The meniscus consists of two cartilages inside your knee between the thighbone and shinbone.
This cartilage is rubbery, which allows it to cushion the bones in the knee joint. A meniscus tear happens when the knee is twisted and the cartilage tears. The meniscus can also tear when it has become thin and worn down over the years.
Common occurrence
A torn meniscus is a common knee injury. People who participate in contact sports like football or rugby often suffer a torn meniscus. It is also a common injury in tennis where players suddenly change direction while running.
Older athletes, and people in general, are especially at risk for meniscus tears since the meniscus weakens with age, becoming thinner and more vulnerable to tearing.
Traumatic tears vs degenerative tears
Doctors distinguish between two types of meniscus tears. Traumatic tears result from a powerful twist of the knee during football, basketball, and soccer matches and practice sessions.
But anyone can tear their meniscus at any time. Just making a wrong step over a boulder while hiking can be disastrous for one’s knees.
Older people typically experience degenerative or atraumatic tears due to degeneration of the meniscal structure. Degenerative meniscus tears are a normal part of ageing and are typical for middle-aged or older people. In these incidences, the tears are often associated with knee osteoarthritis.
Degenerative tears look different from traumatic tears, and doctors treat them differently.This is not to be mixed up with lumbar or cervical disc degeneration, which is another topic by itself.
Symptoms
At the moment the tear occurs, a person may experience a popping sensation. Thereafter, it may be difficult to bend or straighten the knee, which will be painful and swollen.
If a piece of the cartilage breaks loose and gets lodged in the knee joint, it may cause the knee to lock up.
Diagnosis
A torn meniscus is diagnosed after a physical exam, during which the doctor may move the leg and knee in different positions, ask the patient to walk and turn around, and so on to evaluate movement range. The doctor may also use imaging tests and arthroscopy to gain more detailed information about the injury.
Magnetic resonance imaging (MRI)
MRIs can provide detailed images of hard and soft tissues. An MRI can highlight bones and soft tissue in the knee to give comprehensive information about the injury.
Arthroscopy
Arthroscopy is a minimally invasive procedure doctors use to diagnose and treat problems within a joint.
The orthopaedic doctor inserts the arthroscope into the joint through a small incision. This enables the doctor to see the joint’s interior on a monitor, complete with all the joint structures, including cartilage, ligaments, and tendons, facilitating accurate diagnosis.
Treatment
Nonsurgical options for meniscus tear treatment include RICE, pain relief medications, physical therapy, and injections.
RICE – Rest, Ice, Compression, and Elevation
Doctors often recommend the RICE protocol for knee injuries. After the knee injury:
Rest: Keep your weight off the injured knee and limit your walking.
Ice: Place an ice pack on your knee for about 20 minutes every day to reduce swelling and relieve pain. Do this several times throughout the day.
Compression: Wrap a bandage around your knee to compress it and reduce swelling.
Elevation: Raise your leg higher than your heart and rest like that to decrease swelling.
Medications for pain
A meniscus tear can cause painful inflammation. Doctors prescribe nonsteroidal anti-inflammatory medications such as ibuprofen and naproxen to help reduce pain and inflammation in the knee. Over-the-counter pain relievers can also help ease knee pain.
Physical Therapy
After the inflammation in the joint has subsided, you should not put all your weight on your leg if it hurts. Once you can stand and walk without significant pain, you can start with light physical therapy exercises to strengthen the muscles, ligaments, and tendons around your knee.
Your physical therapists will recommend a treatment plan to suit your situation. The regiment will include exercises to strengthen the thigh and leg muscles, which will help you regain full movement of your knee.
Low-impact exercises are the best for healing a torn meniscus. You can consider using a stationary bike to restore your knee function. This exercise should not cause any pain.
It may take a while for the torn meniscus to heal completely. Be prepared for an exercise regime of at least four to eight weeks, even longer if it is a severe tear.
Cortisone Injections
Cortisone injections are powerful medications injected directly into a joint to reduce inflammation and relieve pain. They contain corticosteroids, which are synthetic medicines that work like hormones.
Corticosteroids serve as strong anti-inflammatory treatments, reducing swelling, inflammation, and pain where injected.
Corticosteroids don’t heal a meniscus; they just treat the symptoms. However, some people do find prolonged relief from these medicines.
Doctors don’t recommend that people have regular corticosteroid injections because of the possibility that repeated cortisone treatments might damage the knee cartilage, and weaken the soft tissue in the knee.
Corticosteroids can also interfere with the body’s ability to regulate blood sugar levels, leading to a condition called steroid-induced hyperglycemia, with blood sugar levels becoming elevated. So, people with diabetes or other metabolic disorders may need to avoid this kind of treatment.
Orthobiologics
Biologic injections are part of so-called biologic therapies in which the medications are derived from living organisms or biological sources like blood or bone marrow.
Biologic injections, particularly platelet-rich plasma (PRP) or stem cell injections, have been investigated as a possible treatment for meniscal tears. This option is considered when conservative treatments don’t provide the desired results and in situations where surgery is not an option. These therapies exploit the body’s own healing mechanisms to heal the damaged area.
If you live in Singapore and you have torn your meniscus, get in touch with a meniscus tear specialist near you today.
