The meniscus is a crescent-shaped cartilage pad that absorbs shock and is found between the bones of the knees. There are two menisci, medial meniscus and lateral meniscus, in each knee. If leg bones rub together, it can lead to osteoarthritis, but the meniscus avoids the rubbing as well. Instead, the menisci do the job of absorbing pressure and distributing the body weight.

CAUSES

Meniscus tears happen due to twisting motions that can occur during sports mostly. There is no specific age for sustaining meniscus injuries. Other causes include climbing stairs or hills, bending the knee too far, squats, and walking on uneven surfaces. The risk of you getting meniscus injury increases with the following-

• With age, the cartilage wears out, so if you are above 30 years.
• You play sports that involve pivoting
• You are a contact sports player (football, hockey or rugby)
• Degenerative conditions like osteoarthritis

Following are the symptoms of meniscus tears-

• Knee buckling (giving away of the knee)
• Inability to strengthen the knee
• Pain
• Pop sound
• Swelling
• Locked knee (Knee stays in a flexed position)
• Tightness of the joint

Meniscus tears are often small and do not appear as acute injuries. As a result, they can often go unnoticed.

SURGERY

In some cases, the RICE (rest, ice, compression and elevation) treatment or NICE (non-steroidal anti-inflammatory drugs, ice, compression and elevation) might treat pain and discomfort due to meniscus tear. However, most meniscus injuries happen in the inner 2/3rds of the meniscus that does not have a rich blood supply. Thus, these injuries do not heal quickly.

If they are not treated, other problems might arise. The loose meniscus cartilage can move around, leading to locking or popping of the knee. A chronically damaged meniscus can lead to arthritis.

PROCEDURES

If your surgeon believes in a minimally invasive approach, they will suggest a knee arthroscopy. It involves using a tube with an arthroscope camera to take inside images of the knee and repair the damage.

Following is the arthroscopy process-

• First, anaesthesia will be administered. After your knee is prepped, the surgeon will insert the arthroscope and look within the knee joint. The surgeon will check if they can repair the injury or partial removal of the meniscus is needed.
• If the tear is repairable, the torn edges will be sutured together. Most surgeons prefer to repair the meniscus rather than meniscectomies. Preserving the meniscus is vital for protecting the knees from arthritis in the future. The sutured torn edges take time to heal and stick back together, so the recovery period is longer.
• If a meniscectomy is needed, it means that the edges cannot be sutured together. It involves the removal of damaged meniscus parts and keeping the rest of the healthy tissue as it is. Patients who undergo partial meniscus removal recover faster than those who receive sutures to repair the torn edges.

Meniscus repair is effective if the tissue is still in a good state, the tears are vertical, tears are small and located on the outer edges of the meniscus. It is most helpful if the injury is in the red zone where there is ample blood supply.

Partial meniscectomy is suggested if the flap of the meniscus is torn, tears are horizontal, or the tear is in the white zone where there is less blood supply. For more information, you may schedule an appointment with Dr. Rewat Laxman.