Meniscus Tear
What is the meniscus?
- The menisci of the knee joint are two crescent-shaped pads of cartilaginous tissue which serve to disperse friction in the knee joint between the lower leg (tibia) and the thigh (femur).
- The medial meniscus is more likely to be injured
Different types of tears:
- Radial tears
- Bucket-handle tears
- Flap or parrot-beak tears
- Horizontal cleavage tears
- Complex, degenerative tears
Special Tests
—McMurray test-simply bending your knee, then straightening it and rotating it.
◦http://www.youtube.com/watch?v=pQ5EmGTIZwc
◦http://www.youtube.com/watch?v=pQ5EmGTIZwc
—Apley Compression Test-hard pressure applied to the leg and rotating the leg back and forth
◦http://www.youtube.com/watch?v=5u6Y_v9WUe8
◦http://www.youtube.com/watch?v=5u6Y_v9WUe8
MOI
- The most common mechanism of injury for a meniscal tear is weight bearing combined with a rotary force while knee is extended or flexed. (twist of the leg when leg is bent)
- Another common MOI would results from a person having cutting motion while running.
Signs & Symptoms
- Symptoms of a meniscus tear depend on the size and location of the tear and whether other knee injuries occurred along with it.
- Since there are no nerve endings to the meniscus, pain is due to swelling and injury to surrounding tissues.
- With large tears pieces of the menisci can lodge into the knee joint and cause “popping” or “locking” of the knee.
Common complaints:
- Knee pain
- Swelling of the knee
- Tenderness when pressing on the meniscus
- Popping or clicking within the knee while bending and extending
- Limited motion of the knee joint
Structures Involved
- Usually with a meniscus tear, the knee has suffered another injury
- Injuries to the Menisci often occur in the following triad known as the “unhappy triad”:
- Meniscal injury
- ACL (anterior cruciate ligament) tear
- MCL (medial collateral ligament) tear
Treatment
- Nonsurgical treatment with rest, ice, compression, elevation, and physical therapy. This may include wearing a temporary knee brace.
- Surgical repair to sew the tear together.
- Partial meniscectomy, which is surgery to remove the torn section.
- Not all tears are repairable, so doctors may preform a total meniscectomy which is the removal of the entire meniscus.
Special Case
—Depending on the severity, the Menisci are able to repair themselves because of the blood flow to them.
—The tears in the red and the red-white zone are more likely to heal themselves if patient immobilizes the leg as much as possible
—The tears in the red and the red-white zone are more likely to heal themselves if patient immobilizes the leg as much as possible
Rehab
—>Rest, ice, compression, elevation
—>Physical therapy
—>Wearing a temporary knee brace
—>Physical therapy
—>Wearing a temporary knee brace
What can happen if injury isn't treated...
Tears can lead to serious articular degeneration with major impairment and disability.