Meniscal tears and trauma

Slip and fall accidents commonly result in injuries to the knee which can be debilitating and costly. Whenever a client presents with a knee injury, their physician will usually proceed with treatment consisting of ice, wrap, motion, and anti-inflammatory medication. However, if the client is diagnosed with a meniscal tear, treatment may be much more involved.

A meniscal tear is a tear in the meniscus. The meniscus is a shock-absorbing structure in the knee. There are two menisci in each knee, one on the inside (medial) and one on the outside (lateral). The meniscus is made of fibro-cartilage and collagen. Since about 4/5th of the meniscus has no blood supply, it cannot heal a tear. The meniscus functions as a shock absorber for the knee, serving to distribute impact and load.

Most injuries to the meniscus are caused by trauma, usually compression and twisting of the knee. A torn meniscus may or may not cause symptoms. The injuries that do not cause symptoms are usually small tears located in the back of the knee. Symptoms may include a “popping” sound at the time of the injury, pain, tightness, swelling within the knee (more often referred to as ‘water on the knee’) or tenderness in the joint. In some cases, the diagnosis can be confirmed with an MRI (magnetic resonance image).

However, if the knee locks up and is painful, the physician may determine that surgery is necessary to remove the damaged meniscus. Surgical treatment involves using a small microscope to look at and treat the tear. Arthroscopic surgery is usually done within a few days in order to relieve pain and prevent long term stiffness. The procedure involves inserting an arthoscope into the knee to examine the meniscus tear. If the tear involves the vascular portion of the meniscus, it will be repaired by passing sutures across the tear. If the meniscus is not repairable, a microscopic shaver is used to remove the torn portion. The goal is to leave the joint surfaces smooth.