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Meniscal Tear

(Torn Meniscus)

Definition

A meniscal tear is a tear in the meniscus. The meniscus is cartilage, which acts as a shock-absorbing structure in the knee. There are two menisci in each knee, a medial one on the inside, and a lateral one on the outside.
There are different types of tears depending on the location and how they look. Treatment depends on the severity of the tear.
Torn Meniscus
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Copyright © Nucleus Medical Media, Inc.

Causes

Most injuries to the meniscus are caused by trauma. This usually includes compression and twisting of the knee. Because the aging process tends to break down the inner tissues of the meniscus, minor trauma can injure the meniscus in an older adult.

Risk Factors

Factors that may increase your risk of:
  • Degenerative tears:
    • Increasing age, especially over 60 years old
    • Male gender
    • Occupations that involve kneeling and squatting
    • Climbing stairs
    • Previous knee injuries
    • Obesity
  • Acute tears:
    • Participating in contact sports, such as soccer or rugby
    • Poor techniques for jumping, landing, pivoting, and cutting

Symptoms

Symptoms may include:
  • A popping sound at the time of the injury
  • Pain and swelling in the knee
  • Tightness in the knee
  • Locking up, catching, or giving way of the knee
  • Tenderness in the joint

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.
Your knee may need to be viewed. This can be done with:

Treatment

Talk with your doctor about the best treatment plan for you. Recovery time ranges depend on the severity of your injury. Treatment steps may include:

Acute Care

Rest
Your knee will need time to heal. Avoid activities that place extra stress on the knee:
  • Do not do activities that cause pain. This includes running, jumping, and weight lifting using the legs.
  • Do not play sports until your doctor has said it is safe to do so.
Your doctor may recommend a knee brace to stabilize the knee, and crutches to keep extra weight off your leg.
Cold
Apply an ice or a cold pack to the area for 15-20 minutes, four times a day, for several days after the injury. Do not apply the ice directly to your skin. Wrap the ice or cold pack in a towel.
Pain Relief Medications
To manage pain, your doctor may recommend:
  • Over-the-counter medication, such as ibuprofen or naproxen
  • Prescription pain relievers
Compression
Compression can help prevent more swelling. Your doctor may recommend an elastic compression bandage around your knee. Be careful not to wrap the bandage too tight.
Elevation
Elevation can also help keep swelling down. Keep your knee higher than your heart as much as possible for the first 24 hours or so. A couple of days of elevation might be recommended for severe sprains.

Recovery Steps

Physical Therapy
Your doctor may refer you to a physical therapist. The therapist can help you control discomfort and regain function.
Heat
Use heat only when you are returning to physical activity. Heat may then be used before stretching or getting ready to play sports to help loosen the knee joint.
Stretching
When the acute pain is gone, start gentle stretching as recommended. Stay within pain limits. Hold each stretch for about 10 seconds and repeat six times. Stretch several times a day.
Strengthening
Begin strengthening exercises for your legs as recommended.

Surgery

Repair or removal of all or part of the damaged meniscus may by performed. This is usually done through small incisions of the skin. A camera and special tools are inserted through the incisions.

Prevention

To reduce your chances of a meniscal tears, take these steps:
  • Maintain proper technique when exercising or playing sports.
  • Wear appropriate footwear for your sport and playing surface.
  • Strengthen both the quadriceps and the hamstrings.
  • Consider wearing a knee brace for sports.

RESOURCES

American Academy of Orthopaedic Surgeons http://orthoinfo.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

Knee sprains and meniscal tears. Merck Manual for Health Care Professionals. Available at: http://www.merckmanuals.com/professional/injuries%5Fpoisoning/fractures%5Fdislocations%5Fand%5Fsprains/knee%5Fsprains%5Fand%5Fmeniscal%5Finjuries.html. Updated August 2013. Accessed February 28, 2014.

Meniscal tears. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00358. Updated February 2009. Accessed February 28, 2014.

Meniscal tears in athletes. American Orthopaedic Society for Sports Medicine. Available at: http://www.sportsmed.org/uploadedFiles/Content/Patient/Sports%5FTips/ST%20Meniscal%20Tears%2008.pdf. Published 2008. Accessed February 28, 2014.

Meniscus tears. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 13, 2014. Accessed February 28, 2014

Torn meniscus. John Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/orthopaedic%5Fdisorders/torn%5Fmeniscus%5F85,P00945/. Accessed February 28, 2014.

04/24/2014 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Snoeker BA, Bakker EW, et al. Risk factors for meniscal tears: a systematic review including meta-analysis. J Orthop Sports Phys Ther. 2013; 43(6):352-367.

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