First let us understand the exact location of the torn meniscus. Our knees give full support to the body by equally distributing the body weight on both the legs and allow flexible movement. Our knees are joint together by three main parts that is – the femur bone (thigh bone), the patella (knee cap)and the tibia (shin bone) . The meniscus, located at the surface of the bones, connects these parts together and acts as a shock absorber.
There are 2 menisci found in each knee. The medial meniscus is located inside the knee, which supports the rounded edge of the femur. The lateral meniscus rests outside of a knee, which supports the same femur’s external rounded part. Together these c-shaped tough cartridges ensure easy movement of the knees and do not let the femur bone crush the tiny tibia bone. However the centre of theses meniscus does not have any blood supply.
TORN MENISCUS CAUSES
In young adults or children, trauma or accident could be the cause for the meniscus to tear. Athletic sports or forceful or a sudden turn or squatting may cause the meniscus to be damaged. In elderly it is mainly the natural degenerative process.
TORN MENISCUS SYMPTOMS
Immediately after the damage the person experiences pain and swelling in that area. In many cases it has been reported that a popping sound is heard. But mainly when the knee becomes stiff or rotation and bending of the knee becomes a problem then the doctor checks the meniscus for damages. Unhappy traid is the injury that is caused mostly to the footballers. In this the anterior cruciate ligament and the medial collateral ligament are damaged together causing tenderness and in a few cases fluid collection. These injuries are also an early sign of osteoarthritis.
TORN MENISCUS DIAGNOSIS AND TREATMENT
A through physical examination, the symptoms and the signs are enough for a doctor to identify a torn meniscus. An x-ray may be done to rule out any other problem like arthritis.
- After a tear is confirmed an ultrasound and MRI is done to know the condition of the tissues and also to determine if a fragment of the meniscus is struck between the joints. As the centre of the meniscus does not have any blood supply, any injury to this area is difficult to heal.
- After proper identification of the injury the treatment is decided by taking into consideration the medical history, age of a patient and level of physical activity. Initially an ice compression and through rest is advised along with some anti-inflammatory drug.
- Even cortisone injections have proved to be very effective. This helps most of the sufferers. But in case of excessive damage, like the patient are unable to bend the knees nor able to straighten them, then a surgery may be performed.
- The most common procedure is meniscectomy. It is done through an arthroscope, where in the instrument is inserted through a pin hole made near the injured knee. The damaged meniscus is viewed and is cut and removed through the surgical instrument which goes through the second incision. Recovery is faster and the patient might need physical therapy. Physical therapy may be given to any patient with or without the surgery as it strengthens the muscles which in turn stabilize the knee.
- Meniscal transplantation and Meniscus repair are also other options available in severe cases. Meniscus repair is the same as meniscectomy only in this case the entire meniscus is removed and sutures are placed. When all types of treatment have failed and the patient has undergone meniscus repair, but is still experiencing knee pain then a transplant may be the only option available. This transplant has very fixed criteria and cannot be performed on most of the patients. Under this procedure the meniscus is taken from a donor and positioned into the knee of the patient. This procedure is still under development. It has been performed on a few patients with different results. Some had to undergo another surgery, whereas few had to get the donor meniscus removed as it just added to the problem.
It should be noted that if the tear is on the outer rim of the meniscus then healing is very effective. However if the tear is in the centre of the meniscus where there is no blood supply (the non-vascular region) the healing is not possible even after a surgery. Prevention and life style changes are necessary. Exercise and protective gear is the best way to keep the pain away. A physiotherapist is the best person to help strengthen the muscles.