Meniscus tear

Especially acute injuries (typically in younger, more active patients) can lead to displaced tears which can cause mechanical symptoms such as clicking, catching, or locking during motion of the joint.

Traumatic tears are usually radial or vertical in the meniscus and more likely to produce a moveable fragment that can catch in the knee and therefore require surgical treatment.

[citation needed] The meniscus is made of cartilage, a viscoelastic material, which makes it more susceptible to rate of loading injuries.

[7] Meniscal ramp lesions (tears of the medial meniscus posterior horn at the menisco-capsular junction) occur in approximately 25% of ACL-injured knees.

[citation needed] Damage to the meniscus due to rotational forces directed to a flexed knee (as may occur with twisting sports) is the usual underlying mechanism of injury.

A valgus force applied to a flexed knee with the foot planted and the femur rotated internally can result in a medial meniscus tear.

A varus force applied to the flexed knee when the foot is planted and the femur rotated externally result in a tear of the lateral meniscus.

[10] Tears produce rough surfaces inside the knee, which cause catching, locking, buckling, pain, or a combination of these symptoms.

Abnormal loading patterns and rough surfaces inside the knee, especially when coupled with return to sports, significantly increase the risk of developing arthritis if not already present.

Contraction by the popliteus during knee flexion pulls the lateral meniscus posteriorly, avoiding entrapment within the joint space.

In light of these findings, it is essential to preserve the peripheral rim during partial meniscectomy to avoid irreversible disruption of the structure's hoop tension capability.

[11] After noting symptoms, a physician can perform clinical tests to determine if the pain is caused by compression and impingement of a torn meniscus.

[12] These include: These tears can then be further classified by their proximity to the meniscus blood supply, namely whether they are located in the “red-red,” “red-white,” or “white-white” zones.

This means that if the sport being played is association football, cleats are an important item in reducing the risk of a meniscus tear.

[18] The last major way to prevent a tear in the meniscus is learning proper technique for the movement that is taking place.

[19] For the sports involving quick powerful movements it is important to learn how to cut, turn, land from a jump, and stop correctly.

In the short term, studies have shown arthroscopic partial meniscectomy (APM) is a more effective treatment with regards to function and pain management.

[24] Initial treatment may include physical therapy, bracing, anti-inflammatory drugs, or corticosteroid injections to increase flexibility, endurance, and strength.

[20] Surgery is not appropriate for a degenerative meniscus tear, absent locking or catching of the knee, recurrent effusion or persistent pain.

[33][34][35] The BMJ Rapid Recommendation includes infographics and shared decision-making tools to facilitate a conversation between doctors and patients about the risks and benefits of arthroscopic surgery.

[40] The implant could be a good option for younger, active patients who are considered too young for knee replacement because that surgery lasts only about 10 years.

The first surgery as part of US clinical trials took place in January 2015 at Ohio State University's Wexner Medical Center.

[45] In September 2019, the manufacturer received breakthrough designation from the U.S. Food and Drug Administration, and the company expected to file for regulatory approval within the following year.

During the first 5 days following the surgery, a passive continuous motion machine is used to prevent a prolonged period of immobilization which leads to muscular atrophy and delays functional recovery.

Aquatic therapy, or swimming, can be used to rehab patients because it encompasses ROM, strength, and cardiovascular exercises while relieving stress on the body.

The goals for Phase II include being able to restore full ROM, normalized gait, and performing functional movements with control and no pain (Fowler, PJ and D. Pompan, 1993).

The proposed criteria include normal gait on all surfaces and single leg balance longer than 15 seconds (Ulrich G.S., and S Aroncyzk, 1993).

Phase III's goal and final criterion is to perform sport/work specific movements with no pain or swelling (Fowler, PJ and D. Pompan, 1993).

[citation needed] People who work in physically demanding jobs such as construction or professional sports are more at risk of a meniscal tear because of the different stresses to which their knees are subjected.

In a few studies the having a higher BMI puts more weight on the joints, which can cause the knee to be non-aligned, resulting in an easier tear.

Bucket-handle tear of the lateral meniscus (red). Medial meniscus intact (green). MRI, coronal T2 *-weighted GRE sequence.
Types of meniscus tears
Proper parallel squat form to improve knee stability
Tear of medial meniscus
Typical locations of arthroscopic surgery incisions in a knee joint following surgery for a tear in the meniscus
Day one through ten of arthroscopy surgical recovery.
Balance exercises on a foam surface in phase 2. The patient tries to maintain balance first with both legs, then with only the affected leg.
The graph shows the percentage of meniscus injuries in various age groups. A plurality of injuries came in the 45–84 age range.