A torn meniscus is a tear to the semi circular cartilage in the knee joint causing pain on the inside of the knee. It is commonly injured through direct impact in contact sports or twisting but can also occur in older athletes through gradual degeneration. Treatment depends on how bad the injury is and may require surgery.
Signs and symptoms
Symptoms include pain on the inside of the knee which may be of sudden onset but can also occur gradually. The patient will usually experience pain when fully bending the knee or squatting down. There may be swelling present but not always and the patient may also complain of the knee locking or giving way.
There will be tenderness along the joint line on the inside of the knee and range of motion is likely to be restricted. A doctor or sports injury professional can confirm the diagnosis with the aid of specific assessment tests including McMurrays test and Apley's test and may refer for an MRI scan.
Read more on assessment and diagnosis.
The most common cause of cartilage meniscus injury is twisting the knee with the foot planted to the ground either with or without contact from another player. A cartilage injury often occurs in conjunction with injury to other structures in the knee such as an anterior cruciate ligament injury or a medial collateral ligament sprain. They can also come on gradually over time through degeneration, especially in the older patient.
Each knee joint has two crescent-shaped cartilage menisci. These lie on the inside and outside of the upper surface of the tibia or shin bone and act as shock absorbers for the knee. Twisting and compression of the cartilage can cause it to tear. There are different ways in which the cartilage can tear including longitudinal, bucket handle tears, radial tear and degenerative.
Read more on causes and types of cartilage meniscus tear.
Immediate first aid is to apply the PRICE principles of protection, rest, ice, compression and elevation. Apply ice or cold therapy and compression to reduce pain, swelling and inflammation. Apply ice wrapped in a wet tea towel to avoid ice burns on the skin or better still a specialist cold compression wrap will apply both cold and compression to the knee joint.
Rest to allow the injured tissues to heal. This is often overlooked but is essential for the injury to heal.
Protect the joint from further injury by wearing a stabilized knee support which has flexible springs in the sides for additional support or for more severe injuries a hinged knee brace with solid metal supports linked by a hinge will help protect the joint from sideways or lateral movement. Compression will also help reduce swelling.
Once a cartilage meniscus injury has been diagnosed then the decision to treat it conservatively, meaning without surgery or whether to operate is made. The decision of whether to operate will depend on a number of factors. A minor tear or small degenerative condition with no restriction of motion or locking will be treated conservatively or without surgery. More severe injuries may require surgical treatment.
Do I need surgery? Read more on treatment and rehabilitation.
Conservative treatment involves continuing to applying the PRICE principles to reduce pain and swelling and wear a knee support to protect the knee. A Doctor may prescribe NSAID's or anti inflammatory drugs such as Ibuprofen in the early stages to help with pain and swelling. Electrotherapy including ultrasound, laser therapy and TENS may also be beneficial in reducing swelling. A glucosamine or joint healing type supplement may be of benefit in the healing of cartilage injuries