Among knee injuries, one of the most common is meniscus tear. Meniscus tear symptoms include popping /snapping in the knee, swelling and pain. Meniscus tear treatment depends on the severity of an injury, symptoms and type of a tear. Below we will review in details how and why do meniscus tears occur, which symptoms manifest it, as well as what treatment options are available for this kind of trauma, including arthroscopic meniscus repair and meniscus replacement.
As it has already been mentioned above, out of all the knee injuries, meniscus tear is the one people usually get and commonly known. Most people refer to this condition as having a torn cartilage in their knee.
WHAT DOES THE MENISCUS DO?
Between your thighbone and shinbone, you also have two shock protection layers, called meniscus. Meniscus is tough and flexible so it is able to protect the joint from shock and prevent friction between the bones.
The meniscus may be damaged and torn in many different ways. Your doctor will determine if the type of tears you have is bucket handle, flap or radial. Based on how the tears look and their location, your doctor will be able to determine your condition.
Meniscus tear is a common condition that could happen to anyone at any age. However, athletes especially of contact sports have higher exposure to the risk of tearing their meniscus. When athletes tear their meniscus, they would often also have other types of knee injuries such as anterior cruciate ligament tears.
MENISCUS TEAR SYMPTOMS
- Feeling that your knee joint is popping or snapping
- Inflation around your knee
- Pain, especially when bending and moving your knee around
- Stiffness and struggles with fully straightening your knee
- Feeling your knee being locked in place and being blocked from moving your knee
MENISCUS TEAR TREATMENT
NON-SURGICAL TREATMENT OPTIONS
You may not require surgical treatment if you only have a small tear and it is located on the outer edge of your meniscus. It is also likely that you may only need non-surgical meniscus tear treatment if your knee is stable and your symptoms do not get worse.
- RICE: The RICE protocol refers to Rest, Ice, Compression, and Elevation.This protocol is useful for most sports-related injuries.
- Rest: You will need to refrain from the activity that triggers your injury. On top of that, your doctor may also suggest you to use crutches to prevent stressing your leg with extra weight.
- Ice: You will then need to use cold compression or cold packs a few times every day and for 20 minutes each time. Your skin should not have direct contact with the ice from cold packs.
- Compression: You should wear an elastic compression bandage to stop additional inflammation, swelling and loss of blood.
- Elevation: When you are resting, you should recline and elevate your leg higher than your heart to reduce further inflation of your knee.
- Non-steroidal anti-inflammatory medicines: Your doctor will suggest medications such as aspirin and ibuprofen, because these drugs can reduce your pain level and inflammation.
SURGICAL MENISCUS TEAR TREATMENT OPTIONS
The sole objective of surgery for people with meniscus tear is to retain as much healthy meniscus tissue as possible. Healthy blood supply is critical when torn meniscuses are recovering. Only the outer third portion of your meniscus has blood supply so that your meniscus can heal from the tear. Therefore, your surgery will usually be limited to only this part of your meniscus.
During your surgery, the surgeon uses several treatment options to repair your meniscus. The available surgical options of meniscus tear treatment include meniscus removal (meniscectomy), meniscus repair, or in rare occasions, meniscus replacement. With the goal of your surgery aimed at retaining as much healthy meniscus as possible, your surgeon will first try to repair your meniscus if your tear is still repairable.
- Meniscectomy: Your surgeon will remove damaged meniscus tissue from your knee. However this treatment option only delivers temporary results because it may cause arthritis to develop ten to twenty years down the road.
- Meniscus repair: This treatment option can also be quite effective. But, in comparison to meniscectomy, you will require longer time to recover after the surgery. Your surgeon can only repair your meniscus if a tear is amenable to repair.
- Arthroscopic meniscus repair:This is one of the most commonly performed surgical procedures and it lasts around an hour. A tear on the outer edges of the meniscus is usually called a peripheral meniscal-capsular tear. This type of tear can be repaired using arthroscopic procedure and the meniscus will be left to heal naturally. Also, a tear that runs vertically through the meniscus can usually be repaired in a arthroscopic surgery with the entire meniscus left intact.Generally, during a knee arthroscopy procedure, your surgeon will insert a miniature camera through a small incision into your knee to get a clear view on the inside of your knee. Then, he or she can decide if the meniscus tear is at the level of damage that is still amendable. If your meniscus is still in good condition and the tear can still be repaired, your surgeon will proceed with the repair during this arthroscopic procedure.
Your orthopedic surgeon will make several tiny incisions and use miniature surgical instruments to pass through them and repair your meniscus tear. The torn edges will be sutured back into place so that the meniscus can heal naturally.
Usually, only ten percent of menisci can still be repaired using this procedure. For the remaining cases with meniscus being irreparable, the surgeon will perform a partial meniscectomy.
- Partial Meniscectomy:During partial meniscectomy, part of the meniscus is removed and only the healthy tissue is left behind. It is a lot easier to recover from a partial meniscectomy. However, there are potential risks for your knee to develop arthritic symptoms in the future.For a different type of meniscus tear such as bucket handle tears, different approach may be required. Depending on the level of damage to your meniscus, your surgeon may need to partially remove it. Like other meniscus repairs, your surgeon will then use a combination of different sutures to treat your torn cartilage through the incisions.
- Meniscus replacement: This approach is usually available to young and active people who already have had most of their meniscus removed. The eligible patients also feel pain in the affected area without having advanced degenerative changes to the gliding surface of their cartilage.