Meniscus tear

A meniscal tear is one of the most frequently occurring injuries of the knee. meniscus is a soft tissue in your knee that cushions and stabilizes the joint. Each knee has two meniscus.It protects the knee joint from wear and tear. 

Meniscus tears are common in contact sports like football as well as noncontact sports requiring jumping and cutting such as volleyball. In India RTA is also a common cause of meniscus tear. They can happen when a person changes his direction suddenly while running or jumping and often occur at the same time as other knee injuries, like an anterior cruciate ligament (ACL) injury. Meniscus tears are a special risk for older athletes since the meniscus degenerate with age. More than 40% of people 65 or older have meniscus tear.

Symptoms (what you feel)

  • Pain in the knee specially on twisting and turning movement
  • Swelling of knee
  • A popping sensation during the injury
  • Difficulty straightening the knee fully
  • A tendency of your knee to get “stuck” or locked

At first, the pain may not be bad. You might even play through the injury. But once the cartilage damaged, your knee will probably hurt quite a bit.

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Diagnosis

Physical examination (What your doctor feel)

your doctor will check your knee for swelling and tenderness — comparing your injured knee to your normal knee. He may also move your knee into a variety of positions to assess range of motion and overall function of the joint and to do some specific test for meniscus injury and various ligaments injuries. He will want to hear details about how you got your injury. 

X-rays.  Won’t show up meniscus but can help to rule out broken bones and other problems. 

Magnetic resonance imaging (MRI). can show the extent of an meniscus injury and signs of damage to other tissues in the knee, including the cartilage, other ligaments tear. 

Treatment 

Treatment for a torn meniscus often begins conservatively, depends on the size and location of the tear. Other factors which influence treatment include age, activity level and related injuries. The outer portion of the meniscus, often referred to as the “red zone,” has a good blood supply and can sometimes heal on its own if the tear is small. In contrast, the inner two thirds of the meniscus, known as the”red white zone” and  “white white zone,” does not have a good blood supply. Tears in this region will not heal on their own.

Nonsurgical treatment 

Tears associated with osteoarthritis often improve over time with treatment of the arthritis and Many other tears that aren’t associated with locking or a block to knee motion will become less painful over time, so they also don’t require surgery.treatment of such tear include 

  • Rest
  • Ice 
  • Compression bandage
  • Medication
  • Physiotherapy

Surgical treatment

If you feel continue pain in your knee despite physiotherapy or if your knee locks, your doctor might recommend surgery. It’s sometimes possible to repaire a torn meniscus, especially in children and young adults.Repaire is depends on location, age and type of tears.

If the tear can’t be repaired, the meniscus might be surgically trimmed, using an arthroscope known as partial meniscectomy 

If the tear is in whole length of meniscus and locked knee in single position with severe pain then you might have bucket handle tear of meniscus , and this may require emergency surgical repair or meniscectomy.

After surgery, you will need to do exercises to increase and maintain knee strength and stability.

Option for meniscus injury treatment by Dr. anil sharma

Conservative treatment of meniscus with supervised physiotherapy.

Meniscus repaire with various technique like all inside repair, inside out repair, outside in repair.

Partial meniscectomy for unrepairable tears.

all meniscus injuries treated by arthroscopic surgery .

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