Meniscus Tear Overview
Several knee injuries can affect the meniscus and are common in sports activities. The meniscus are small “c” shaped structures in the knee between the femur and tibia that act like cartilage and “shock absorbers” for the joint. The function of the meniscus is to distribute load and protect the articular cartilage of the knee from early degeneration. Each knee has two menisci- the medial meniscus and the lateral meniscus. Both of these structures can experience a tear from repeated squatting, a sudden twist, a sports injury or a severe fall. Dr. Nikhil Verma, knee specialist serving the Chicago, Westchester, Oak Brook and Hinsdale, Illinois area, is well trained in treating a meniscus tear, including a medial meniscus tear and a lateral meniscus tear.
The medial meniscus bears up to 50% of the load applied to the inside of the knee. The lateral meniscus absorbs up to 80% of the load applied to the outside of the knee. The primary functions of these structures are to distribute forces and prevent arthritis. They also aid the ligaments of the knee in providing stability.
A meniscus tear can vary in size, location and severity. A medial meniscus tear is an injury to the meniscus located on the inside of the knee. These tears may occur in combination with other knee structure injuries such as an ACL or MCL injury. Medial meniscus tears typically occur due to excessive twisting and weight bearing pressure, commonly in sports activities. In addition, they can occur as a result of degeneration over time. A lateral meniscus tear is an injury to the meniscus located on the outside of the knee. These tears are less common than a medial meniscus tear and also occur in combination with other knee injuries. Lateral meniscus tears occur from twisting forces and weight bearing pressure, but may also occur due to overuse and degeneration of the structure.
Symptoms of a Meniscus Tear
Depending on the severity of the injury, pain will range from mild to severe. Many patients will also experience stiffness and swelling. Patients often complain that the knee feels like it is going to lock up, give away or get stuck in a certain position. Patients report pain with squatting or kneeling, or pain with rotation of the knee including rolling over in bed at night. These common symptoms are present in both a medial meniscus tear and a lateral meniscus tear.
Diagnosis of a Meniscus Tear
Dr. Verma will perform a thorough physical examination of the knee and look for any changes in appearance or any deformities. Tests include bending the patient’s knee and rotating the leg inward to assess the pain or clicking as the leg is straightened. This is referred to as the McMurray test. X-rays and an MRI will also be performed to diagnose the meniscus tear.
Have you sustained a meniscus injury?
There are two ways to initiate a consultation with Dr. Verma:
You can provide current X-rays and/or MRIs for a clinical case review with Dr. Verma ($250).
You can schedule an office consultation with Dr.
Treatment of a Meniscus Tear
The treatment for a meniscus tear, either a medial meniscus tear or a lateral meniscus tear, will depend on the size and location of the tear. The lateral (outside) portion has a rich blood supply and a tear is more likely to heal on its own. The medial (inside) portion lacks a good blood supply and cannot typically heal on its own.
For acute or chronic tears, a combination of rest, ice, anti-inflammatory medications and physical therapy may be recommended by Dr. Verma. In addition, cortisone injections are often employed to decrease swelling and inflammation and improve symptoms.
For more severe tears, arthroscopic surgery may be recommended. During arthroscopy, two tiny incisions are made and a small camera is inserted so the injured area can be examined. After reviewing, torn pieces of the meniscus are repaired and/or removed. An arthroscopic approach is less invasive and allows for a quicker recovery time with less pain in most cases.
Based on the patients age, the size of the tear, the location of the tear, and the presence of other injuries, a decision is made as to whether the meniscus can be repaired (stitched) or should be debrided (torn portion is removed). When applicable, sutures can be used to stitch the meniscus to facilitate healing and preserve meniscal function. In this situation, the knee is protected and activities are restricted while the meniscus is healing over the first 12-16 weeks. In some cases however, the meniscus tear is degenerative, complex and non-repairable. In this situation, the torn portion of the meniscus is removed to provide stability to the remaining segment. In this case, patients may weight bear immediately, return to work or school within 1-2 days, and generally return to all activities including sports by 6-8 weeks.
For more information on repair and rehabilitation of a meniscus tear in the knee, please contact the office of Dr. Nikhil Verma, orthopedic knee specialist serving the Chicago, Westchester, Oak Brook and Hinsdale, Illinois area.