The patient with meniscal injury may present with pain, swelling, or mechanical symptoms and often requires surgical intervention for symptom resolution. An injury to your knee meniscus or joint cartilage can happen when you move suddenly or repeatedly move the wrong way. Younger and elderly patients typically sustain different types of tears. This page will explore how and what happens when the menisci become injured a tear and or a rupture.
Meniscal injury is common, and the medial meniscus is more frequently injured. How well the knee will heal and whether surgery will be needed depends in large part on the type of tear see figure in appendix and how bad the tear is. Tears present as severe pain, swelling, and possibly catching, clicking, difficulty on deep knee bending and locking of the knee in partial flexion. You may also feel like your knee is locked where you are unable to move it through the full. Physical therapists can ensure that you and others with these injuries receive quality care to optimize recovery. Degenerative meniscal lesions high signal or tear are frequent in the general population and are often incidental findings on knee mri. These injuries vary in severity from simple ligamentous sprains to complex pathologies that involve ligamentous disruption, meniscal damage. Work with your doctor to plan a rehabilitation rehab program that helps you regain as much strength and flexibility in your knee as possible.
Types of common knee injuries include sprains, strains, bursitis, dislocations, fractures, meniscus tears, and overuse injuries knee injuries are generally caused by twisting or bending force applied to the knee, or a direct blow, such as from sports, falls, or accidents. Meniscus tears are among the most common knee injuries. This process of tissue degeneration makes it very unlikely that a surgical repair will heal or that the surrounding meniscus will be strong enough to hold the sutures used to repair it. A meniscal tear is the most common injury to the knee, occuring from both athletic events and activities of daily living. Meniscal motion follows the direction of femoral condyle displacement. The outer onethird of the meniscus has a rich blood supply. Articular cartilage is made up of collagen, proteoglycans and water and lines the end of the bones that meet to form a joint. An injury can cause altered biomechanics of the knee joint and pain. Often times these tears can be diagnosed by taking a thorough history and completing a physical examination. Meniscal tear symptoms, diagnosis and treatment bmj. Meniscal tears can occur when the knee is forcefully twisted, sustains a direct blow, deep squatting or during activities that require changing directions. How well the knee will heal and whether surgery will be needed depends in large part on the type of tear and how bad the tear is. Athletes, particularly those who play contact sports, are at risk for meniscus tears. Pain and swelling are the most common signs of an injury to your meniscus.
Jan 21, 20 as reported by majewski, injuries to the menisci are the second most common injury to the knee, with an incidence of 12% to 14% and a prevalence of 61 cases per 100,000 persons6. Meniscal tears can occur in isolation or in combination with a ligamentous injury. Meniscal tears are the most common lesions followed by the meniscal cyst. As we age, this cartilage begins to lose elasticity and can easily be torn without any type of trauma.
A meniscal tear occurs in 2 primary planes, vertical and horizontal. For many years the meniscus was treated with disrespect as an unnecessary appendage that could be sacrificed with the first hint of malfunction. Meniscal injuries are rare in children younger than 10 years with morphologically normal menisci. Pdf meniscal repair is a viable alternative to resection in many clinical situations. Two of the five orthopedics and traumatology residents of hospital sao lucas, pucrs, examined 162 patients 163 knees with meniscal andor acl injury who were going to undergo knee videoarthoscopy afterwards. Consequently, menisci can tear due to traumatic injury or degenerative wear e. The aim of phase 3 of a meniscus tear rehabilitation program is to ensure full range of movement in the knee, regain normal strength with the ability to perform a full squat and start to return to running and normal training. A partial or total tear of a meniscus may occur when a person quickly twists or rotates the upper leg while the foot stays planted. Traumatic knee injuries, such as injuries to the anterior cruciate ligament and menisci, are associated with the early onset and progression of osteoarthritis oa.
Optimal diagnosis and management is essential to prevent long term sequelae. There may or may not be a memorable history of knee injury. A crosssectional study, with prospective data collection performed between january 2008 and june 2009. For most tears, some simple exercises can help maintain muscle strength in the front of the thigh quadriceps, back of the thigh hamstr. Behrens, md abstract meniscal injury is a common cause for presentation to the emergency department or primary care physicians office. Sep 25, 2014 the evidence suggests a rethinking on the management of meniscal tears. If you just found out that the pain and swelling in your knee is a torn meniscus, you probably have a decision to make about how to treat it. An mri may be used to assist in making the diagnosis. Being part of the bulimia recovery program brp has been an integral part of my own success. Like a lot of knee injuries, a meniscus tear can be painful and debilitating. However, our understanding of the pathobiologic processes underlying this association is limited. Our understanding of the pathobiology underlying this association is limited, and detailed studies of knee injury populations are needed.
The meniscus in the knee is usually damaged by a twist occurring on a slightly flexed knee. The typical meniscal pain profile comprises well localised jointline. Crutches will allow you to walk while permitting the injury or surgical site to heal a. In his epidemiological study conducted on 17,397 patients in germany and switzerland, soccer, followed by skiing, are the sport with an increased risk of meniscal. Association of anterior cruciate ligamentmeniscal injury. Meniscal injuries are usually related to other knee injuries like acl, which need to be treated with your meniscal tear. The decision by the surgeon to repair or remove is based primarily on the location of the meniscal tear. A meniscal injury is a very common injury of the knee, usually resulting from an intrinsic or extrinsic component. Meniscal and articular cartilage lesions revision 2018 clinical practice guidelines linked to the international classification of functioning, disability and health from the orthopaedic section of the american physical therapy association. Symptoms of a torn meniscus include knee pain, swelling, popping, and giving way. They act to provide shock absorption and reduce friction between the tibia and. We explain how these injuries occur, and help you recognize the symptoms of a damaged meniscus. Conclusion the risk of radiographic knee oa was higher, but the risk of secondary meniscal injury was lower 10 years after surgical treatment of acl rupture. The meniscus is a wedge shaped cartilage ring found on both the inside and outside of the knee between the femur thigh bone and tibia shin bone.
A patients guide to meniscal tears and injuries in richmond, va. The size and location of the meniscal tear may also affect the rate of postoperative progression. Sports injury medicine department 9250 sw hall blvd. Racgp meniscal tear presentation, diagnosis and management. Whats best for you depends on what the tear s like. Optimizing recovery after knee meniscal or cartilage. Localized knee pain and tenderness knee swelling catching or locking of the knee. Symptoms of an acute meniscus tear include swelling, pain along the joint line, catching, locking and a specific injury. Rehabilitation guidelines for meniscal repair of root and. Rehabilitation guidelines for meniscal repair there are two types of cartilage in the knee, articular cartilage and meniscus cartilage.
Common tears include longitudinal, parrotbeak, flap, bucket handle, and mixedcomplex. Knee injury meniscal cartilage injury what is the knee meniscus. Diagnosis and management of meniscal injury jacob babu, md, mha. Association of knee ligament andor meniscal injury with. The meniscus is a commonly injured structure in the knee. Its a piece of cartilage in your knee that cushions and stabilizes the joint. Cabaud et al performed transverse medial meniscal lacerations and repair with a single dexon suture on 20 canine and 12 rhesus knee joints.
Should the menisci fail to follow the femoral condyles along the tibial plateau they risk entrapment between the two articulating surfaces and sustaining injury due to compression. This study examined the precipitating effect of knee ligament andor meniscal injury on radiographic oa in. The typical meniscal pain profile comprises well localised jointline pain with medial pain generally being indicative of a medial tear and viceversa. A meniscus tear can happen when playing sports and commonly occurs in children. Meniscal tears often occur in young patients who have suffered a twisting injury to the knee. Each knee joint contains a medial and lateral meniscus inner and outer meniscus. Your physical therapist will talk with you about how much pressure to place on your leg while on crutches. Undifferentiated knee pain in the adult, physical examination of the knee, and other specific knee injuries. Many factors contribute to this, but genetics, a past history of injury or surgery, overuse, and body weight seem to be the most important causes. Meniscal injury knee anatomy knee injuries are fairly common problems, not just in athletes. Medial meniscus tear brace wearing a rehabilitative knee brace will help recover from a torn meniscus by adding support to the joint and limiting the wearer from provoking the injury even further. The primary function of the articular cartilage is to provide.
There have been multiple studies that have demonstrated the clinical success of meniscal repair. No difference was found in the proms ie, international knee documentation committee, tegner, knee injury and osteoarthritis outcome, and lysholm scores. If the tear occurs from a sudden injury, you may feelhear a pop at the time of the injury. When the foot is planted and the femur is internally rotated, a valgus force applied to a flexed knee may cause a tear of the medial. History of locking episodes suggests a meniscal tear. Background meniscus tears are one of the most common injuries to the knee and should often be included at the top of the differential diagnosis for patients presenting with knee pain. In younger people, the meniscus is fairly tough and rubbery, and tears usually occur as a result of a forceful twisting injury. Restrains excessive mobility of the medial meniscus contact stresses tensile properties modulus 250 mpa4 i. In fact, a meniscal tear is one of the most frequently occurring cartilage injuries. Meniscal injuries can be the result of a forceful, twisting event in a young athletes knee or it can insid. Protocol for the management of acute injuries to the knee introduction the majority of knee injuries result from trauma to the joint as a result of direct, torsional or angulatory forces. As reported by majewski, injuries to the menisci are the second most common injury to the knee, with an incidence of 12% to 14% and a prevalence of 61 cases per 100,000 persons6. Injuries of the meniscus of the knee, sports medicine richmond va. Meniscal injury fact sheet introduction meniscal injuries are common in sports see figure below.
Although less common than in adults, knee meniscal injuries do occur in individuals who are skeletally immature. The patient may present with complaints of popping, clicking or locking, and a block to full knee range of motion due to a displaced meniscal fragment or buckethandle tear. A common mechanism of injury is a varus or valgus force directed to a flexed knee. The knee is a hinge joint, formed by the ends of two bones. Optimizing recovery after knee meniscal or cartilage injury. The thessaly test is the most sensitive and specific clinical test to diagnose meniscal injury. Acute meniscal tears occur most often from twisting injuries. Contact area is increased by 50% with addition of menisci. Traumatic knee injuries, such as injuries to the anterior cruciate ligament acl and menisci, are associated with early onset osteoarthritis oa. The success of meniscus repair depends on tear pattern recognition and location for the capacity to heal. Rehabilitation exercises a meniscus tear is a common knee joint injury.
Occupational cartilage and meniscal injuries of the knee lyndon b. Evidence based management of meniscal tears kenneth g. Symptoms of meniscal injury in the knee summit orthopedics. If you have a meniscal or cartilage injury to your knee and need surgery, your recovery will often require crutches or a similar tool to help you walk. The knee is one of the most common body parts to be injured. This longitudinal study examined the association between knee injury and function, pain. Acute meniscal pathology presents with a history of a twisting injury, mild joint effusion, and pain localized to the affected joint line. I am proud to say i am at almost a month free of bingeing and purging. A meniscal tear is a defect or split in the meniscocapsular complex, which can occur in a degenerative or nondegenerative meniscus. Treatment of a torn meniscus may include observation and physical therapy with muscle strengthening to stabilize the knee joint. The menisci are thick pads of cartilage tissue within the knee which act as shock absorbers to absorb body weight and help improve smooth movement and stability of the knee. Does surgery reduce knee osteoarthritis, meniscal injury and. When people talk about torn cartilage in the knee, they are usually referring to a torn meniscus.
The menisci act as shock absorbers in the knee, and provide stability to the joint. Discover common causes of knee injuries and what a meniscus tear feels like. Each meniscus is a roughly moonshaped pad and they lie beside each other on the top surface of the tibia shin bone. In fact, a meniscal tear is one of the most frequently occurring cartilage injuries of the knee. In the early 1980s animal studies were performed to evaluate the response of the meniscus to injury, and showed that meniscal tissue was capable generating a healing response particularly at its periphery.
However, anyone at any age can sustain a meniscus injury. Patient guide to meniscus injuries what is the meniscus. Does surgery reduce knee osteoarthritis, meniscal injury. Swelling after the injury can often gradually increase over a 12 day period. Generally, the results of repair have been good, with high. B for knee specific outcomes, clinicians should use the international knee documentation committee 2000 subjective knee evaluation form ikdc 2000 or knee injury and osteoarthritis outcome score koos or a culturally appropriate version for patients whose primary language is not english and may use the lysholm scale. If you have such an injury, you may feel knee pain and have limited motion. Read about exercises for knee injury, and learn about symptoms, signs, treatment, home remedies, recovery times and prevention of knee injuries.
Symptoms of meniscal injury in the knee the meniscus is the tough cartilage that cushions the bones in our knee joint. See medial collateral ligament injury of the knee and anterior cruciate ligament injury. Figure 4 schematic representation of the meniscal effect on contact pressure in the knee. Although the exact incidence and prevalence of meniscal injury are unknown, it is a fairly common sportsrelated injury among adults. If you hear a popping sound from your knee, that can be a first sign of a tear. Athletes, especially those who play contact sports, are at risk for meniscus tears. Meniscus tears cartilage damage as we age and remain active, the menisci and cartilage often get injured or wear out. Meniscal injuries, particularly sportsrelated injuries, usually involve damage due to rotational force. A torn meniscus occurs because of trauma caused by forceful twisting or hyperflexing of the knee joint.
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