Injuries of the Meniscus

The menisci, shown in yellow, are horse-shoe shaped when viewed from above.

The menisci are the ‘shock absorber’ cartilages, present in both the medial and lateral compartments of the knee joint. They have a tough, rubbery texture but can become weaker and frayed as we become older.

Tears of the menisci are common and occur when the knee is in a bent position supporting the weight of the body and a sudden twist occurs. A common method of injury is in football when a player twists their knee with the foot planted on the ground. In older people, changes in the composition of the menisci render them more susceptible to injury, particularly in those with osteoarthritis affecting the knee joint. A tear in the meniscus can occur during day to day activity or following trivial trauma.

Meniscal injuries cause focal pain, along with symptoms such as a feeling of ‘something catching’, giving way or locking of the knee joint, and in some cases swelling or stiffness. The extent of a tear may vary considerably, as shown below. Small tears may only become painful 24 hours after the injury. By contrast, larger tears (for example the ‘bucket handle tear’ which occurs longitudinally around the meniscus) are immediately very painful and often restrict movement thereafter.

The meniscus can be torn in different places, some examples are shown in red in this picture.

Meniscal injuries may be suspected from how the injury occurred, your symptoms and clinical examination findings (e.g. soreness along the joint, swelling and reduced range of movement). However the diagnosis may only be confirmed by MRI scan or arthroscopy (‘key-hole’ surgery). Treatment options depend on the severity of the tear. Smaller tears may be treated without surgery through a combination of prescribed pain relief tablets and a rehabilitation programme designed by a physiotherapist. This management is often effective and sufficient.

Arthroscopy image showing meniscal tear.

If the tear is more severe or doesn’t improve after 6 weeks of pain relief and physiotherapy arthroscopic surgery may be recommended. Often these more severe tears occur as a result of a significant injury and locking of the knee is a common symptom.

Meniscal Tears

The video below shows a detailed explanation of the causes and presentation of Meniscal Tears. They show a basic outline of the procedures used by Amir Qureshi and after care required in order that you, the patient, may recover to your full fitness once again.