Tearing and Repairing your Meniscus

Written by Dr. David Cortese, MD on in Health & Wellness

Imagine you’re on the basketball court or soccer field. You’re moving the ball, hoping to score for your team. You make a tight pivot, twisting your knee and you feel a popping sensation and sudden sharp pain in your knee.

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Imagine you’re on the basketball court or soccer field. You’re moving the ball, hoping to score for your team. You make a tight pivot, twisting your knee and you feel a popping sensation and sudden sharp pain in your knee.

This scenario describes one of the most common knee injuries – the meniscus tear. Studies have shown there are more than 200,000 cases of people suffering this injury every year. Having completed a fellowship in sports medicine at the Southern California Orthopedic Institute, and in my recent experience as a military surgeon, I have treated many of these injuries with excellent results.

The meniscus is the rubbery knee cartilage cushioning the shinbone from the thighbone, kind of like a shock absorber. A meniscus tear is typically caused by a forceful twisting or rotating of the knee such as in a sports injury. The risk of tearing the meniscus also increases as you age with normal wear and tear on your knee.

In addition to the popping sensation, you may feel swelling, catching and pain when rotating your knee. You may have difficulty bending or straightening your knee fully, and it may feel as if your knee is about to “give way.”

Some meniscus tears might be small enough to be insignificant or possibly heal on their own, but many require arthroscopic surgical treatment to either repair the meniscus or trim back the torn, frayed tissue.

Because some sports-related meniscus tears are known to occur along with other knee injuries, such as ACL (Anterior Cruciate Ligament) tears, consulting an orthopedic surgeon is essential.

If you postpone seeing a physician, pieces of the meniscus may come loose and drift into your knee joint. These “loose bodies” might cause further problems if they move to a spot that would prevent motion, potentially causing locking or damaging other parts of the knee joint surfaces.

When patients come to me with these injuries, I check for tenderness along the joint line. I will also bend your knee, straighten it and rotate it slightly. If the knee has suffered a meniscus tear, this movement might result in a “clicking” sound.

Depending on many factors, I may also want you to undergo additional imaging tests, which may include x-rays or an MRI (Magnetic Resonance Imaging) scan to view the soft tissues such as the meniscus.

The treatment options for your meniscus tear will depend on the type of tear, the size, and its location. You and I will discuss those at length, taking into consideration the severity of the tear, your age, your ability to do rehabilitation exercises and more.

Sometimes, no surgery will be needed. You can follow the regimen called RICE, or Rest, Ice, Compression, Elevation. Aspirin and ibuprofen can reduce the pain and swelling.

Other tears cannot heal independently. Typically, for these types of tears, orthopedic surgeons will suggest arthroscopic surgery. This routine surgery involves inserting a small probe called a scope through a small incision on your knee, allowing me to see and evaluate the tear and make a decision on the best way to treat the tear.

Imagine you’re on the basketball court or soccer field. You’re moving the ball, hoping to score for your team. You make a fixed pivot, twisting your knee and you feel a popping sensation and sudden sharp pain in your knee.

This scenario describes one of the most common knee injuries – the meniscus tear. Studies have shown there are more than 200,000 cases of people suffering this injury every year. Having completed a fellowship in sports medicine at the Southern California Orthopedic Institute, and in my recent experience as a military surgeon, I have treated many of these injuries with excellent results.

The meniscus is the rubbery knee cartilage cushioning the shinbone from the thighbone, kind of like a shock absorber. A meniscus tear is typically caused by a forceful twisting or rotating of the knee such as in a sports injury. The risk of tearing the meniscus also increases as you age with normal wear and tear on your knee.

In addition to the popping sensation, you may feel swelling, catching and pain when rotating your knee. You may have difficulty bending or straightening your knee fully, and it may feel as if your knee is about to “give way.”

Some meniscus tears might be small enough to be insignificant or possibly heal on their own, but many require arthroscopic surgical treatment to either repair the meniscus or trim back the torn, frayed tissue.

Because some sports-related meniscus tears are known to occur along with other knee injuries, such as ACL (Anterior Cruciate Ligament) tears, consulting an orthopedic surgeon is essential.

If you postpone seeing a physician, pieces of the meniscus may come loose and drift into your knee joint. These “loose bodies” might cause further problems if they move to a spot that would prevent motion, potentially causing locking or damaging other parts of the knee joint surfaces.

When patients come to me with these injuries, I check for tenderness along the joint line. I will also bend your knee, straighten it and rotate it slightly. If the knee has suffered a meniscus tear, this movement might result in a “clicking” sound.

Depending on many factors, I may also want you to undergo additional imaging tests, which may include x-rays or an MRI (Magnetic Resonance Imaging) scan to view the soft tissues such as the meniscus.

The treatment options for your meniscus tear will depend on the type of tear, the size, and its location. You and I will discuss those at length, taking into consideration the severity of the tear, your age, your ability to do rehabilitation exercises and more.

Sometimes, no surgery will be needed. You can follow the regimen called RICE, or Rest, Ice, Compression, Elevation. Aspirin and ibuprofen can reduce the pain and swelling.

Other tears cannot heal independently. Typically, for these types of tears, orthopedic surgeons will suggest arthroscopic surgery. This routine surgery involves inserting a small probe called a scope through a small incision on your knee, allowing me to see and evaluate the tear and make a decision on the best way to treat the tear.

There are two types of procedures that can be done to the tear:

  • Partial meniscectomy: This allows the damaged meniscus tissue to be surgically trimmed.
  • Meniscus repair: This is a long process, involving the surgical repair of the tear. Recovery time will be longer and more restrictive.

The key to both of these options is post-surgical work by the patient. Rehabilitation exercises are necessary to give you more strength and increase your mobility. For the meniscectomy, I suggest about a month or two for healing and rehabilitation, while the repair rehab may take four to six months.

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Author: Dr. David Cortese, MD, Orthopedic Surgeon

Board Certified Dr. David Cortese, MD is trained in sports medicine, arthroscopy, and reconstructive surgery and specializes in treating a wide array of orthopedic conditions. A 17-year U.S. Army veteran, he has an extensive background in combat and non-combat injuries, as well as a full range of traumatic and degenerative orthopedic conditions. He uses advanced arthroscopic and minimally invasive techniques for treating shoulder, hip and knee injuries. Continue reading...

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