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Torn Meniscus

Definition :
The knee is a complicated joint consisting of various structures, including bones, tendons and ligaments. Two C-shaped pieces of cartilage known as the menisci (plural of meniscus) curve around the inside and outside of the knee to stabilize and cushion the joint.

Any activity that causes you to forcefully twist or rotate your knee can lead to a torn meniscus. In older adults, degenerative changes of the knee may contribute to a torn meniscus.

Conservative treatment — such as rest, ice and medication — is sometimes enough to relieve the pain of a torn meniscus. In other cases, however, a torn meniscus requires surgical repair.

Causes :
A torn meniscus can result from any activity that causes you to forcefully twist or rotate your knee, such as aggressive pivoting or sudden stops and turns. Occasionally, kneeling, squatting or lifting something heavy leads to a torn meniscus. In older adults, degenerative changes of the knee may contribute to a torn meniscus.

In athletes, a torn meniscus may accompany other injuries, such as a torn anterior cruciate ligament — one of two ligaments that cross in the middle of the knee.

Risk Factor :
Anyone at risk of twisting the knee is at risk of a torn meniscus. The risk is particularly high for athletes — especially those who participate in contact sports, such as football, or activities that involve pivoting, such as tennis. The risk of a torn meniscus also increases as you get older, due to years of wear and tear on the knee.

When to seek medical advice :
Contact your doctor if you suspect a torn meniscus — you feel a popping sensation in your knee, your knee is painful or swollen, or you can't move your knee like usual. In the meantime, apply ice to the affected knee. If you're in pain, take an over-the-counter pain reliever.

Symptoms :
The meniscus may tear in various directions. Occasionally, a lengthwise tear flips into the knee joint instead of staying around the joint's edge — an injury called a bucket-handle tear. Less often, the meniscus may split in two directions.

The first symptom of a torn meniscus might be a popping sensation in the knee. Within 24 to 48 hours, you may notice knee swelling and pain. In some

cases, a flap of the torn cartilage "locks" the knee joint. You may have trouble walking or bearing weight on your knee.

Diagnosis :
Often, a torn meniscus can be identified during a physical exam. Your doctor may bend your knee and ask you to move your foot in various directions. Your doctor may use an X-ray of the knee or magnetic resonance imaging (MRI) — a technique that uses a magnetic field and radio waves to create cross-sectional images of your knee — to confirm the diagnosis or study the extent of the tear.

In some cases, your doctor may use an instrument known as an arthroscope to study the inside of your knee. The arthroscope is inserted through a tiny incision near your knee. The device contains a light and a small camera, which projects an enlarged image of the inside of your knee onto a monitor. If necessary, surgical instruments can be inserted through the arthroscope or through additional small incisions in your knee.

Complications :
A torn meniscus can lead to knee instability, the inability to move your knee like normal or persistent knee pain.

Treatment:
Treatment for a torn meniscus often begins conservatively. Your doctor may recommend :

  • Rest. Avoid activities that aggravate your knee pain. You might want to use crutches to take pressure off your knee and promote healing.
  • Ice. Ice can reduce knee pain and swelling. Use a cold pack, a bag of frozen vegetables or a towel filled with ice cubes for 15 to 20 minutes at a time. Do this every couple of hours the first day or two, and then as often as needed.
  • Medication. Over-the-counter pain relievers also can help ease knee pain.
  • Knee exercises. Physical therapy can help you strengthen and stabilize the muscles around your knee and in your legs.
  • Orthotic devices. Arch supports or other shoe inserts can help to distribute force more evenly around your knee or decrease stress on certain areas of your knee.

If your knee remains painful, stiff or locked, surgery may be recommended. For younger adults, it's sometimes possible to repair a torn meniscus. In other cases, the meniscus is trimmed. Surgery is often done through an arthroscope.

During arthroscopic surgery, the doctor inserts an instrument called an arthroscope through a tiny incision near your knee. The arthroscope contains a light and a small camera, which projects an enlarged image of the inside of your knee onto a monitor. Surgical instruments can be inserted through the arthroscope or through additional small incisions in your knee.

Recovery from knee arthroscopy is much faster than is recovery from traditional knee surgery. You can often go home the same day. Full recovery may take weeks or months, however.

If the meniscus has degenerated, your doctor may recommend a knee joint replacement.

Prevention:
Regular exercise, including strength training, can help you strengthen and protect your knees. Start slowly, and increase your intensity gradually. Use proper form and protective gear for your given sport.

 
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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