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A knee meniscal injury is a tear in the cartilage that lines the knee joint. We look at the signs of a torn meniscus and treatments.
The menisci of the knee are two crescent-shaped structures that sit on the knee joint surface of the lower leg bone (tibia).
The term meniscus is generally used to refer to the cartilage of the knee, either to the lateral or medial meniscus. The medial meniscus sits on the inner aspect of the joint while the lateral meniscus sits on the outer aspect of the knee joint.
Each meniscus is actually made from strong, soft tissue, known as fibrocartilage. The menisci provide several important functions to the knee and these include:
In younger individuals, a meniscus can be torn when playing contact sports that require rapid changes of direction such as football, rugby or netball.
In middle aged or older individuals, they may have some areas of degeneration in their menisci. As such a meniscus can suffer a tear when doing innocuous activities, such as walking or climbing stairs.
Another common symptom is a ‘locking’ of the knee joint. This is when you are unable to fully straighten your leg and you must then handle the knee to ‘unlock’ the joint. Occasionally, this can be accompanied by a ‘catching’ or ‘clicking’ feeling in the knee. This action may also be associated with pain. You may also have the sensation of the knee giving way in your leg.
Often you may recall the specific activity that you were doing when the injury was sustained. The tear can happen in either the lateral or medial meniscus and it usually follows a trauma that involves the rotation of the knee while it was slightly bent. This movement can also aggravate the pain after the injury, such as when getting into or out of a car.
If the meniscus is torn while you are doing an activity then there will be an immediate onset of pain. The pain will also be localised to the specific meniscus. If the pain is on the inside of the knee then you have torn the medial meniscus.
If the pain is on the outside of the knee then the lateral meniscus has been torn. You may also notice some swelling of the knee later on.
Although the pain and swelling will often improve over the course of a few weeks following a torn meniscus, complete recovery from symptoms may be prolonged. Regular activity and strengthening exercises of the knee can ease symptoms.
Ongoing symptoms may also occur with walking and heavier impact activities such as jogging, running or sports requiring rapid changes of direction.
A doctor or physiotherapist will be able to diagnose a torn meniscus knee by looking a history of your condition or by conducting a physical examination. The main feature on examination is tenderness directly over the joint line of the knee. Other physical tests may help in confirming the diagnosis.
The cost includes all your hospital visits, such as initial consultation, the surgery and recovery afterwards when you are an inpatient. We provide high-quality care throughout and we reflect that within our costs.
We also understand that your treatment needs to be tailored to your needs, both physical and emotional. This no one-size-fits-all approach means that the cost of knee replacement surgery often varies from person to person.
Your consultant will discuss with you the management of degenerative meniscal tears and the role of surgery in an acute meniscal tear of the knee. The torn meniscus recovery time is around six to eight weeks without surgery.
In the majority of cases, particularly in the older age group, meniscal tear management can help maintain flexibility and strength of the knee joint. Meniscal tear management involves doing a series of regular exercises.
These exercises need to be performed regularly on the affected knee joint: 5×30 second holds, 2 times per day 3-4 sets of 10 reps, 3-4 times per week 3-4 sets of 10 reps, 3-4 times per week
For individuals who have done a course of supervised physical therapy and followed the advice of a doctor, a corticosteroid injection may occasionally be offered as a treatment. These injections can be useful for patients who have had significant age-related changes to the meniscus or knee joint. You can read more about local corticosteroid injections here. Corticosteroid injections are not normally offered for individuals with mechanical symptoms, such as locking.
If management of the knee pain fails and the range of motion of the knee remains limited then an orthopaedic surgeon may examine your knee. Arthroscopic (keyhole) surgery may be an effective option for patients who:
In a few cases where the knee becomes “locked”, an urgent arthroscopy will be offered as the first line of treatment. Please note that there is evidence to indicate that undergoing a knee arthroscopy will increase the risk of requiring a knee replacement in the future. Therefore, a decision on whether to proceed with surgery should only be taken on the basis of current symptoms and limitations.
Consultant Orthopaedic Surgeon
FRCS (Eng) FICS, FLLA Honorary Senior Lecturer at Guy's, King's & St Thomas' Schools of Medicine, Visiting Professor Tamil Nadu Medical University, Honorary Clinical Senior Lecturer University of Sussex
BMI The Blackheath Hospital
Consultant Orthopaedic Surgeon
MBBS, MRCS (England), FRCS (Trauma and Orthopaedics), Visiting Professor University of Bedford (ISPAR), Visiting Professor University of Bedfordshire (Health Sciences), Visiting Professor Cranfield University (Materials Science and Manufacturing)
BMI The Saxon Clinic