Torn Meniscus

Regenerative Medicine for Meniscus Tears

When the meniscus cartilage tears due to a traumatic injury or age-related wear and tear, it is referred to as a meniscus tear.  Meniscus tears are often very painful and can severely limit activity.  The knee will often not operate correctly with this type of injury as it frequently results in a mechanical interference with normal knee function.  The meniscus is a softer rubbery piece of cartilage that accident as a bodies shock absorber and also plays a role in stabilizing and lubricating the knee joint.

There are multiple varieties of meniscus tears, some being traumatic in nature and others being degenerative in nature.  Not all meniscus tears require surgical repair, and are able to be treated with rest, medications, and other nonsurgical modalities.  For the larger meniscus tears that results and mechanical issues, these typically need to be addressed with an arthroscopic surgery to remove or repair the torn meniscus and allow the knee to function normally.

Advanced Regenerative Orthopedics offers a minimally invasive alternative to major surgery or joint replacement.  Our physicians treat the underlying issues that cause the joint pain with our advanced forms of regenerative therapies.  By using this regenerative approach, your body can repair the damaged tissue and regain its function.

What is a Meniscus?

The meniscus is a wedge or C-shaped piece of cartilage that acts as a cushion between your thighbone and shinbone. Each knee joint contains two menisci.

Symptoms

One of the first things you may notice when you tear your meniscus is a “pop” sound from your knee. This is immediately followed by severe meniscus pain.
Other torn meniscus symptoms include:

  • Stiffness
  • Swelling
  • Pain when moving the knee
  • Difficulty extending the knee
  • The sensation of your knee joint locking or catching

Causes

A torn meniscus usually results from an activity that causes you to rotate your knee abruptly and forcefully. In sports, many meniscus tears happen when an athlete stops or turns suddenly or when they turn aggressively with their foot firmly in place.
A meniscus tear isn’t just an athlete’s injury; anyone can suffer one from movements such as:

  • Kneeling
  • Squatting
  • Heavy lifting

Degenerative changes in the knee due to wear and tear from aging can also contribute to a meniscus tear. Cartilage becomes prone to tears as it weakens and sometimes something as simple as getting up from a seated position or getting out of a car can cause a tear.

Risks

Certain factors may increase your risk. These include:

  • Participating in contact sports, such as football and hockey
  • Participating in activities and sports involving pivoting or “cutting”, such as basketball
  • Aging
  • Having a medical condition that affects the knee joint, such as osteoarthritis

Diagnosis

A meniscus tear is diagnosed using details of your medical history, a physical exam, and imaging tests. If you’re experiencing possible meniscus tear symptoms, your doctor will:

  • Take your medical history.
    You will be asked to describe your symptoms and how they began. Your doctor will likely want to know what activity or movement caused your symptoms. You may also be asked if you suffer from degenerative joint disease.
  • Physical exam.
    The doctor will press along the area where the meniscus is located to check for tenderness, which is a common sign of a tear. He or she will also perform what’s called the McMurray test, and bend and straighten your knee and rotate it. This will cause a clicking sound if you have a torn meniscus.
  • X-ray.
    Though cartilage cannot be seen on an X-ray, it is usually the first type of diagnostic imaging test ordered to help rule out other causes of knee pain, such as bone fractures, which can also cause similar symptoms.
  • Ultrasound.
    This creates real-time images that let your doctor visualize the inside of your knee while it’s moving in order to check for a loose piece of cartilage that may be interfering with the movement of your knee joint.
  • Magnetic resonance imaging (MRI).
    This type of scan creates cross-sectional, 3-D images that show both hard and soft tissues in great detail without the use of radiation.
  • Arthroscopy.
    This procedure can be used to diagnose a torn meniscus and other knee damage, as well as repair it. It entails inserting a thin, flexible instrument with a fiber optic camera on the end (arthroscope) through a tiny incision and viewing the inside of the knee on a monitor.

Options

You have a few options for treating your meniscus tear symptoms. Conservative treatment is almost always recommended first and is successful for most people. How your torn meniscus is treated will also depend on the extent of the damage, the size of the tear, and the location, as one type of tear is unable to heal without surgical intervention.

One-third of the outside of the meniscus has a rich supply of blood that makes it more likely to heal on its own. The two-thirds of the inner portion of the meniscus, on the other hand, lack the blood supply needed to enable the tear to heal and grow back together. Surgery is required to treat this type of tear.

Other factors that will be taken into consideration when it comes to treating a torn meniscus are your age, overall health and your activity level.

As long as your knee is stable, you may be able to treat your symptom with nonsurgical treatments. This can include a combination of the following:

  • Rest.
    Resting your leg and taking some time off of the activity that caused the tear can help you heal and improve your meniscus tear symptoms. Keeping weight off of the knee by using crutches may also be recommended. Elevating your leg when resting can also reduce swelling.
  • Ice packs.
    Apply ice packs to the area for periods of 20 minutes, several times each day to relieve swelling.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs).
    Ibuprofen and Naprosyn relieve pain and swelling. Prescription anti-inflammatory medications may also be given.

Surgery may be recommended if conservative treatments fail to provide relief of your meniscus tear symptoms. The most commonly used surgical procedure for a torn meniscus is knee arthroscopy. This minimally-invasive surgery is performed through very small incisions using a thin, flexible camera (arthroscope) inserted into one incision and tiny surgical instruments in another. The surgeon is able to view the inside of the knee on a monitor as he or she trims (partial meniscectomy) or repairs the tear (meniscus repair). We combine this procedure with regenerative medicine and denervation to help our patients get back to their active lives as quickly as possible.

After surgery for your torn meniscus, you may be required to wear a knee cast or brace as part of your recovery. Crutches may also be required for approximately four weeks following surgery if you have a meniscus repair surgery. Once you’ve healed, you will begin special exercises to restore your knee’s strength and mobility, as well as improve flexibility and range of motion.