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Knee Meniscus injuries
Wnat is a meniscus injury?
A meniscus tear is a significant knee injury that affects the shock absorbing cartilage between the bones in the knee.
The meniscus is a piece of cartilage in your knee that cushions and stabilises the joint and protects the bones from wear and tear. There are two of them in each knee. Twisting injury can tear the meniscus.
In some cases with meniscal tears, a piece of the torn cartilage breaks loose and gets wedged in the knee joint, causing the knee to lock.
Meniscal tears are common in contact sports, like football, as well as in cricket, skiing and volleyball. They can happen when a person changes direction suddenly while running, and often occur at the same time as other knee injuries, like an anterior cruciate ligament (ACL) injury. Meniscal tears are a special risk for older sportspeople, because the meniscus weakens with age. More than 40% of people aged 65 or older have meniscus tears, although they do not always cause symptoms.
How do we treat knee meniscus injuries at the Mansfield Clinic?
It depends on the extent of the meniscus injury. If the meniscus injury is degenerative in nature, and simple anti-inflammatory measures have not helped, then a cortisone injection into the knee can be very helpful.
Patients will be given a regime of strengthening exercises to do, in order to help stabilise the knee.
If there has been a large meniscal tear, or part of the meniscus has detached, then it may be necessary to obtain a surgical opinion. Dr Allfree can arrange appropriate surgical referral.
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What does a meniscus tear feel like?
Symptoms of a meniscus tear include:
- Pain
- Swelling
- A popping sensation at the moment of injury
- Difficulty bending and straightening the leg
- A tendency for your knee to lock
At first, the pain may not appear to be too bad. You might even be able to play through the injury. But once the inflammation starts to set in, your knee will begin to hurt considerably.
To diagnose a meniscal tear, Dr Allfree will examine your knee, and will want to find out exactly how the injury took place. X-rays may be necessary, to rule out broken bones and other problems. You may also need an MRI scan,because this can show the damage precisely by taking cross-sectional pictures through the knee. If an MRI is necessary, this can be arranged at the Mansfield Clinic.
Sometimes, in older people, meniscal tears can be degenerative in nature. Degenerative meniscal tears can happen quite easily, with everyday activities like simply climbing stairs, especially if the leg twists at the same time.
What is the treatment for a meniscus tear?
Fortunately, mild-to-moderate meniscus tears may settle on their own, given time. If Dr Allfree feels you have a relatively minor injury, he may simply treat you with some gentle osteopathy, and advise some simple exercises. In addition, to help speed the healing, you can use the RICE regime:
- Rest the knee. Try to avoid putting weight on your knee as much as possible. You may need to use crutches for a time.
- Ice your knee to reduce pain and swelling. Do this for 20-30 minutes every 3-4 hours for 2-3 days, or until the pain and swelling is gone. Never apply ice directly to the skin, always wrap it in a cloth.
- Compress your knee. Use an elastic bandage on your knee to control swelling.
- Elevate your knee on a pillow when you're sitting or lying down.
Other helpful measures include the following:
- Wear a knee brace to protect your knee from getting re-injured.
- Take anti-inflammatory painkillers. Anti-inflammatory drugs like ibuprofen will help with pain and swelling. However, these medicines can have side-effects, like an increased risk of bleeding and ulcers.
- Practise stretching and strengthening exercises.
Degenerative meniscal tears can sometimes respond very nicely to a steroid injection into the knee joint, simply to reduce the inflammation. Dr Allfree has had many years’ experience in the use of steroid injections for musculoskeletal injuries.
Conservative treatments may not always be enough. If a large piece of cartilage has torn, or the meniscus has split, you may need surgery to remove the damaged part of the cartilage. The procedure is fairly simple, and is usually done with a type of keyhole surgery called an arthroscopy. An arthroscope is a thin, flexible tube with a camera on the end. It can be inserted into your knee through a very small incision. Through this instrument the surgeon can see the extent of the damage, remove any broken pieces of cartilage, and trim frayed areas of the meniscus. Normally you will be able to go home on the same day. If you need a surgical opinion, Dr Allfree will be able to arrange a referral.