- 1 Introduction To Meniscus Tears
- 2 Meniscus Tear Symptoms — How Can You Tell If Your Meniscus Is Torn
- 3 General Categories Of Meniscus Tears
- 4 Non-Surgical Treatment Options for Meniscus Tear
- 5 Non-Surgical Treatment Options for Meniscus Tear
- 6 Comparative Table of Meniscus Tear Surgical Options
- 7 Why Patients Prefer Knee Arthroscopy
- 8 Next Steps
- 9 A/Professor Andrew Quoc Dutton Orthopaedic & Sports Clinic Insurance
Introduction To Meniscus Tears
Meniscal tears occur with a notable frequency in Singapore, affecting 60 to 70 individuals per 100,000 population annually, according to the AFP journal. The incidence rate can be even more pronounced in certain demographics, reaching as high as six per 1,000 individuals. Men are more likely to experience this injury —up to 4 times more than women.
The meniscus, a crescent-shaped cartilage between the shinbone and the thigh bone on both sides of the knee joint, is pivotal in maintaining joint stability, reducing friction, and balancing the weight exerted on the knee.
Meniscus tear symptoms can vary widely based on age. In younger patients, meniscal tears often occur through a twisting force applied to a flexed knee bearing weight. This type of injury typically results in what is known as a “bucket-handle” tear.
Meanwhile, in older patients, the causes of tears tend to shift towards degenerative factors associated with ageing. These tears are generally horizontal in nature and align with the wear and tear that naturally occurs over time.
Understanding these distinctions is essential for both prevention and treatment, as addressing the underlying cause can greatly influence the approach to care and rehabilitation.
Meniscus Tear Symptoms — How Can You Tell If Your Meniscus Is Torn
A meniscus tear often occurs when the knee twists suddenly in one direction while the foot remains grounded. It might manifest as a “pop” sensation, followed by acute pain.
Typical scenarios include high-contact sports like rugby, where unexpected impacts or sudden changes in direction can cause injury.
Symptoms of a torn meniscus may include:
- Pain, especially when attempting to straighten the knee
- Swelling and stiffness
- Limited range of motion, sometimes accompanied by the joint catching or locking
- Delayed symptoms, sometimes not appearing until a full day after injury
- In severe cases, the knee may become non-functional until appropriate medical intervention
Immediate care for a suspected meniscus tear should include immobilising the knee, compressing the area with a bandage, and applying ice regularly, plus elevation to reduce swelling (RICE). Following initial care, medical consultation is vital for proper diagnosis.
A healthcare provider specialising in sports medicine will conduct a physical examination and may utilise imaging studies like X-rays or MRI scans. Treatment options vary depending on the injury’s location and severity.
General Categories Of Meniscus Tears
- RADIAL TEAR: This type of tear occurs in the area of the knee that isn’t supplied with blood, so it cannot heal on its own. Surgery may be required if the tear is severe. In the case of a radial tear, the surgeon will trim away the damaged part of the meniscus.
- HORIZONTAL TEAR: A horizontal meniscus tear is one of the easiest types of tears to repair in the knee. Rather than removing the portion of the meniscus that is damaged, the surgeon will try to sew together the circumferential fibres of the meniscus back together.
- INCOMPLETE TEAR: An incomplete tear is a partial tear of the meniscus. This type of tear may not require surgery and can often be treated with rest and physical therapy.
- COMPLEX TEAR: A complex tear is a combination of different types of tears in the meniscus. This type of tear may require surgery to repair or remove the damaged portion of the meniscus.
- FLAP TEAR: A flap tear occurs when a portion of the meniscus is pushed into the joint space, causing pain and discomfort. This type of tear may require surgery to remove the damaged portion of the meniscus.
- BUCKET HANDLE TEAR: A bucket handle tear is a vertical tear in the posterior horn of the meniscus that runs toward the anterior horn, forming a loose section that remains attached anteriorly and posteriorly. This type of tear may also require surgery.
Non-Surgical Treatment Options for Meniscus Tear
- REST: Resting the knee can help relieve symptoms of meniscus tear.
- ICE: Applying ice to the affected area can help reduce swelling and pain.
- COMPRESSION: Compression bandages or sleeves can help reduce swelling and provide support to the knee.
- ELEVATION: Elevating the affected leg can help reduce swelling and improve blood flow.
- MEDICATIONS: Nonsteroidal anti-inflammatory medications such as ibuprofen and naproxen can help reduce inflammation and pain caused by a meniscus tear. Acetaminophen can also help manage pain but does not reduce inflammation.
- PHYSICAL THERAPY: Physical therapy can help improve knee function and reduce pain. Exercises may include range-of-motion exercises, strengthening exercises, and balance training.
- CORTICOSTEROID INJECTIONS: In some cases, corticosteroid injections may be recommended to reduce inflammation and pain.
Non-Surgical Treatment Options for Meniscus Tear
- ARTHROSCOPIC SURGERY: Arthroscopic surgery is a minimally invasive procedure that involves making small incisions in the knee and using a tiny camera to guide the surgeon in repairing or removing the torn meniscus.
- MENISCAL REPAIR: Meniscal repair involves suturing the torn meniscus back together. This procedure is usually recommended for younger patients with tears in the outer third of the meniscus, where there is a good blood supply.
- MENISCECTOMY: Meniscectomy involves removing the torn portion of the meniscus. This procedure is usually recommended for older patients or those with tears in the inner two-thirds of the meniscus, where there is a poor blood supply.
Comparative Table of Meniscus Tear Surgical Options
ESTIMATED RECOVERY TIME
Why Patients Prefer Knee Arthroscopy
Knee arthroscopy is often preferred over open surgery because it requires only small cuts instead of large incisions. This usually means less pain and stiffness for the patient, along with quicker recovery, so they can return to their normal activities sooner.
This technique, also known as keyhole surgery, has grown in popularity for treating certain knee problems. It allows doctors to see inside the knee joint without making a large cut, making it a minimally invasive option.
An arthroscope is a very thin and flexible scope made out of fibre optics. It has a tiny camera, a light, and very small instruments for delicate surgical procedures. Surgeons use an arthroscope for making diagnoses and repairs—it can be used for removing pieces of damaged cartilage, reconstructing ligaments, cleaning (debridement), and for removing the lining of a joint (synovectomy).
During Knee Arthroscopy, an arthroscope can be used to identify what’s causing a person’s Knee Pain as well as carry out Ligament Reconstruction and other procedures. It can also be used to treat kneecap problems and infections in the knee.
Keep in mind that the only way to determine if your knee problems warrant the medical procedures we mentioned is by consulting with a board-certified orthopaedic surgeon. The information we provide, however medically factual and vetted by a doctor, should never replace a medical consultation.
A/Professor Andrew Dutton of the Dr Andrew QuocOrthopaedic & Sports Clinic is a certified medical professional specialising in helping patients restore their knee health. With a medical practice spanning more than 25 years, A/Professor Dutton has honed his specialty in hip and knee surgery at the renowned Massachusetts General Hospital and Harvard Medical School. To book an appointment, you can reach out via phone at (+65) 6836 8000, or fill out the contact form on our website.