Anatomy: Menisci are the cartilages in the knee joint, between the femur (thigh bone) and the tibia (shin bone). There are two menisci in the knee. One is medial and the other is lateral. The menisci serve three purposes in the knee:
- They serve as shock absorbers to the knee.
- They give some minor stability to the joint.
- They assist in lubricating the knee joint.
After they stop growing, the menisci slowly lose their blood supply and therefore cannot heal themselves. Also, by soaking up the joint fluid, they also soak up mineral deposits from the knee, making them brittle. It is partly for these reasons that the menisci are so commonly torn, especially in older people.
Mechanism of Injury: There are several different types of meniscal tears with different mechanisms of injury. Commonly, a sudden twisting of the knee when the foot is planted and the knee is slightly bent, compresses the meniscus and causes it to tear.
Diagnosis: From the history, symptoms, and examination, a tentative diagnosis is often possible. To support this diagnosis, an MRI is usually ordered (a meniscus tear cannot be identified on an x-ray). An MRI (Magnetic Resonance Image) produces pictures of your knee, frequently identifying the problem.
Treatment: Having a torn meniscus in your knee is uncomfortable and can damage surrounding structures. For these reasons, Dr. Gardner’s usual treatment of choice for certain types of meniscus tears is knee arthroscopy, which is an outpatient procedure typically involving 2 little puncture holes through which the damaged portion of the meniscus is removed (or repaired). But, not all meniscus tears require surgery. Some are fairly “benign” and can be treated with “healing therapies” such as prolotherapy, PRP, or bone marrow extracted cellular therapies among a growing list of “regenerative” options.
Recovery: Most people will require 2-6 weeks of physical therapy after surgery. Most people will walk within a day or two of surgery but may need crutches or a walker for a short time. Pain medication needs are quite variable. Within 2 months, you should be near your pre-injury level of activity.
Outcome: For most people, the arthroscopic procedure alleviates the pain and their outcome is excellent. However, if there are arthritic changes in the knee or extensive damage to the joint surface, you may still experience weather-change or activity-related pain, but it is typically improved.