Meniscal Injuries

Meniscal injuries are commonly referred to as "torn cartilage". The meniscus is a C-shaped cartilaginous structure within the knee joint in between the joint surfaces of the knee. There are two types of meniscus in each knee and they are tough and rubbery. It acts like a shock absorber and is one of the commonly injured structures in the knee. This injury can occur in any age group and is usually a result of twisting of the knee in younger individuals. The meniscus becomes weaker with age and can occur in older individuals with minor injuries.

Joint Replacement

Meniscal tears are generally of different types and a bucket-handle type of tear usually gives the most trouble. These can cause the torn part to come into the joint and get wedged between the 2 joint surfaces (of the shin and thigh bone) causing the joint to get 'locked'. Here there is tremendous pain and inability to fully extend the knee. It has been described as getting something wedged in the hinges of a door causing the door to get stuck.

Investigation

  • X-rays are not useful however may help in diagnosing other follow-up damage or injuries
  • MRI scans can detect meniscal tears and can also delineate the type of tear and thereby help in treatment

Treatment Procedures

Peripheral tears have some capacity to heal; unfortunately tears in the periphery of the meniscus are uncommon. Most meniscal tears do not heal and require surgery in the form of arthroscopy.

Arthroscopic surgery may be in the form of excision of the torn fragment (meniscectomy) or repair (if the tear is in the periphery). Meniscal repair is usually performed in young individuals when the tear is in the periphery.

Following meniscectomy, there is usually no restriction in weight bearing, although patients may need support with crutches. After meniscal repair, patients will be asked to remain non-weight bearing with crutches for a few weeks followed by gradual exercises to regain movement in the knee and weight bearing. Results are generally good and there is considerable decrease in pain.