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What Types of Cartilage are in the Knee?
There are two types of cartilage in the knee; meniscal cartilage and articular cartilage. The meniscus is like the shock absorber of the knee. One is located in the lateral (outside) compartment of the knee and the other is in the medial (inside) compartment. The articular cartilage is a protective covering over the bone. When articular cartilage breaks down in the knee it is called arthritis.
How Does the Meniscus Tear?
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The meniscus can be torn in a single twisting event or it can tear slowly over time. Many patients who acutely tear ligaments (such as the ACL) will also have a meniscus injury or tear. Sometimes, however, the meniscus may slowly breakdown under repetitive stress. Once the meniscus has been torn it usually causes pain that is worsened with kneeling, squatting or twisting activities. In addition to pain there may also be swelling, catching or even locking of the knee.
How is a Meniscus Tear Diagnosed?
Photo credit: Shriners Hospital for Children
The diagnosis of a meniscus tear can be made by a thorough physical exam. Most patients will have tenderness along the joint line as well as pain with hyperflexion and twisting of the knee (McMurray Test). Sometimes an effusion (swelling) may be noticed. Although x-rays can show arthritis they aren’t used to confirm a meniscus tear. MRI is the most common imaging study utilized to make the diagnosis.
How is a Meniscus Tear Treated?
Treatment of a meniscus tear typically involves an arthroscopy (scope) where the work is done through two small portals (poke holes) in the front of the knee.
Photo credit: Arthrex
If the meniscal tissue is still healthy the meniscus can be repaired with sutures. If the meniscal tissue is unhealthy a debridement (meniscectomy) of the damaged tissue is preferably performed. Meniscal repairs take longer to recover from since the tissues have to heal back together before returning to sports. Most patients who undergo a meniscal repair can get back to their normal activities in about 3 to 4 months. When the meniscus is removed the healing process is much quicker. Patients can walk right away and be healed up in about 2 to 3 weeks as long as no arthritis is present. The surgery is done as an outpatient and, depending on the desire of the patient, can be done either while the patient is asleep or awake under a local anesthetic.
If you have been dealing with knee pain for a while or just haven’t got over that recent twisting injury come in for an evaluation at ISMI. To set up an appointment for further evaluation, please call (208) 336-8250.