is swelling or fullness in the knee and often times the swelling is felt as pain in the back of the knee. The best test to tell if your knee has a torn meniscus it an MRI scan. [philly.com]
- Inflammation
When your body has inflammation, it uses naturally produced stem cells to reduce inflammation and heal the inflamed area. [thekneepainguru.com]
Steroid is a strong anti-inflammatory that helps to reduce the inflammation. It doesn’t fix the meniscus tear, it just takes away the inflammation and basically resets the inflammatory clock to zero. [arthritis-health.com]
Initial treatment may include medications such as analgesics which help reduce the pain, non-steroidal anti-inflammatory drugs – NSAIDS – which reduce the pain and inflammation and steroid injections which reduce inflammation and provide short-term relief [theregenerativeclinic.co.uk]
This may be helpful in easing the inflammation that occurs with a torn meniscus. Anti-inflammatory medications, such as ibuprofen (Advil, Motrin) or naproxen (Aleve), may help relieve pain and inflammation. [medicinenet.com]
- Surgical Procedure
In many cases, a surgical procedure called "arthroscopy" is used to repair or remove a torn meniscus. [orthoinfo.aaos.org]
However, if the symptoms do not resolve with nonsurgical treatment, surgical treatment may be recommended. Surgical Treatment Knee arthroscopy is the commonly recommended surgical procedure for meniscal tears. [carrellclinic.com]
Knee arthroscopy is a commonly performed surgical procedure in which a miniature camera is inserted through a small incision to better view the knee. [advancingyourhealth.org]
Today, regenerative therapies and/or customized physical therapy may be equally effective in repairing the damage – so you can potentially recover from your injury without an invasive surgical procedure. [orthohealing.com]
- Severe Pain
If the torn cartilage lodges in the joint, severe pain and locking of… Read More In joint disease: Traumatic joint diseases Usually it is the medial meniscus that is disrupted. [britannica.com]
Sign of a torn meniscus: Minor pain and swelling accompanied by mild to severe pain. If there is a moderate tear, you may have lateral knee pain with severe swelling. If the injury is severe, the symptoms may include sharp pain and inflammation. [turningpointmedicalgroup.com]
Meniscus tears are a very common cause of knee pain. That pain might be mild or it might be severe. In some patients who develop as mensicus tear and also have arthritis, the pain can be due to both issues. [howardluksmd.com]
pain, especially when you hold the knee straight Stiffness Swelling Weakness in the knee The knee joint may catch, click or lock Treating a torn meniscus Treatment for a torn meniscus depends on the severity of your injury as well as your age, overall [cooperhealth.org]
Severe pain and swelling may occur up to 24 hours afterward. Walking can become difficult. Additional pain may be felt when flexing or twisting the knee. [cedars-sinai.org]
Cardiovascular
- Thrombosis
Additionaly, this surgery was associated with significant risks, like: infection, deep venous thrombosis, pulmonary embolism, and death. [regenerativeorthopedicinstitute.com]
Musculoskeletal
- Knee Pain
Believe it or not, this knee injury happened almost 26 years ago. Knee pain is all too common. | Source Knee Pain Knee pain is a very common ailment. [healdove.com]
In many cases, a torn meniscus could be an early sign of arthritis rather than the source of knee pain. It would be the arthritis—not the tear in the meniscus—causing the pain. [bottomlineinc.com]
See this post online at: https://bottomlineinc.com/health/knee/torn-meniscus-common-surgery-for-knee-pain-works-no-better-than-fake-surgery [bottomlinehealth.com]
If you feed your body with the proper fuel it needs, it can begin to heal it’s own wounds, leaving not only your knee, but your entire body feeling healthier. the knee pain guru Bill is “The Knee Pain Guru” and “ The Best in the World at Eliminating Knee [thekneepainguru.com]
Twisting or over-flexing the knee can cause a tear in the meniscus cartilage in the knee. Meniscus tears are a common cause of knee pain, especially in athletes. [rush.edu]
- Arthritis
In many cases, a torn meniscus could be an early sign of arthritis rather than the source of knee pain. It would be the arthritis—not the tear in the meniscus—causing the pain. [bottomlineinc.com]
“Amount of arthritis that’s in the knee is the biggest determinant of satisfaction” “Amount of arthritis that’s in the knee is the biggest determinant of patient satisfaction. [realsurgery-meniscustear.com]
Published on Apr 23, 2017 If you have knee pain and joint swelling, doctors say it could be more than arthritis pain. Age and injury can lead to arthritis, but excessive knee pain and swelling could also be caused by a meniscus tear. Dr. [youtube.com]
X-rays of the knee are usually negative, although they may show arthritis in older patients. [nwoa.com]
- Joint Effusion
Examination of the knee may reveal a swelling of the joint (effusion), a 'crunching' of the joint (crepitus) or locking but these things can be caused by other conditions too. [patient.info]
On examination, there may be joint effusion, joint line tenderness, and the joint is held in a flexed position.1 in late presentations, there may be significant quadriceps wasting. [racgp.org.au]
A similar appearance may be seen in patients with knee instability or joint effusion when the flounce can be also seen in the lateral meniscus. [radiologykey.com]
Psychiatrical
- Suggestibility
If the history and physical examination strongly suggest that a torn meniscus is present, then arthroscopy may be suggested to confirm the diagnosis and treat the problem at the same time. [orthonorcal.com]
Your orthopedic surgeon will examine your knee, evaluate your symptoms, and medical history before suggesting a treatment plan. The treatment depends on the type, size and location of tear as well your age and activity level. [carrellclinic.com]
Signs & Symptoms Treatments Videos Signs and symptoms of an Meniscus Tear may include: Pain in knee Swelling and stiffness Fluid build-up inside on top of knee Sensation that knee is getting stuck or locking Self Care The doctor may suggest resting, icing [tria.com]
Read More Three Simple Suggestions for Getting Ready for Skiing and Snowboarding By Dr. Edward Loniewski, DOOrthopedic SurgeonAsk any competitive skier about the one joint they are most concerned about and most would point to their knees. [jointhealing.com]
Embiid was captured on video at a Meek Mill concert on Friday night, which of course has prompted people to suggest he should not have been dancing with the injury, as if that was going to exacerbate it. [cbssports.com]
Neurologic
- Confusion
The meniscus is a rubber disc-like piece of cartilage (not to be confused with joint cartilage). It serves as a shock-absorber to protect the joint cartilage. [wrvo.org]
Their crossovers confuse opponents who can’t tell if they’re going left or right. They swerve, sprint, jump, and dunk as if they have no bones. However, those seemingly effortless twists and turns can come with a price if one wrong move is made. [pennmedicine.org]
There is often confusion about whether or not there is a difference between a meniscus tear and a cartilage tear. Many patients will use these words interchangeably, and many doctors may describe an injury using one of these terms. [verywellhealth.com]
Conditions with similar symptoms Sometimes the symptoms of a torn meniscus can be confused with a fragment of arthritic articular cartilage that is hanging from the surface of the bone or that has broken free in the joint. [orthop.washington.edu]
Workup
Diagnosis is made on the basis of the following [3]:
- Patient’s history and inquiring the detail of the injury.
- Physical examination. The signs that are useful in diagnosing torn meniscus include McMurray test, Steinmann test, Apley test, Thessaly test, Bragard sign, Böhler sign, Payr sign, Merke sign, Childress sign and Finochietto sign [4] [5].
Additional investigations include:
- X-rays of the knee (both anteroposterior and lateral views)
- Knee arthroscopy (visualization of the joint with the help of an endoscope) [6]
- Computerized tomography (CT) and magnetic resonance imaging (MRI) [7] [8]
- Ultrasound of the knee joint
Treatment
Conservative treatment modalities for torn meniscus include the following.
- Complete rest should be advised.
- Ice packing should be done to prevent swelling and pain. Ideally, the packs should be applied every 6 hours.
- Compression and elevation of the involved knee are also helpful.
- Anti-inflammatory drugs (such as ibuprofen, naproxen) can be given. Other analgesics can also be used if the pain is severe.
- Steroid injections (cortisone) are helpful in severe cases.
- Electro-acupuncture can also be used to reduce the pain.
- Physiotherapy consisting of exercises specially designed for strengthening and stabilizing the muscles (mainly the quadriceps and hamstrings) is highly recommended.
Surgical treatment consists of the following:
- Arthroscopy guided meniscectomy (partial, total or subtotal removal of the menisci) [9]
- Repair of the torn meniscus [10]
- Micro fracture surgery
- Joint replacement
Rehabilitation therapy includes:
- Use of braces for weight bearing
- Shoe orthotics
Prognosis
Prognosis of the condition after medical and surgical repair is good. Even the athletes and gymnasts, who are involved in excessive activity, achieve good level of healing and repair within 4 to 6 weeks. Healing time depends on dedication to physiotherapy and adherence to rehabilitation program.
Complications of meniscectomy are rare (2%) and rarely does the condition recur with proper care. However, lack of care can result in gross morbidities like deviated gait.
Etiology
- Abnormal posture while squatting, kneeling or lifting heavy weight can lead to torn meniscus. People involved in sport activities like athletes are more prone to such injuries due to the degree of rotation, flexion and extension to which the knee is subjected.
- Osteoarthritis: Degenerative changes in the meniscal cartilage with age that lead to wear and tear phenomenon.
Epidemiology
The prevalence rate of torn meniscus is 61:10,000. A male is to female predisposition of 2.5:1 has been found as males participate in sports more compared to females. No racial predisposition exists.
In males, menisci are prone to tears in the age of 31 to 40 years. Females are susceptible during 11 to 20 years of age. In children younger than 10 years of age, these injuries are rare due to more elasticity of the menisci.
It is common in individuals performing sports activities. Approximately 60% of the patients are prone to a torn meniscus over the age of 65.
Pathophysiology
Meniscus is a fibrocartilaginous structure that partially covers the various joints of the body, including the knee joint. Knee menisci are two in number (lateral and medial) and are C-shaped flaps that function to reduce the friction between the femur and upper end of tibia by providing a cushioning effect.
Tears of menisci may occur due to excessive grinding of femur into the tibia or due to thinning of menisci with age. The medial meniscus is firmly attached to the cruciate ligament whereas the lateral meniscus is not and is relatively more mobile as compared to the medial meniscus. This accounts for tears of medial meniscus being more common as compared to the lateral meniscus.
Depending upon the morphology, tears are of various types including [2]:
- Transverse
- Longitudinal
- Bucket handle
- Parrot beak
If the injury occurs in well-perfused region of the joint, healing is more likely to occur as compared to scarcely perfused areas.
Prevention
- Proper technique of sports should be followed while playing, overextending the joints beyond their normal range of motion should be avoided.
- During the healing period, activities that are prone to put excessive strain on the concerned. Joint stability should be maintained.
- Lifelong care must be exercised in an individual with history of torn meniscus as the fibrocartilaginous tissue is damaged once and does not regain same strength as before.
Summary
Torn meniscus refers to the tear in meniscus surrounding the knee joint as a result of direct trauma or as a progressive degenerative phenomenon [1]. Menisci are fibrocartilaginous structures that surround many joints of the body but the term “torn meniscus” conventionally refers to the damage of meniscus of the knee joint.
Inflammation and swelling of the knee joint are common symptoms of the disease. Conservative treatment modalities are employed for the relief of symptoms and surgical interventions are used for repair.
Patient Information
Torn meniscus refers to the condition when one of the protective cushioning layers around the knee joint known as “meniscus” gets torn. The cause of damage is excessive grinding of the joint while squatting, kneeling or while bearing heavy weights. Alternatively, the meniscus may also get torn in old age as a result of wear and tear changes that occur with age.
The affected knee becomes swollen and painful. The pain worsens on movement and the range of motion is decreased. The effective treatment plan is to rest the knee, apply cold packs and elevate the leg to avoid putting undue strain on the knee. Drugs are given for swelling and pain. In extreme cases, surgery is done for repair or removal of the damaged menisci.
Once repaired, care should be taken to avoid straining the already weakened menisci. With proper care and treatment, healing occurs within 4-6 weeks.
References
- Sinton WA. Knee injuries. Part I: the torn meniscus. The Journal of sports medicine. Sep-Oct 1972;1(1):37-40.
- Mesiha M, Zurakowski D, Soriano J, Nielson JH, Zarins B, Murray MM. Pathologic characteristics of the torn human meniscus. The American journal of sports medicine. Jan 2007;35(1):103-112.
- Martin G, Connor AC. Diagnosis of torn meniscus. American journal of surgery. Oct 1961;102:573-575.
- Hegedus EJ, Cook C, Hasselblad V, Goode A, McCrory DC. Physical examination tests for assessing a torn meniscus in the knee: a systematic review with meta-analysis. The Journal of orthopaedic and sports physical therapy. Sep 2007;37(9):541-550.
- Solomon DH, Simel DL, Bates DW, Katz JN, Schaffer JL. The rational clinical examination. Does this patient have a torn meniscus or ligament of the knee? Value of the physical examination. Jama. Oct 3 2001;286(13):1610-1620.
- Freiberger RH. Arthrography of the knee for diagnosis of torn meniscus. The Journal of sports medicine. Sep-Oct 1972;1(1):24.
- DeRamos RK. CT diagnosis of torn meniscus. Computerized radiology : official journal of the Computerized Tomography Society. Sep-Oct 1982;6(5):263-264.
- Lee MH, Choi SH, Woo SY. Quantitative analysis of the difference between an intact complete discoid lateral meniscus and a torn complete discoid meniscus on MR imaging: a feasibility study for a new classification. Skeletal radiology. Dec 2010;39(12):1193-1197.
- Adachi N, Ochi M, Uchio Y, Kuriwaka M, Shinomiya R. Torn discoid lateral meniscus treated using partial central meniscectomy and suture of the peripheral tear. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. May 2004;20(5):536-542.
- Ahn JH, Chang MJ, Lee YS, Yoo JC, Pae YR. Arthroscopic split transpositional repair for torn complete discoid lateral meniscus. Orthopedics. Jul 2009;32(7):524.