Your knee is formed by the junction of three bones: the thighbone (femur), the shinbone (tibia), and the kneecap (patella), as well as the soft tissue that connects them. Between your femur and your tibia are two C-shaped discs of cartilage that act as shock absorbers for the bones and help keep your knee stable. These are your menisci (plural of meniscus), and they can be torn, particularly if the knee twists suddenly while it is bent.
Viewed from the front or back, the meniscus is wedge shaped. This shape helps keep the rounded surface of your femur from sliding off the flat top of your tibia. The outer edges of this wedge receive a good supply of blood, and tears in this part of the meniscus heal well on their own. The inner part of the meniscus, however, has no direct blood supply. Tears in this area can require surgery to correct. Cause — Sudden meniscal tears often happen during sports. Players may squat and twist the knee, causing a tear. Direct contact, like a tackle, is sometimes involved.
Older people are more likely to have degenerative meniscal tears. Cartilage weakens and wears thin over time. Aged, worn tissue is more prone to tears. Just an awkward twist when getting up from a chair may be enough to cause a tear, if the menisci have weakened with age.
The Symptoms of a torn meniscus will vary depending on the severity of the tear. Someone who gets a minor tear may only have slight pain and swelling that goes away after 2 or 3 weeks. Moderate to severe tears also might cause these symptoms:
Physical Examination and Patient History : After discussing your symptoms and medical history, your doctor will examine your knee. He or she will check for tenderness along the joint line where the meniscus sits. This often signals a tear.
One of the main tests for meniscal tears is the McMurray test. Your doctor will bend your knee, then rotate and straighten. This puts tension on a torn meniscus. If you have a meniscal tear, this movement will cause a clicking sound. Your knee will click each time your doctor does the test.
Imaging Tests : Because other knee problems cause similar symptoms, your doctor may order imaging tests to help confirm the diagnosis.
How your orthopaedic surgeon treats your tear will depend on the type of tear you have, its size, and location.The outside one-third of the meniscus has a rich blood supply. A tear in this “red” zone may heal on its own, or can often be repaired with surgery.
A longitudinal tear is an example of this kind of tear. Along with the type of tear you have, your age, activity level, and any related injuries will factor into your treatment plan.
If your tear is small and on the outer edge of the meniscus, it may not require surgical repair. As long as your symptoms do not persist and your knee is stable, nonsurgical treatment may be all you need.
RICE : The RICE protocol is effective for most sports-related injuries. RICE stands for Rest, Ice, Compression, and Elevation.
If your symptoms persist with nonsurgical treatment, your doctor may suggest arthroscopic surgery.
Procedure : Knee arthroscopy is one of the most commonlyperformed surgical procedures. In this, a miniature camera is inserted through a small incision. This provides a clear view of the inside of the knee. Your orthopedic surgeon inserts miniature surgical instruments through other small incisions to trim or repair the tear.
Rehabilitation : After surgery, your doctor may put your knee in a cast or brace to keep it from moving.Once the initial healing is complete, your doctor will prescribe rehabilitation exercises. Regular exercise to restore your knee mobility and strength is necessary. You will start with exercises to improve your range of motion. Strengthening exercises will gradually be added to your rehabilitation plan. For the most part, rehabilitation can be carried out at home, although your doctor mayrecommend physical therapy.
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