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1. This shows the anatomy of the knee, including the menisci.

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3. This is an MRI of a meniscus tear.

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3. This shows the different types of meniscus tears.

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4. Hokas are supportive footwear, which can help prevent meniscus tears

Meniscus Tears

The Basics

The menisci are two fibrocartilaginous disks located in the knee that play a major role in stability and shock absorption. The menisci also help in providing nutrition to the cartilage and lubrication to the joint, and have been implicated in preventing arthritis.

Who Is At Risk?

Meniscus tears commonly occur in young athletes and elderly populations. Sports like soccer and basketball that involve cutting, twisting, and similar movements can lead to acute trauma in young athletes. In older people, the wear and tear of tissues over time leaves them more vulnerable to be injured. Meniscus tears often occur with other issues such as ACL tears and the “deadly triad” of tearing the ACL, MCL, and meniscus.

Diagnosis

If you suspect that you have torn your meniscus, several imaging tests can help diagnose it. X-rays can help determine the cause of knee pain, while MRI and ultrasound can help diagnose soft tissue damage. Arthroscopy can be used to examine the knee if these techniques are unsuccessful.

Symptoms and Treatment

Meniscus tears present with pain, swelling, and decreased range of motion, among other symptoms. Like many other lower extremity injuries, they can be treated through RICE (rest, ice, compression, and elevation). They can also be treated with physical therapy, non steroidal anti-inflammatory drugs (NSAIDS), and corticosteroid injection. 

 

There are three main surgical options for a meniscus tear: partial meniscectomy, meniscal repair, and meniscal reconstruction. In a partial meniscectomy, the damaged meniscus is trimmed away. This used to be the most common approach to surgery when the meniscus was not thought to be important. Now, surgeons often want to save the meniscus, either through reconstruction or repair. Reconstruction involves using allografts to repair the meniscus, while repair involves stitching the torn pieces of meniscus back together.

Outlook

The recovery for repair is longer than a meniscectomy (3-6 months compared to 3-6 weeks). However, a study from the American Academy of Orthopaedic Surgeons states that may not improve outcomes for patients with symptoms a degenerative medial meniscus tear that do not have knee osteoarthritis. If surgery is not used, the healing of the meniscus depends on where it is torn, because the areas of the meniscus get varying blood supply and therefore have variable healing ability.

Prevention

To prevent meniscus tears, stretch and warm up before physical activity. Learn the proper form for exercise that puts weight on the knees, wear supportive footwear, and strengthen the muscles around the knee. You can find examples of supportive footwear at  Footwear Recommendations.

References

  1. https://www.mayoclinic.org/diseases-conditions/torn-meniscus/symptoms-causes/syc-20354818

  2. https://newsnetwork.mayoclinic.org/discussion/infographic-meniscus-injury-repair/

  3. https://journals.lww.com/jaaos/Fulltext/2017/05000/Physical_Examination_of_the_Knee__Meniscus,.6.aspx

  4. https://journals.lww.com/jaaos/Fulltext/1993/09000/Meniscus_Tears__Treatment_in_the_Stable_and.6.aspx

  5. https://www.mdpi.com/2073-4409/9/1/92/htm

  6. https://journals.lww.com/jaaos/pages/articleviewer.aspx?year=1993&issue=09000&article=00006&type=Fulltext&casa_token=1FuIQoSMabgAAAAA:iHuMbaWKS_YggJF2vsOv41Uvxx1OsKijV56XtprYyoxfdYNUIkDSHo5ukPV3jOVCYd_cUv1RQ2gagppDKFfb