In the middle of the knee joint lies the meniscus. There are actually two of them in both knees, the medial and lateral meniscus. The medial meniscus is located on the inside of your knee joint and the lateral meniscus is on the outside. They are made of a soft, fibrocartilaginous tissue that acts as a shock absorber. Think of the menisci as a sponge between the thigh bone (femur) and shin bone (tibia) in between where these bones meet at the knee. They are crescent-shaped and much thicker around their edges on the periphery of the knee than towards the middle. The thickness decreases towards the middle of the knee, ending in a thin, flat piece of cartilage in the very middle of the knee. They sit on and attach to the top of the tibia. The menisci are concave on top and flat on the bottom part where they attach to the shin bone. The outside edges are much more vascularized than the inner portion, meaning that there is more blood flow to the periphery of each meniscus. For this reason, a tear to the inner edge of a meniscus has a less positive prognosis in terms of recovery than the outer edges because there is less blood flow.

As said above, the menisci are a shock absorber for the knee and help to maintain an even spread of force throughout the knee joint. The outer edges of menisci have greater innervation as well, meaning the periphery of menisci have more nerve endings and can cause more pain if damaged. When the knee is put in an awkward position by rotating or too much force is applied to the knee while twisting, the meniscus may tear. There are different kinds of tears depending on the severity and location. It is common for a meniscus tear to occur simultaneously as a ligament tear in the knee, particularly the anterior cruciate ligament (ACL).

A meniscal tear most commonly occurs because of a twisting motion causing a shearing force on the knee. Sudden stops and turns, forceful rotation or pivoting of the body may cause a tear to a meniscus. Meniscal tears are attributed to both contact and noncontact sports. A direct blow to the knee is not a requirement to tear a meniscus, they can happen as a result of forceful and excessive twisting.

As you age, the menisci lose some integrity and become weaker, making them more vulnerable and susceptible to injury. Degenerative meniscus tears in older individuals above the age of 40 make up 30% of these injuries. More commonly however they occur in younger, more active individuals.

The symptoms that you may experience with this injury may be very similar to another injury of the knee so a prompt, accurate diagnosis is of prime importance when determining the best treatment strategy. With an injury of this kind, you may experience some or all of the following:

● Immediate pain in the knee
● A ‘catching’ or ‘locking’ sensation in the knee when walking
● You may have heard a ‘popping’ sound at the time of injury
● Significant loss of range of motion of the knee, with an inability to completely straighten and /or bend the leg
● Swelling and erythema (reddening of the skin)

If You Are Experiencing Symptoms, Schedule an Appointment Dr. Burke Orthopedics Immediately.

Immediate interventions for a meniscus tear that you should do right away are the same as for most acute orthopedic injuries. This is the RICE protocol. RICE is an acronym for:

● Rest
● Ice
● Compression
● Elevation

Some tears to a meniscus will require surgical intervention, but not all. Being that the outer edges have a much better blood supply than the inner edges of a meniscus, if a tear is small enough, it may heal on its own with proper rest and conservative treatment. This is not always the case however and some meniscus tears will require surgery to fix the injury. Surgery for a meniscus tear is quite simple, and recovery is not hard. It will require rest, and a course of physical therapy to stretch and strengthen the surrounding musculature in order to speedily return you to maximum function.