Meniscus Tear
Diagnosis & Treatment
Dr. Pamela Mehta, MD
Orthopedic Surgeon, San Jose
Table of Contents
What is a Meniscus Tear?
You may have a meniscus injury if you’ve experienced sudden knee pain, a popping sensation, or discomfort in your knee when placing weight on that leg.
The meniscus works as a shock absorber to protect your knee joint. The joint comprises bones, ligaments, tendons, and cartilage. It must support your entire body weight. Your knee is always working to ensure your legs are stable while you bend, twist, and turn.
Your knee joint has two menisci which keep the knee joint stable, called the medial and lateral meniscus.
The menisci are made of rubbery cartilage. They sit between the knee joint to spread your weight across the knee. This helps to protect the cartilage that lines the bones, and the ligaments and tendons of the knee.
When you bend your knee or turn your leg, the menisci create a cushion so that your joint can move easier. There is less friction in the joint, so there is less wear and tear.
Common causes of damage to your meniscus include:
- Sudden twisting motions during sports and exercise
- Putting excessive strain on your knees while you bend, such as when squatting
- Wear and tear injuries as we age
Meniscus injuries can occur suddenly and often happen at the same time as other injuries such as damage in the ACL or other knee ligaments. It can also mimic other knee injuries and requires an expert in sports medicine or orthopedics to diagnose.
If you think you might have a meniscus injury, seek advice from an orthopedic doctor as soon as possible. If you leave it too late it might cause lasting damage.
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Symptoms of a Meniscus Tear
Some symptoms like a clicking sound and knee pain are classically associated with a meniscus tear. However, a diagnosis might need careful examination by an orthopedic surgeon. They can order an x-ray and/or MRI to determine the cause and extent of the injury.
Knee pain can be caused by several other knee conditions, so it’s important that you get the right diagnosis. A bucket handle meniscus tear can lead to a locked knee, which needs immediate attention.
You may have a meniscus tear if you are experiencing any of the following symptoms:
- A clicking or popping sound associated with sudden pain in your knee
- Pain when you move or touch your knee joint
- Swelling or bruising around your knee
- Knee discomfort when your leg is weight bearing
- Your knee joint locking up or giving way
- Difficulty bending your leg
Can a Torn Meniscus Cause Hip Pain?
While a torn meniscus usually affects the knee joint, it can also cause referred pain in the hip area.
In some cases, a torn meniscus can also cause pain in the hip. This is because the hip and knee are connected by a network of muscles and ligaments. When your tear your meniscus, it can put stress on these muscles and ligaments, which can lead to pain in the hip.
Sometimes it’s tricky to work out whether the pain you feel is coming from the place you feel it.
The pain from a torn meniscus is usually felt in the front of the hip. It can be worse when walking, running, or climbing stairs. The pain may also be accompanied by other symptoms, such as numbness, tingling, or weakness in the hip.
If you are experiencing hip pain, you should see an orthopedic doctor to find the exact cause.
Types of Meniscus Tear
Meniscus tears can present in various ways, each with unique characteristics and implications. Diagnosing which type of tear is present helps us with diagnosis. The type will tell us the extent of the injury and guide appropriate treatment options.
Prompt diagnosis and treatment can help reduce pain, improve movement, and shorten recovery.
Here are the types of meniscus tears commonly encountered:
Radial Meniscus Tear
A radial meniscus tear is a tear that runs from the inner edge to the outer edge of the meniscus in a straight(ish) line. This type of tear can occur due to traumatic injuries or wear and tear, and its severity can vary. The location and size of the tear affect the treatment options and prognosis.
Horizontal Tear
A horizontal meniscus tear runs parallel to the surface of the meniscus, dividing it into two layers. This type of tear occurs in both traumatic and degenerative cases. Horizontal tears can affect the stability and function of the meniscus. This type of tear sometimes needs surgical intervention for better healing.
Incomplete Tear
An incomplete meniscus tear is when the meniscus does not completely separate into two pieces. This is also known as a partial meniscus tear. This type of tear can range in severity from minor fraying to a significant tear which goes right through the meniscus. The extent and location of the tear determine the appropriate treatment approach.
Complex Tear
A complex meniscus tear involves a combination of different tear patterns within the meniscus. For example, it may include features of both radial and horizontal tears. Complex tears can be challenging to manage and often need surgical repair to restore stability and function.
Flap Tear
A flap meniscus tear occurs when a piece of the meniscus folds over itself, creating a flap-like structure. This type of tear can result in mechanical symptoms, such as catching or locking of the knee joint.
Flap tears often need surgical treatment to remove or repair the folded part to reduce symptoms and restore normal knee function.
Bucket Handle Tear
In a bucket handle tear, a long vertical strip of the meniscus gets displaced. This resembles a bucket handle, hence the name. This type of tear can significantly affect the stability and mobility of the knee joint.
Prompt medical attention and appropriate surgical intervention are crucial in bucket-handle meniscus tears. Surgery helps to reposition and repair the displaced meniscus to avoid further complications.
Parrot Beak Tear of the Meniscus
A parrot beak tear of the meniscus resembles the beak of a parrot and usually occurs at the junction of the meniscus. This tear can vary in size and shape and may cause symptoms such as pain, swelling, and limited knee mobility.
Treatment options depend on the severity and location of the tear. These range from conservative management to surgical intervention.
How is a Meniscus Tear Treated?
If you suspect that you might have a meniscus tear, you should avoid putting strain on your knee. By resting, elevating the knee, and using a crutch, you can avoid worsening damage to the joint. Pain and swelling is eased using an ice pack and by wearing a compression bandage over the affected knee.
After diagnosis by an orthopedic surgeon, they may recommend the following treatments:
- Resting, ice packs, and compression bandages
- Anti-inflammatory medication
- Physical therapy
- Meniscus surgery – meniscal repair or partial meniscectomy
Dr. Pamela Mehta, orthopedic surgeon based in San Jose, CA, can help you find the best treatment for your knee. Meniscus surgery might be appropriate for large tears. It can also help for those who have tried physical therapy without any improvement. Minimally-invasive techniques are used to help healing time and leave a smaller scar.
The right treatment approach depends on age, severity, and your treatment goals. That is why it is vital to find an orthopedic surgeon who listens to you. Together with Dr. Mehta, you can create a holistic treatment plan to suit your priorities.
Can I Run With a Torn Meniscus?
Running with a torn meniscus is usually not advisable. This is because you may worsen your injury and prolong the recovery process. Taking part in high-impact activities like running can place a lot of strain on the knee joint. This aggravates the torn meniscus and causes increased pain and discomfort.
When you have a torn meniscus, the protective cushioning between the bones in your knee gets compromised. Running can worsen the tear, leading to more damage to the meniscus and knee joint. This can result in worsening symptoms including:
- Increased pain
- Knee swelling
- Knee instability
- Reduced range of motion in the knee
- Worsening mobility
To determine the best, you should see an orthopedic or sports medicine doctor. They can diagnose the severity of your injury and provide a care plan personal to you.
Can a Torn Meniscus Heal on its Own?
Meniscus tears, unfortunately, have a limited ability to heal on their own. This is because there is a restricted blood supply to the area.
The meniscus acts as a shock absorber in the knee joint. The blood supply is even more limited in the inner two-thirds of the meniscus, where tears often occur. The lack of blood flow prevents the natural healing process. This makes it difficult for the torn meniscus to heal by itself, so treatment is necessary.
For smaller or less severe tears, conservative treatment options can be safely recommended. These can include:
- Rest
- Ice
- Compression
- Elevation
- Pain medication
You may also need physical therapy to improve knee strength, stability, and range of motion.
Surgery is recommended if simple measures do not improve symptoms or if the tear is more complex. Arthroscopic surgery is a commonly performed surgery where the meniscus gets repaired or removed. In this procedure, the surgeon makes small cuts and either repair the torn meniscus or removes the damaged part.
Following surgery, you will need knee rehabilitation to restore knee function and mobility. This involves exercises, physical therapy, and a gradual return to activities. This is usually under the guidance of an orthopedic doctor or physical therapist.
The decision to pursue surgery or conservative treatment depends on various factors. You should discuss this with your orthopedic surgeon. They can give you advice based on your specific circumstance and injury.
In summary, due to the limited blood supply to the meniscus, torn meniscus injuries often do not heal on their own. Interventions such as surgical or non-surgical treatments, is necessary to heal the knee.
Meniscus Tear Surgery
If your meniscus tear is severe or conservative treatments fail to improve symptoms, surgery may be the best option. The choice of surgical procedure depends on several factors, including:
- Type of tear
- Location of tear
- Injury severity
- Your age
- Your activity level
- Other medical conditions
Meniscectomy and Meniscus Debridement
Meniscectomy involves the removal of the damaged part of the meniscus. During this procedure, the surgeon trims or shaves off the torn or frayed edges of the meniscus. They will try to preserve as much healthy tissue as possible.
In cases where the tear is extensive and irreparable, a partial meniscectomy may be performed. A partial meniscectomy is where only part of the meniscus gets removed. While this procedure provides symptom relief, it may also increase the risk of wear and tear in the future.
Arthroscopic Meniscus Repair
Arthroscopic meniscus repair is a minimally invasive procedure which uses an arthroscope. An arthroscope is a thin, flexible camera which can help your surgeon see inside your joint. The arthroscope gets inserted into the joint through small cuts. Your surgeon can then use specialized instruments to repair the meniscus.
This procedure is suitable for specific types of tears, such as vertical or longitudinal tears. The aim here is to preserve the meniscus rather than remove it. Sutures or anchors stitch the torn edges together, promoting healing and restoring stability.
Meniscal Reconstruction
In meniscal reconstruction, your surgeon creates a new meniscus using a graft. This is sometimes required when a significant part of the meniscus gets injured or is removed during surgery.
The graft can come from various locations, such as your own tissue (autograft) or a donor (allograft). The graft gets implanted in place of the damaged meniscus, providing support, cushioning, and stability.
Meniscal Scaffolds
Meniscal scaffolds are synthetic materials designed to mimic the meniscus. These materials try to recreate the structure and function of your meniscus.
During surgery, your surgeon implants scaffolds to provide support and promote the growth of new tissue. Meniscal scaffolds are appropriate where there isn’t enough meniscus tissue left to repair.
This method can also be a supplement to meniscus repair or reconstruction procedures.
Inside Out Meniscus Repair
In some complex cases, an inside-out meniscus repair technique is used. This procedure involves making larger incisions to gain access to the torn meniscus.
Your surgeon then uses sutures or other fixation devices to repair the tear. While this requires bigger incisions, inside-out repair allows better access to your joint for a more robust repair.
Meniscus Root Repair
The meniscus root is the attachment point of the meniscus to the tibia bone. When the root tears, it can lead to instability and compromised function of the meniscus.
Meniscus root repair reattaches the torn meniscus to its normal position. It is usually fixed to the tibial attachment using sutures or other fixation devices.
This procedure helps restore the integrity and function of the meniscus.
How Painful is a Meniscus Root Repair?
- Your pain tolerance
- Your reaction to pain medication
- The extent of the tear
- The success of the surgical repair
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What Knee Services Do We Offer?
Knee Pain Assessment
Knee pain can make moving around incredibly frustrating, interrupting your daily activities and making your life difficult. Dr. Mehta is a knee doctor and can offer various knee pain treatments.
Knee Surgery
If your knee condition is severe, or nothing you have tried has helped, Dr. Mehta can advise you on the options for surgery. She is a knee specialist and can offer expert opinion and care.
Treatment of Knee Conditions
ACL Tear
ACL tears are usually the result of sports injuries and may require surgery.
Patellar Tendon Tear
The patellar tendon connects your patella to your shinbone, and tears of this make movement difficult.
Meniscus Tear
A meniscus tear is a rupture of the cartilage in your knee joint causes difficulty moving.
Knee Arthritis
Knee arthritis is a common and painful condition that often requires a knee replacement.
And Many More!
Dr. Mehta offers diagnosis and treatment of all knee conditions and can offer her specialist opinion as an expert knee doctor.
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