Published: Jan. 6, 2012
Updated: Jan. 6, 2012
The knee is one of the most commonly injured parts of the body, and meniscal tears are often the cause of knee injury.
The meniscus is the tough, rubbery cartilage that absorbs shock between the shin bone and thigh bone and distributes weight across the knee joint. When this cartilage tears, it can cause pain and instability in the knee joint.
Meniscal tears can result from a twisting injury in sporting activities, such as football or soccer, or even something as simple as turning to put the dishes away.
Donald F. O'Malley Jr, MD, a knee expert at Duke, explains how knee arthroscopy is used to treat meniscal tears.
People of all ages can suffer from meniscal injuries, but each age has different types of tears and different ways to treat the tears.
Almost all tears have similar symptoms, including:
When you experience these symptoms, it is important to see an orthopaedic surgeon so that your knee can be examined to make an accurate diagnosis.
Occasionally, the diagnosis is obvious based upon a description of the injury and an examination of the patient. However, x-rays and magnetic resonance imaging (MRI) are frequently used to help identify any other associated injuries.
The most common findings on exam include tenderness over the joint line where the meniscus is torn, swelling, and sometimes loss of motion.
Once the diagnosis of a meniscal tear is made, patients must discuss a treatment plan with their orthopaedic surgeon. For most people who have a symptomatic meniscal tear, arthroscopic surgery is selected to remove or repair the torn tissue.
Arthroscopy has revolutionized how knee surgery is performed. In the past, a torn meniscus required a three- to four-inch incision and an overnight stay (or two) in the hospital.
Now, the meniscal tear can be repaired with the arthroscope through two tiny (less than a half inch) incisions. The surgery can be performed on an outpatient basis in less than an hour.
For some patients, the surgery can be performed under local anesthesia with sedation so that there is minimal anesthesia risk. Occasionally, small stitches can be placed into the torn cartilage to sew it back together; this technique can successfully treat large tears in younger patients.
Recovery from arthroscopic meniscal tear surgery is relatively quick, and most patients are able to resume normal activities within a few weeks. The pain relief is dramatic, and the postoperative incision pain is quite minimal.
Physical therapy is often necessary in the recovery process. As with any surgery, there are risks, including the risk of infection or blood clots. Additionally, there are risks associated with anesthesia used during the surgical procedure.
While meniscal tears are very common, painful, and activity-limiting, these injuries can be quickly, easily, and successfully identified and treated.
The following video shows an actual menisal tear and an arthroscopic removal of the meniscal tear. My goal in creating the video was to give patients a better understanding of what meniscal tears look like and how they can be treated.
Donald F. O'Malley Jr, MD, is a surgeon at Duke Orthopaedics.