Meniscal injury knee pdf

Like a lot of knee injuries, a meniscus tear can be painful and debilitating. A sensation of popping at the time of injury suggests ligamentous injury, probably complete rupture of a ligament thirddegree tear episodes of giving way are consistent with some degree of knee instability and may indicate patellar subluxation or ligamentous rupture. The decision by the surgeon to repair or remove is based primarily on the location of the meniscal tear. Athletes, especially those who play contact sports, are at risk for meniscus tears. However, anyone at any age can sustain a meniscus injury. A crosssectional study, with prospective data collection performed between january 2008 and june 2009. If the tear occurs from a sudden injury, you may feelhear a pop at the time of the injury. Evidence based management of meniscal tears kenneth g. The medial and lateral menisci play an important role in absorbing force and assisting in the role of nourishing the knee joint. Symptoms of meniscal injury in the knee the meniscus is the tough cartilage that cushions the bones in our knee joint.

Meniscal tears are the most common lesions followed by the meniscal cyst. 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. 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. Figure 4 schematic representation of the meniscal effect on contact pressure in 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. Meniscal injury knee anatomy knee injuries are fairly common problems, not just in athletes. Rehabilitation guidelines for meniscal repair there are two types of cartilage in the knee, articular cartilage and meniscus cartilage. 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. Knee stability must be assessed in every patient suspected of having a meniscal injury. Traumatic knee injuries, such as injuries to the anterior cruciate ligament acl and menisci, are associated with early onset osteoarthritis oa. Meniscus tears cartilage damage as we age and remain active, the menisci and cartilage often get injured or wear out. Sports injury medicine department 9250 sw hall blvd. This study examined the precipitating effect of knee ligament andor meniscal injury on radiographic oa in.

Tears present as severe pain, swelling, and possibly catching, clicking, difficulty on deep knee bending and locking of the knee in partial flexion. The thessaly test is the most sensitive and specific clinical test to diagnose meniscal injury. 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. The menisci act as shock absorbers in the knee, and provide stability to the joint. 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 injuries can be the result of a forceful, twisting event in a young athletes knee or it can insid. Crutches will allow you to walk while permitting the injury or surgical site to heal a. Discover common causes of knee injuries and what a meniscus tear feels like. Although less common than in adults, knee meniscal injuries do occur in individuals who are skeletally immature. In fact, a meniscal tear is one of the most frequently occurring cartilage injuries of the knee. Pain and swelling are the most common signs of an injury to your meniscus. A common mechanism of injury is a varus or valgus force directed to a flexed knee. Meniscal tears can occur in isolation or in combination with a ligamentous injury.

Meniscal injuries are rare in children younger than 10 years with morphologically normal menisci. This longitudinal study examined the association between knee injury and function, pain. Articular cartilage is made up of collagen, proteoglycans and water and lines the end of the bones that meet to form a joint. Occupational cartilage and meniscal injuries of the knee lyndon b. Being part of the bulimia recovery program brp has been an integral part of my own success. Each meniscus is a roughly moonshaped pad and they lie beside each other on the top surface of the tibia shin bone. Younger and elderly patients typically sustain different types of tears. The outer onethird of the meniscus has a rich blood supply. There have been multiple studies that have demonstrated the clinical success of meniscal repair.

Diagnosis and management of meniscal injury jacob babu, md, mha. Each knee joint contains a medial and lateral meniscus inner and outer meniscus. These injuries vary in severity from simple ligamentous sprains to complex pathologies that involve ligamentous disruption, meniscal damage. When people talk about torn cartilage in the knee, they are usually referring to a torn meniscus. The knee is a hinge joint, formed by the ends of two bones. Patient guide to meniscus injuries what is the meniscus. 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. No difference was found in the proms ie, international knee documentation committee, tegner, knee injury and osteoarthritis outcome, and lysholm scores. 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. Optimizing recovery after knee meniscal or cartilage injury. They act to provide shock absorption and reduce friction between the tibia and.

The typical meniscal pain profile comprises well localised jointline pain with medial pain generally being indicative of a medial tear and viceversa. Swelling after the injury can often gradually increase over a 12 day period. Meniscal injury is a major cause of functional impairment of the knee. Work with your doctor to plan a rehabilitation rehab program that helps you regain as much strength. History of locking episodes suggests a meniscal tear. I provide a brief report on my thoughts from clinical experience and the evidence on meniscus injuries and their management.

Symptoms of meniscal injury in the knee summit orthopedics. Optimizing recovery after knee meniscal or cartilage. Contact area is increased by 50% with addition of menisci. Common tears include longitudinal, parrotbeak, flap, bucket handle, and mixedcomplex. Whats best for you depends on what the tear s like. Rehabilitation guidelines for meniscal repair of root and.

Generally, the results of repair have been good, with high. Its a piece of cartilage in your knee that cushions and stabilizes the joint. Localized knee pain and tenderness knee swelling catching or locking of the knee. Athletes, particularly those who play contact sports, are at risk for meniscus tears. The meniscus is a commonly injured structure in the knee. 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. Meniscal tear symptoms, diagnosis and treatment bmj. The size and location of the meniscal tear may also affect the rate of postoperative progression.

See medial collateral ligament injury of the knee and anterior cruciate ligament injury. Meniscal injuries are usually related to other knee injuries like acl, which need to be treated with your meniscal tear. Restrains excessive mobility of the medial meniscus contact stresses tensile properties modulus 250 mpa4 i. Acute meniscal pathology presents with a history of a twisting injury, mild joint effusion, and pain localized to the affected joint line.

In fact, a meniscal tear is one of the most frequently occurring cartilage injuries. Consequently, menisci can tear due to traumatic injury or degenerative wear e. Symptoms of an acute meniscus tear include swelling, pain along the joint line, catching, locking and a specific injury. 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. As we age, this cartilage begins to lose elasticity and can easily be torn without any type of trauma. 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. A meniscal tear is a defect or split in the meniscocapsular complex, which can occur in a degenerative or nondegenerative meniscus. An injury to your knee meniscus or joint cartilage can happen when you move suddenly or repeatedly move the wrong way. Acute meniscal tears occur most often from twisting injuries.

Often times these tears can be diagnosed by taking a thorough history and completing a physical examination. Meniscal injury is suggested by the presence of joint line tenderness, particularly the posteromedial or posterolateral joint line. Your physical therapist will talk with you about how much pressure to place on your leg while on crutches. Injuries of the meniscus of the knee, sports medicine richmond va. Physical therapists can ensure that you and others with these injuries receive quality care to optimize recovery. Racgp meniscal tear presentation, diagnosis and management. The knee is one of the most common body parts to be injured. For many years the meniscus was treated with disrespect as an unnecessary appendage that could be sacrificed with the first hint of malfunction. The meniscus in the knee is usually damaged by a twist occurring on a slightly flexed knee. This page will explore how and what happens when the menisci become injured a tear and or a rupture. 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. Traumatic knee injuries, such as injuries to the anterior cruciate ligament and menisci, are associated with the early onset and progression of osteoarthritis oa. There may or may not be a memorable history of knee injury. Although the exact incidence and prevalence of meniscal injury are unknown, it is a fairly common sportsrelated injury among adults.

Meniscal tears often occur in young patients who have suffered a twisting injury to the knee. Sep 25, 2014 the evidence suggests a rethinking on the management of meniscal tears. 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. Optimal diagnosis and management is essential to prevent long term sequelae. Behrens, md abstract meniscal injury is a common cause for presentation to the emergency department or primary care physicians office. 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. 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. Meniscus tears are among the most common knee injuries. In younger people, the meniscus is fairly tough and rubbery, and tears usually occur as a result of a forceful twisting injury. For most tears, some simple exercises can help maintain muscle strength in the front of the thigh quadriceps, back of the thigh hamstr.

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. Degenerative meniscal lesions high signal or tear are frequent in the general population and are often incidental findings on knee mri. An injury can cause altered biomechanics of the knee joint and pain. A patients guide to meniscal tears and injuries in richmond, va. Meniscal injuries, particularly sportsrelated injuries, usually involve damage due to rotational force. You may also feel like your knee is locked where you are unable to move it through the full. Association of anterior cruciate ligamentmeniscal injury. If you hear a popping sound from your knee, that can be a first sign of a tear. 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. 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. 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. Symptoms of a torn meniscus include knee pain, swelling, popping, and giving way.

Meniscal motion follows the direction of femoral condyle displacement. 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. Work with your doctor to plan a rehabilitation rehab program that helps you regain as much strength and flexibility in your knee as possible. A meniscal tear occurs in 2 primary planes, vertical and horizontal. Meniscal tears can occur when the knee is forcefully twisted, sustains a direct blow, deep squatting or during activities that require changing directions. Association of knee ligament andor meniscal injury with. Pdf meniscal repair is a viable alternative to resection in many clinical situations. 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. Cabaud et al performed transverse medial meniscal lacerations and repair with a single dexon suture on 20 canine and 12 rhesus knee joints. 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. 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. The success of meniscus repair depends on tear pattern recognition and location for the capacity to heal.

A meniscal tear is the most common injury to the knee, occuring from both athletic events and activities of daily living. Does surgery reduce knee osteoarthritis, meniscal injury. An mri may be used to assist in making the diagnosis. 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. Rehabilitation exercises a meniscus tear is a common knee joint injury. Meniscal injury fact sheet introduction meniscal injuries are common in sports see figure below. A meniscus tear can happen when playing sports and commonly occurs in children. The typical meniscal pain profile comprises well localised jointline. Meniscal injury is common, and the medial meniscus is more frequently injured. We explain how these injuries occur, and help you recognize the symptoms of a damaged meniscus. If you have such an injury, you may feel knee pain and have limited motion.

Treatment of a torn meniscus may include observation and physical therapy with muscle strengthening to stabilize the knee joint. The patient with meniscal injury may present with pain, swelling, or mechanical symptoms and often requires surgical intervention for symptom resolution. Undifferentiated knee pain in the adult, physical examination of the knee, and other specific knee injuries. Knee injury meniscal cartilage injury what is the knee meniscus. The primary function of the articular cartilage is to provide. Our understanding of the pathobiology underlying this association is limited, and detailed studies of knee injury populations are needed.