Meniscal Tears

The knee contains two menisci, fibrocartilaginous material which functions as stabilizers of the knee and provides a measure of shock absorption. Meniscal tears are the most common of all knee injuries, but the characteristics of each tear are variable. 

Symptoms

A patient with a meniscal injury will usually report a twisting event and sometimes the sensation of a “tear” or “pop” followed by severe pain on the medial (inside) portion of the knee. The patient will sometimes report that the knee “locks up.” It may be difficult to walk up or down stairs or to squat. There may be some edema (swelling).

Diagnosis

Diagnosis is made via plain films and clinical history, and confirmation is generally made through an arthroscopy, rarely by MRI (magnetic resonance image).

Treatment

Some meniscal tears heal spontaneously after a period of rest, elevation and icing. Crutches are often used until the patient can walk without pain. Physical therapy would include a range of motion and a quadriceps strengthening program to decrease edema and regain any muscle tone that may have been lost. 

If the knee persistently “locks up” or the patient is unable to return to full activity, an MRI (magnetic resonance image) could be ordered to rule out a cyst or blockage. Arthroscopically, the meniscus can be repaired or partially removed with potentially excellent results. However, an exercise program would be the first choice in conservative management.