Your Health - Meniscal Tear

Meniscal Tear

(Torn Meniscus)

Definition

A meniscal tear is a tear in the meniscus, 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

Causes

Most injuries to the meniscus are caused by trauma, usually compression and twisting of the knee. Movements that can cause trauma to the knee include pivoting, cutting, and decelerating. 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:

Participating in contact sports
Improper techniques for jumping, landing, pivoting, and cutting
Previous ACL injury

Symptoms

Torn meniscus may or may not cause symptoms. The ones that do not cause symptoms are usually small tears located 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

The doctor will ask about your symptoms and how you injured your knee, and perform a physical exam . The doctor will perform 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 scan —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 deemed 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 aren't 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/tabs/Index.aspx/

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/tabs/Index.aspx . 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.

Last reviewed October 2009 by John C. Keel, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.