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Meniscal Tears

Menisci are horseshoe shaped soft cushion like structures (like the half doughnut) present in the knee joint. Each knee has two menisci, one in the inner (medial) and the other in the outer (lateral) side.

The most important function of the menisci is to share the load passing through the knee joint during various activities and to protect the cartilage of the knee.

Menisci of the knee joint
Shape of meniscus is like a half doughnut

Functions of Meniscus

  • More than 50% of the knee load is transmitted through the menisci.
  • The menisci function as the shock absorber of the knee. Like a cushion between the shinbone and the thighbone. They spread out the forces that are transmitted across the knee.
  • The Menisci give additional stability to the knee.
  • The menisci play a role in the nutrition & lubrication of the knee.
  • The menisci help in recognizing the knee movement and position.

Causes of Meniscal Tear

Meniscal injuries can occur at any age. In younger people (under 30 years), the meniscus is a fairly tough and rubbery structure. Tears usually occur as a result of a forceful twisting injury more likely to be caused by a sport activity. People of older ages often end up with a tear as result of a minor injury,such as from the up-and-down motion of squatting. Sometimes Meniscal tears occur secondary to knee arthritis.

Types of Meniscal Tear

The meniscal tears are of following types.

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Symptoms of Meniscal Tear

  • The most common problem caused by a torn meniscus is pain. The pain may be felt along the edge of the knee joint or may be vague and involve the whole knee.
  • The knee may swell, causing it to feel stiff and tight. This is because fluid accumulates inside the knee. This is sometimes called water in the knee.
  • The knee joint can also lock up if the tear is large enough. Locking refers to the inability to completely straighten out the knee. This can happen when a fragment of the meniscus tears free and gets caught in the knee, like a pencil stuck in the hinge of a door.
Common symptoms of meniscal tears

Diagnosis of Meniscal Tear

X-rays will not show the torn meniscus. X-rays are mainly useful to determine if other injuries are present.

Magnetic resonance imaging (MRI) is very good at showing the meniscus. MRI creates pictures that look like slices of the area.

MRI showing Meniscal tear

Treatment of Meniscal Tear

The procedure to take out the damaged portion of the meniscus is called a partial meniscectomy. Surgeons would rather not take out the entire meniscus. Removal of the meniscus increases the risk of knee arthritis. Young people who have recently torn their meniscus are generally good candidates for repair. Older patients with degenerative tears are not. With the current advanced technology we can do this procedure through KeyHole Technique. There are multiple advantages to this technique such as a) less blood loss, b) less pain, c) early recovery, d) less tissue damage, e) lesser chance of infection, f) more cosmetic, etc. On most occasions patient will be able to walk on the same day after surgery and go home the same day.

Key Hole technique used to treat meniscal tears.
Complex irreparable and neglected tears are treated by partial meniscectomy.
Meniscal repair done for fresh reparable tears in young patients.
Authored By DR Raj Kanna - Orthopaedic and Knee surgeon, Chennai

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