The meniscus lies between the shinbone and the thigh bone, on either side of the knee joint. Its purpose is to protect the joint from friction during movements, and balance the weight that comes down on the knee.
The menisci are also one of the more at risk parts of the knee, along with the anterior cruciate ligament (ACL) and medial collateral ligament (MCL). Over 500,000 meniscus tears are reported every year, according to the Boston Children’s Hospital. A torn meniscus is a common sports injury, especially in contact sports like football and hockey.
Is My Meniscus Torn?
A meniscus tear occurs when the knee twists suddenly in another direction while your feet is planted on the ground. You might feel a “pop” followed by sharp pain. It can happen in high-contact sports like football when another player runs into you while you’re pivoting, or when an athlete suddenly changes direction while running.
A torn meniscus will feel painful, especially when you try to extend it. A piece of torn meniscus can also become lodged in the spaces between the joint, and prevent full extension. You may feel some relief from keeping it bent. The joint will usually swell, and the knee will feel stiff. The joint can also lock and catch, and may be unable to support you. The symptoms can a whole day after sustaining injury. In severe cases, the knee may be unable to function until reparative surgery is performed.
Okay, So Now What?
For immediate care, you need to immobilize your knee. Place a bandage around the area to apply compression and elevate to reduce swelling. Apply ice for 30 minutes for the next 3 to 4 hours.
After you stabilize your knee, you’ll need to go to your doctor for tests and to confirm that you injured your meniscus, as a torn meniscus shares similar symptoms with ACL and MCL tears. Your doctor will perform simple tests like the McMurray test to check for tears. Your doctor will maneuver your knee, listening for the telltale “click” of a meniscus tear. The doctor may order an x-ray or an MRI scan of your knee. If your injury is indeed a meniscus tear, then you may or may not need surgery, depending on the severity of your injury.
What Happens If I Don’t Get Surgery?
A meniscus tear is one of the few knee injuries that may not require surgery. If the tear falls within the “red zone”, or the outer area of the menisci that gets supplied with nutrient rich blood, it can heal on its own with enough rest.
However, if the tear falls within the “white zone” or the inner part of the menisci, blood cannot reach it, therefore cannot facilitate healing. Tears in this region need to be surgically snipped off in a procedure called a meniscectomy. It’s important to consult with your doctor to get the proper course of treatment for your case.
What Happens During Meniscus Tear Surgery?
Knee arthroscopy is one of the most common orthopedic procedures. Thousands of people undergo the surgery every year, and nearly 100 percent can walk without crutches after the recovery period.
Arthroscopic surgery is carried out with the help of a tiny camera. The camera is inserted through a small cut, and helps the surgeon maneuver instruments to repair the meniscus. The surgeon can either perform a meniscectomy, where they cut off strips of unsalvageable meniscus, or a meniscus repair, where the surgeon stitches together the torn parts of the meniscus in hopes of facilitating healing.
Some severe tears may require open knee surgery for better recovery and repair.
How Soon Can I Go Back To Sports After Surgery?
Recovery time depends on the procedure you’ve had done on your knee. For non-surgical treatment, recovery time takes anywhere from 6 to 8 weeks. The healing process is aided by taking anti-inflammatory drugs. During this time, patients are advised to refrain from strenuous activities, but also to stretch and do strengthening exercises to reduce stress on the knee, and strengthen support structures around the joint. Using a knee brace to support the knee while moving around is recommended.
A meniscus repair takes a longer healing period versus a meniscectomy, because you’ll need to wait for the meniscus to put itself back together. This process takes around 3 months. A meniscectomy heals after 3 to 4 weeks, but it also puts patients at a higher risk of developing osteoarthritis. Fewer athletes also return to their previous level of activity after undergoing a meniscectomy, which is why surgeons try to remove as little of the meniscus as possible. Patients who have to undergo total meniscectomy have to prepare and manage expectations about going back to sports.
Patients are expected to undergo rehabilitation therapy after surgery, and before going into sports to avoid risk of further, graver injuries, or retearing the menisci. Treatment plans differ for each person depending on the type of tear they’ve sustained and the type of surgical procedure they’ve undergone.
How Do I Keep My Knee Healthy After Surgery?
To avoid infection, it is recommended to keep the area dry up until 3 days after surgery. Bathing is permitted, although patients should protect the knee from getting wet. Icing is still important to control swelling, but take care not to burn the skin.
You should avoid putting weight on the affected knee. It is recommended to use crutches for the next 2 weeks following surgery. When lying down, avoid placing a pillow directly under the knee that may cause it to bend. Place the pillows instead beneath the ankle or foot to elevate.
Some numbness and pain after the surgery is normal. However, if the pain becomes intolerable, or is accompanied by a fever, redness around the surgical site, and an excessive fluid discharge, then you should call your doctor as soon as possible.
Consult with your surgeon for the appropriate regimen for you, and your lifestyle. Dr. Dutton of the Dr. Andrew Quoc Dutton Orthopaedic and Sports Clinic will be glad to answer any questions related to treatment options for meniscus tears.