The knee meniscus is a cartilage structure positioned in the knee joint attached to the tibia which has a role of absorbing shocks whilst weight bearing and also to complete the congruence between the round surface of the femur(thighbone) ant flat surface of the tibia (shin bone). Each knee joint has two menisci – medial and lateral, each slightly different from the other.
Causes of Meniscal Injury
The menisci can be damaged or torn during activities which involve loading and pivoting the knee joint such as during a football tackle or when the foot remain planted into the astro turf and the body continues the rotation carried by the momentum – sudden pivot.
Most athletes are at risk of meniscus injury with a higher incidence in sports such as football, rugby, netball, tennis.
Also, the non-athlete or sporty person could suffer a meniscus tear by standing too quickly from a squatting position.
Age is a contributing factor to the meniscus injury. The structure is made of several layers of fibrocartilage which are well attached to each other and flexible; as we age the menisci can become delaminated and stiffer which predispose it to injury especially when squatting or stepping.
Diagnosing a Meniscal Tear
A clinical examination will be performed and depending on the findings, an MRI scan might be recommended in order to establish the best management.
Depending on the severity of your injury, there will be treatment options varying from conservative treatment to day case surgery.
Initially, you should treat the knee injury with conservative techniques that include rest, ice, compression, and elevation, or the RICE method:
- Rest your knee. Use crutches to avoid any weight bearing on the joint. Avoid any activities that worsen your knee pain.
- Ice your knee every three to four hours for 30 minutes.
- Compress or wrap the knee in an elastic bandage to reduce inflammation.
- Elevate your knee to reduce swelling.
You can also take medication such as ibuprofen (Nurofen) or any other nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and swelling around your knee only if you have no contraindications and if you respect the instructions in the medication leaflet.
You shouldn’t put your full weight on your injured knee if it’s painful.
Physiotherapy should help reduce the pain and swelling and improve the knee function.
This type of management is not suitable for everyone, therefore please get in touch to discuss your knee condition with Mr Nita and benefit from specialist management.
If your knee is locked or not improving with conservative treatment, Mr Nita might recommend arthroscopic exploration and will give you specific instructions as to how to prepare for this surgery. This will most likely include:
- Complete pre surgery requirements, such as blood test, electrocardiogram (EKG), and other medical clearances, including an anaesthetic pre-assessment
The procedure will take place through couple of small incision in front of your knee. I will insert tools and a camera through the incision to repair or trim away the damaged meniscus.
You can usually go home the same day after this procedure. Full recovery will take time. However, you can begin participating in physical therapy exercises within days after surgery.
If your procedure involves a meniscal repair, the recovery and rehabilitation time is about six weeks. You’ll wear a knee brace and crutches during this time.
Surgery involves risks and we will discuss this in detail to determine if you are a good candidate for this procedure. The recovery period will include regular visits to the Physios to strengthen the muscles supporting your knee.
Tips to Prevent Meniscus Tears
You can prevent meniscus tears by regularly performing exercises that strengthen your leg muscles. This will help stabilize your knee joint to protect it from injury.
You can also use protective gear during sports or a brace to support your knee during activities that may increase your risk of injury.
We recommend Don Joy knee braces. Patient information leaflets can be found on the Don Joy website: https://www.djoglobal.eu/en_UK/Patient_Leaflet.html
Always prepare before exercising or engaging in activities that may put pressure on your knee joint. It is a good idea to:
- Warm up and stretch before exercising
- Use proper gear, such as athletic shoes designed specifically for your activity
- Lace up your footwear properly
- Learn the proper techniques for the activities you engage in
Long-Term Outcome Post Arthroscopic Meniscal Surgery
With proper diagnosis and adherence to treatment, your knee can have the mobility and function it had before the injury. If a meniscus tear is not surgically treated, the potential for healing depends on the location of the tear.
Cartilage doesn’t have a significant blood supply, which can affect its ability to heal. However, there are some areas of the meniscus, such as the outer portions, which have more blood vessels and are more likely to heal.