Explore Meniscus Injuries
What is a meniscus?
The meniscus is a crescent-shaped shock absorber in the knee that sits between the femur (thighbone) and tibia (shinbone). Each knee has two menisci. One is on the medial side, closest to the other knee, and the other is on the lateral side, closest to the outside of the leg. During activities on your feet, the meniscus cartilage cushions the amount of wear and tear on the surrounding articular cartilage, which is the protective layer on the ends of the bones.
Types of Meniscus Injuries
Injury or damage to the meniscus can result from abruptly twisting or rotating the knee; strain during squatting, bending or lifting heavy objects; and hard impacts from a tackle or other sports activity. Injuries can range from a meniscus strain to a partial or full meniscus tear. The treatment for meniscus injury symptoms varies on the degree of injury, and can be as conservative as rest and icing up to more drastic interventions like surgery. Our Sports Medicine team will work with you to determine the best course of treatment.
What Is a Meniscus Tear?
A torn meniscus is a common injury wherein the cartilage that makes up the meniscus cushion is damaged and the integrity of the surface is disrupted. Like with most meniscus injuries, a meniscus can tear during sports activities like running and quickly pivoting. In older adults, degeneration of the cartilage in the knee, also known as osteoarthritis, can weaken the meniscus so that it tears, even if there is little athletic activity or strain. or a degenerative condition. Like a crack in ice, a meniscus tear in a knee can run in many different directions. With some severe tears, a portion of the meniscus can detach or break off from the meniscus.
How to Tell a Meniscus Sprain vs. Tear
The signs of a meniscus sprain are similar to a meniscus tear. Both can include knee pain, swelling and stiffness. Being unable to move your knee and hearing popping sounds can indicate a more severe injury. The more intense your symptoms, the more likely your injury is a tear and not a sprain. Our doctors will conduct a physical examination and may recommend X-rays or MRI to diagnose your injury.
What Causes a Meniscus Tear?
The meniscus can tear suddenly with acute trauma, or wear down gradually and tear over time. Seen often during athletic activity wherein the knee gets twisted with the foot planted, such as basketball, soccer and skiing, a meniscus tear can happen with or without physical contact with other players, like a tackle or body check. A degenerative meniscus tear results from the meniscus wearing out, a condition more common in older people. Pre-existing conditions like osteoarthritis can also contribute to meniscus tears.
Meniscus Injury Symptoms
Pain in the knee, especially during physical activity, is often the first symptom of a meniscus injury. Symptoms generally worsen with additional strain and weight-bearing activity and may include:
- Pain in one or both sides of the knee
- The sensation of the knee catching or locking during movement
- Feeling or hearing a pop with a sudden onset of pain
- A loss of range of motion in the knee
- Weakness in the knee during activity
Symptoms of a Meniscus Tear
Signs of a torn meniscus can include pain and difficulty twisting or moving laterally. In the event of meniscus tears, the patient is more likely to have a decreased range of motion and increased weakness and pain during activity.
Symptoms of a Meniscus Sprain
A meniscus sprain can still be painful and bring about swelling and stiffness. However, a strain won't limit the range of motion as much as a tear and doesn't commonly result in the knee catching or locking.
Meniscus Injury Diagnosis
Diagnosis of meniscus injuries is largely based on a physical examination by one of our providers that takes your medical history into account. We may also employ imaging, such as standing x-ray or MRI, to aid in diagnosis.
Meniscus Injury Treatment
Our providers will work with you to customize a treatment plan based on your recovery goals, the extent of your injury, symptoms, age and activity level. Strains and minor tears may not need surgery, while more severe tears may require surgical repair.
Learn how Mass General Brigham Sports Medicine specialists diagnose and treat a full spectrum of knee conditions, including knee cartilage injuries such as meniscus and meniscus root tears.
Nonsurgical treatment of meniscus injuries is common and includes:
- Acitivity modifications
- Weight loss
- Physical therapy/home exercise
There are three surgical treatments for meniscus tears - trimming the meniscus, repairing the meniscus and putting in a new meniscus.
- Meniscectomy (Meniscus Trimming): The most common meniscus surgery, accounting for about of 90% of all meniscus surgeries, trims back the torn portion of the meniscus to leave behind as much of the fully functioning meniscus as possible. These surgeries can generally be performed on an outpatient basis, meaning that patients generally return home the same day as surgery. Physical therapy and home exercises are common for the first month after surgery. You may use a crutch for a couple of days following surgery, and can typically return to full activity in 4-6 weeks.
- Meniscus repair: Meniscus repairs are typically performed for certain patterns of tears and in certain locations. Your doctor will discuss with you the success rates and potential complications of meniscus repair. This procedure is most common in younger patients, and often performed during concomitant surgical procedures such as ligament reconstruction (ACL, PCL, etc).
- Meniscus transplant: Meniscus transplant is often chosen for patients who have had a meniscus trimmed in the past and may have continued issues due to a lack of the meniscus, even though the surfaces on the ends of the bones are still well-preserved. This is not common, and the recommendation for this will be determined by your healthcare provider.
How to Prevent Meniscus Tears
Most meniscus tears occur during an acute injury, like a slip, fall or athletic strain or overextension. Acute injuries are tough to prevent, but proper knee care can help decrease the chances of injury.
- Strengthen the muscles in your leg to provide better support to your knee
- Warm up properly before activity
- Don't overfatigue leg muscles, which places more strain on your knee
- Ease into new activities and gradually increase activity intensity
- Wear appropriate footwear when exercising to avoid slipping and/or twisting the knee (cleats where appropriate)
What does a torn meniscus feel like?
Patients with a torn meniscus may feel a pop during activity, followed by slight pain. That pain likely will intensify once the inflammation sets in. Patients may also have trouble straightening or bending the knee, experience a sensation of the knee catching or locking during movement and/or notice additional swelling and stiffness.
What does a torn meniscus look like on the outside?
It may be difficult to notice a significant difference in your knee with a torn meniscus just by looking at it. There may be swelling on either side of the knee.
Can a meniscus tear heal on its own?
Some meniscus tears, especially those on the outer one-third of the meniscus where the blood supply is the greatest, may heal on their own. Surgery may be required to heal a torn meniscus that does not heal on its own.
What is a lateral meniscus tear?
A lateral meniscus tear occurs to the meniscus located on the outside of the knee.
Can you walk with a torn meniscus?
Typically, a patient can walk normally with a torn meniscus, and many patients won't experience pain when walking. The pain often intensifies with twisting or bending of the knee and intensified impact.
Can a torn meniscus cause pain down the leg?
The pain from a torn meniscus usually remains localized in the knee.
Can you sprain your meniscus?
Yes, you can sprain your meniscus. YYou will experience similar (but potentially milder) symptoms to those for a torn meniscus.
Can a torn meniscus cause ankle swelling?
Following surgery for a torn meniscus, excess fluid in the body may reach the ankle and cause swelling that will subside within days/weeks.
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