What is a torn meniscus?

What is meniscus?

A torn meniscus is the most common injury to the knee, accounting for 61 cases per 100,000 people in the US.  The menisci are wedge-shaped structures located between the condyles of the femur and the tibial plateau. The medial meniscus is “U” shaped structure at the “inside” portion of the knee, and the lateral meniscus is more “C” shaped structure on the “outside” portion of the knee. Meniscal tissue consists mainly of water and collagen circumferential fibers that help to absorb the compression energy, and radial fibers which prevent longitudinal splitting of the circumferential fibers. Blood is supplied from the periphery of the menisci, which is of great importance for the potential healing of a meniscal repair, and the structure of these meniscal fibers are important clinically when deciding which meniscal tears are stable or which are unstable and warrant resection or repair.

 

What are the different types of meniscal tears?

Vertical longitudinal tears occur between the circumferential collagen fibers. Complete vertical tears can sometime twist within the joint known as “bucket handle” tears. These are unstable tears which cause mechanical symptoms or true locking of the knee.

Vertical radial tears disrupt the circumferential collagen fibers and affect the ability of the meniscus to absorb tibiofemoral load. These tears are usually not responsive to repair.  Partial meniscectomy does not restore complete function and accelerated degenerative changes are likely to occur.

Horizontal tears split the meniscus into an upper and lower part and can exist without clinical symptoms. They are usually mechanically stable but may give rise to flap tears. Their frequency increases with age and often accompanied by meniscal cysts.

Oblique tears give rise to flaps which are mechanical unstable and associated with mechanical symptoms. This pattern of tear requires resection to prevent propagation of the tear as the flap gets caught within the joint during flexion.

Complex or degenerative tears are where two or more tear patterns exist. They are more common in the elderly and have associated osteoarthritic changes in the knee.

 

What should I do if I have a meniscus tear?

Initially a person should see their physician to have an X-ray to rule out fractures or other bone injuries as the cause of pain, and you may be prescribed medications to assist with pain and swelling.  An MRI may be help reveal the type and location of the tear but often won’t be ordered until conservative approaches have been tried first.

Physical therapy should begin immediately to assist with decreasing inflammation and preventing loss of function.

 

A referral for physical therapy is not required for you to be seen at Biokinetics Rehab; you can call us to make an appointment right now at (828) 528-1222.  

We work one-on-one with our clients instead of having 1-2 other clients overlapping your session.  Your sessions will always be for a 60-minute duration with the same physical therapist.  We will make every attempt to get you seen within 24-48 hours instead of having to wait weeks for an appointment.  We have the ability to spend the time needed to address your concerns and have the knowledge and experience to restore you to your highest level of function.