One of the most common knee injuries are meniscal tears. A recent study has shown that over a half a million Americans experience a meniscus tear each year. The meniscus is a piece of rubber, C-shaped cartilage that provides cushion between the tibia (shinbone) and femur (thighbone) with two menisci in each knee joint. Tears are sometimes small enough that they can be managed with physical therapy and don’t require surgery. In other cases, surgery may be the only option to reduce pain and allow for normal functions of the knee once again.
Meniscal tears are often associated as an athletic injury. Though many athletes experience meniscal tears, you don’t have to be an athlete to get a meniscus tear. Meniscus can be torn during regular activities that put excessive pressure on or rotate the knee joint. Common activities that may require pivoting quickly or squatting such as yard work can cause a tear. Exercises that strengthen leg muscles and proper technique during strenuous activities can help prevent meniscal injury.
A meniscus can be torn during activities that require put weight on the knee while doing forced twists or rotation of the knee. Movements such as deep squatting, heavy lifting and sudden pivots or turns can lead to tears. With athletes being at high risk for meniscus tears, sports that require sudden stops or turns are at the highest risk.
Meniscus tears in children and adolescents are becoming more common due to the participation of organized sports at a younger age. Also, when focus is only on one sport, it’s more likely an injury will take place.
The meniscus weakens and becomes thinner with age. This means that it’s common for people over the age of 30 to experience meniscus tears that may not be from excessive exercise or strenuous movement but rather degeneration of the knee. The odds of a meniscus tear increase more if the adult has osteoarthritis.
A quick popping sound around the knee joint can sometimes be heard when a meniscus is torn. Common pain that may be experienced is:
It’s common to experience a sensation of slipping along with popping, which is an indication that a piece of cartilage may have become loose between the knee joint and is blocking proper movement. When these symptoms occur for more than 72 hours of rest after injury it’s recommended a doctor is called immediately before further damage can occur.
After discussing symptoms with a doctor the first it’s common for the first type of examination to be a range of motion test. The doctor will likely rotate, bend and straighten the knee listening for a slight pop which may indicate a tear of the meniscus. If this simple exam is inconclusive additional imaging tests may be conducted.
X-ray – Won’t show a meniscus tear but may uncover other injuries that are causing knee pain such as osteoarthritis.
MRI – AN MRI is capable of taking pictures of the cartilage and ligaments around the knee.
Ultrasound – This technology uses sound waves and is able to determine if there is loose cartilage caught on the knee.
Arthroscopy – This is often a last result and is also used with preforming surgery on the knee. This is a small incision near the knee that allows for a small camera and light to be inserted in the knee.
The first treatment that should be conducted after a suspected meniscus tear is a conservative treatment known as the RICE method:
R – Rest. Use crutches to minimize the amount of weight on the knee. Avoid all activates that aggravate the knee.
I – ICE. Use ice or cold compresses for 15-30 minutes every four hours.
C – Compression. Use elastic bandages or a compression sleeve to reduce inflammation.
E – Elevation. Elevate the knee to reduce swelling.
Over the counter medication such as ibuprofen, NSAIDs (Advil) or aspirin can be used to reduce pain and swelling around the knee.
If the knee is positively responding to conservative treatments surgery may be recommended. Arthroscopic surgery will more than likely be the preferred method of the surgeon.
The surgeon will make a small incision around the knee for a camera and other tools. The damages meniscus will wither be repaired or the tear will be trimmed off to prevent further tears. The entire procedure typically lasts about an hour.
Patients usually go home the same day after this procedure. Full recovery will take time. Patients other begin to participate in physical therapy exercises within days after surgery. The recovery and rehabilitation time is approximately six weeks depending on your age and other factors. It’s common to wear a knee brace or crutches during this time.
Surgery involves risks and a doctor should always be consulted to determine if surgery is the right procedure. The recovery period will include regular visits to the doctor as well as physical therapy to strengthen the muscles supporting your knee.
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