Meniscus Tear

The meniscus is a C-shaped piece of cartilage in the knee joint that acts as a cushion between the thigh bone (femur) and the shin bone (tibia). Each knee has two menisci: the medial meniscus on the inner side of the knee and the lateral meniscus on the outer side. These structures play a critical role in stabilizing the knee, distributing weight, and absorbing shock during movement.

A meniscus tear is damage to the cartilage which can compromise knee function and cause pain. Tears vary in severity and type of tear. The treatment approach depends on the type and location of the tear, as well as the patient’s age, activity level, and overall health.

Meniscus tears can vary in type based on their shape and location. Each type requires a tailored treatment plan to restore knee function and mobility.

1. Radial Tear: A common tear that cuts from the center to the edge of the meniscus, like slicing a pie. It can disrupt shock absorption.
2. Horizontal Tear: Splits the meniscus into top and bottom halves, often seen in older adults and may form cysts.
3. Longitudinal Tear: Runs along the curved edge of the meniscus, which can develop into a severe “bucket-handle tear.”
4. Bucket-Handle Tear: A large piece flips over, causing the knee to lock or feel stuck.
5. Flap Tear: A loose piece moves around, causing catching or discomfort.
6. Complex Tear: A mix of tear types, often in older individuals with significant wear and tear.
7. Degenerative Tear: Frayed damage from age-related wear, common in those with arthritis.

Meniscus tears can result from acute injuries or degenerative changes in the knee.

• Trauma: Acute meniscus tears often occur during sports or activities that involve sudden twisting, pivoting, or impact to the knee. Athletes participating in contact sports like football or basketball, or those requiring abrupt changes in direction, such as soccer and tennis, are at higher risk. These tears frequently occur in younger, active individuals. Meniscus tears often occur alongside anterior cruciate ligament (ACL) tears, with the two injuries commonly linked in both sports and trauma-related knee injuries.
• Degeneration: Over time, the meniscus can weaken due to wear and tear. These tears are more common in middle-aged and older adults, particularly those with underlying conditions like osteoarthritis. Even minor activities, such as squatting or stepping awkwardly, can cause a tear in an already weakened meniscus.
• Contributing factors: Obesity, previous knee injuries, and poor biomechanics can increase stress on the meniscus.

The symptoms of a meniscus tear can vary depending on the severity and location of the injury. Common signs include:

1. Pain: The pain may be sharp during activity or a dull ache at rest.
2. Swelling: Swelling often develops within hours of the injury but may also appear gradually over days.
3. Stiffness: Many patients experience limited range of motion and difficulty bending or straightening the knee fully.
4. Locking or Catching: In some cases, a torn meniscus fragment may interfere with joint movement, causing the knee to lock, catch, or feel unstable.
5. Instability: A sensation of the knee giving way can occur, particularly if the tear impacts the knee’s structural stability.
6. Popping Sensation: A popping sound or feeling at the time of injury is common in acute tears.

Diagnosing a meniscus tear begins with a thorough clinical evaluation. Dr. Boden takes a detailed history of the injury, including how it occurred, the onset of symptoms, and any prior knee issues. Understanding the mechanism of injury can provide crucial clues. Then she performs a hands-on examination to assess tenderness, swelling, range of motion, and stability.

Imaging Studies including X-rays and an MRI will be ordered. MRI is the gold standard for diagnosing meniscus tears. In some cases, Dr. Boden may recommend arthroscopy for both diagnosis and treatment. This minimally invasive procedure involves inserting a small camera into the knee joint to directly visualize the meniscus and surrounding structures.

Prompt diagnosis and treatment are essential to prevent complications such as chronic pain, knee instability, or further damage to the joint. For athletes, early intervention can significantly reduce downtime and enhance recovery outcomes.

Dr. Stephanie Boden’s approach emphasizes patient education, empowering individuals to understand their condition and make informed decisions about their care. Whether addressing an acute sports injury or a degenerative tear, her goal is to provide expert guidance and advanced treatment options tailored to each patient’s needs.