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Knee - Meniscal Tears in Raleigh, Durham, Apex and Triangle Patients

The menisci are soft tissue structures located between the femur and tibia. There is one meniscus present within each compartment of the knee, a medial(or inner knee) and a lateral meniscus (outer knee).

Due to the location and function of the menisci, meniscus injuries are very common.

What Is The Function Of A Meniscus?

Located between the two major bones of the leg, the thigh bone and the shin bone, these tissues essentially function as cushions or shock absorbers and stabilizers.

As these tissues are soft tissue in nature, the menisci aid in smooth, guided motion and assist with "lubrication."

Knees which have lost the menisci due to meniscus injuries and surgery demonstrate significantly higher incidence of developing osteoarthritis in the long term. The actual extent and onset of this arthritis depends on factors such as age, activity levels, weight and extent of meniscus injuries.

What Is The Natural History Of Knee Meniscal Tears?

Knee meniscal tears usually occur through a traumatic event such as a twisting and or falling injury. This can happen with athletes during competition or training but is not solely confined to these events. Meniscus injuries in the older population can be degenerative in nature and these tissues can be injured with minimal to no trauma due to the thinning and aging of the tissue itself. The menisci have a very poor blood supply therefore proper healing and functioning typically does not take place without surgical intervention and therapy involving meniscus tear strengthening exercises.

How Can I Tell If I Have Knee Meniscal Tears?

The most common sensation patients relate with meniscus injuries, is having felt a "pop" in the knee with simultaneous pain, not always severe. Often times they are able to continue walking or light sports without too much pain. The pain tends to be more localized to one side of the knee.

Swelling may begin within several hours, even into the following day of the injury. It is usually not severe in nature.

The patient may experience "locking" of the knee. This occurs when the knee gets stuck in one position and unable to move. A usual position of limitation is with straightening or extension due to a torn fragment of the meniscus getting caught between the bones.

The patient may report a sensation of "giving way" when in reality, the knee gives out due to transient, positional pain. There may also be an audible and palpable "clicking sensation" in the knee with movement.
 

How Is This Injury Specifically Diagnosed?

Diagnosis of this particular injury can usually be made based on the history and physical examination by a trained physician. An MRI (Magnetic Resonance Imaging) test is often ordered to confirm the diagnosis and determine need for surgical intervention.MRI will also assist the physician in excluding other injury or pathology.
 

What Type Of Treatment Or Intervention Should I Expect?

As with any acute injury, the most prudent treatment would include Rest, Ice, Compression and Elevation. Depending on the severity of the symptoms, crutches may also be helpful. The knee should be examined within several days of the injury but there is no urgency to be seen immediately unless you have a "locked knee".

A torn meniscus rarely is able to heal itself due to its poor blood supply. Standard intervention for a meniscal tear usually involves minimally invasive arthroscopic surgery. The procedure for correcting a torn meniscus is one of repair or partial removal (trimming). The decision to repair a torn meniscus is based on the severity and location of the tear, as well as the patient's age, activity level, occupation and sporting demands. The final decision is made at the time of surgery once the injury is well visualized and again depending on the size, location and the quality of the remaining healthy meniscus tissue.

Repair is usually performed entirely arthroscopically using special devices. Occasionally additional incisions may be required based on the location of the tear. We have listed below some of the advantages and disadvantages of meniscal repair.
 

Advantages

Maintain as much normal anatomy and function that the normal meniscus can provide.

Restores function in the knee.

Diminishes the accelerated risk of arthritis.

Disadvantages

The recovery time and rehabilitation period is prolonged due to time healing constraints.

The period of time to return to work and sporting activities in prolonged due to healing and rehabilitation constrains.

Lack of healing within the meniscal repair (15-20%) due to it's poor blood supply. If proper healing does not occur, a repeat arthroscopy may be required in an attempt to repair or remove the torn fragment.

More involved surgery slightly increases the risk to nerves and blood vessels.

For more information on how the meniscus injuries specialists at Cary Orthopaedics can help you, contact us today at 919-467-4992 for an appointment!

Cary Orthopaedics serves patients from Raleigh, Garner, Cary, Apex, Holly Springs, Fuquay-Varina, Clayton, Chapel Hill, and Pittsboro, NC.