Meniscus Tear

Torn meniscus is one of the commonest knee injury. It is caused by twisting injury of knee. It presents with pain in knee, swelling, stiffness and some time with locking. Pain is usually localized around the knee joint. Patients feel pain while straightening of bent knee, while getting up or using stairs. Usually MRI is required to diagnose it. Conservative treatment with medicines, ice pack application and rest helps in reducing pain. Peripheral tears can heal but complex tears require meniscectomy. It is a keyhole surgery where torn portion of meniscus is removed with instruments through small hole.

Causes

A meniscus tear can result from any activity that causes you to forcefully twist or rotate your knee, such as sudden stops and turns while playing. Even kneeling, deep squatting or lifting something heavy can sometimes lead to a torn meniscus.

In older adults, degenerative meniscal tear can develop with little or no trauma.

Symptoms

Pain – pain in knee joint
Difficulty in straightening of knee
Difficulty in getting up
Swelling
Popping sensation
Feeling of instability i.e. knee giving way

Diagnosis

Meniscal tear can be suspected by clinical examination by various examination tests and manoeuvre. Diagnosis can be confirmed by evaluation

MRI – it is helpful in diagnosing meniscal tear also in planning further treatment
X ray – It’s a basic investigation. Meniscus is not seen in x ray but other bony injury can be seen.
Diagnostic arthroscopy – after the easy availability of MRI, role of diagnostic arthroscopy has decreased over years.

Treatment

Rest – avoid activities that aggravate pain
Ice – reduces swelling and pain
Medication – Takes care of pain
Physical therapy – strengthening of muscles help in reducing symptoms
Arthroscopy – helps in treating meniscal tear. Whether meniscectomy (removal of torn piece) or repair depends on type of tear, age.