What is the meniscus?
The meniscus is a pad of cartilage with a limited blood supply. There are two in each knee. It is a separator cushion between the upper and lower leg bones preventing them from rubbing together and protects the cartilage covering the ends of the bones. It is an indispensable part of the knee and plays a vital role in shock absorption and load transmission while walking, running and jumping.
The meniscus provides knee stability, limits knee flexion and extension and provides proprioception. Knee proprioception protects the knee from extreme movements, stabilizes posture, maintains balance and coordinates movements.
What is a meniscus tear?
Meniscus tears can result from trauma and from the aging process. A meniscus tear is one of the most common knee injuries among athletes, particularly competitive athletes. The professional athlete’s agility may seem effortless, yet jumping, sprinting and swerving can lead to a torn meniscus. You have likely heard of a meniscus tear in the news when a player suffers a knee injury. A serious meniscus tear can end a professional career. The incidence of meniscus injuries is on the rise due to increased sports participation by youth. Meniscal injury is one of the most common sports injuries in day-to-day practice.
Meniscus tears are increasingly common with age and are often discovered without knee trauma. Degenerative cartilage and meniscus tears often occur together in older individuals. Moreover, knee trauma in younger people is often not reported and some individuals may have a predisposition to atraumatic meniscus damage which reflects a propensity for developing OA.
Common symptoms are pain particularly with weight bearing and knee rotation, stiffness and swelling; and causes knee instability. An initial injury evokes sense of knee popping and also an audible popping sound. However, it is not uncommon that a meniscus tear causes no pain or other symptoms particularly in older people. Many patients have reported being unaware of an injury and waking up from sleep due to the pain.
How dangerous is a meniscus tear?
While a meniscus tear can seem like a minor injury with only a little pain because you can still walk, but left untreated it can interfere with your ability to exercise and play sports; and can cause meniscus cartilage fragments in the joint which can lead to the knee locking and catching.
Many individuals can walk after a tear and some athletes can even play but this can be deceiving because symptoms may not appear for several days after the injury occurs.
A damaged meniscus is also associated with injury to the articular cartilage on the ends of the bones which causes pain and impairs function.
How can a meniscus tear affect the long-term health of my knee?
Studies show that these tears are common in the elderly especially in people who have symptoms of knee arthritis. As baby boomers develop knee osteoarthritis (OA) research is focused on why and the studies suggest that a torn meniscus increases the risk of knee OA.
As early as 2009 studies reported that meniscus damage plays an important role in the development of knee OA. A 2013 study reported that knees with meniscus tears are at greater risk for developing OA later in life.
Knees with known meniscal injury have accelerated cartilage wear, leading to early onset of osteoarthritis. Studies report that meniscus tears can lead to osteoarthritis of the knee, and conversely, OA of the knee can cause degenerative meniscus tears. Treatment for a meniscus tear may be conservative with injections and physical therapy. However, as evidence continues to grow on the essential role of the meniscus, my practice and shifted more and more to repairing meniscus tears to protect the cartilage of the knee and improve the long-term health of the knee.
When should I see an orthopedic surgeon?
If you have pain during or after practice or days later, or you don’t play sports look for these symptoms: knee swelling, hearing a popping sound or a feel that the knee is buckling or locking and knee motion is limited, it is time to call Dr. Cooper.
He will ask about your symptoms and what causes them, examine your knee, and perform specific range of motion tests of the knee. When these tests cause a feeling of clicking or you can hear the clicking it is likely a torn meniscus. He will order an MRI to diagnose your condition. Then he will recommend the best treatment for you with the goal of preventing onset of degenerative wear and tear arthritis including meniscus repair or replacement.
Dr. Joe Cooper is a fellowship trained orthopedic surgeon who specializes in sports medicine with a focus on the knee, hip, elbow and shoulder. He has devoted his career to helping people of all ages and athletic ability to attain their best function and live a pain free life.