A meniscal tear is a common knee injury that occurs when one of the two C-shaped pieces of cartilage in the knee joint, called the menisci, are torn. The menisci act as shock absorbers and help to stabilise the knee joint. They are made of tough, rubbery cartilage, and they can become torn with twisting or rotation of the knee. The meniscus is a resilient structure in younger individuals but with age the meniscus undergoes degenerative change and becomes easier to tear as we age.
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Meniscal tears are common in people who play sports or participate in activities that involve twisting or rotating the knee, such as football, basketball, and skiing. They can also occur in older adults who have degenerative changes in their knees. In older age a meniscal tear can result from low force injuries and as a result are far more common.
The main symptoms of a meniscal tear are focal pain, catching, swelling, and stiffness in the knee. You may also have difficulty bending or straightening your knee, or you may feel a clicking or popping sensation when you move your knee. In some cases, the knee may give way or lock up.
A doctor will diagnose a meniscal tear by taking a medical history and performing a physical examination. They may also consider an MRI or X-ray to confirm the diagnosis. A meniscal tear can be easily identified on a MRI where a line is seen through the structure. Sometimes the torn meniscus can be unstable, where a part of the meniscus may be floating or moving in and out of the joint, resulting in mechanical symptoms, such as catching, locking and giving way.
The treatment for a meniscal tear depends on the severity and age of the tear and the patient's symptoms and their day-to-day functional requirements. In some cases, nonsurgical treatment, such as appropriate physiotherapy may be all that is needed. However, if the tear is severe or causing mechanical symptoms then surgery may be necessary to repair or trim the torn meniscus.
On occasion the torn meniscus may be associated with localised inflammation and focal pain along the joint line (inner or outer side of the knee). When focal pain occurs without mechanical symptoms, such as locking, catching or giving way, then a targeted, ultrasound-guided knee joint line injection can be an effective way of facilitating rehabilitation.
At The Joint Injection Clinic, these injections are performed after a thorough consent process, whereby the risk and benefits of the procedure are discussed in detail with your doctor. The experienced medical doctor will then place you in a side-lying position. The knee joint line is cleaned using a cleaning solution to ensure that the procedure is performed under sterile conditions. The combined local anaesthetic and steroid is injected from the skin to the joint line under ultrasound guidance.
The injection itself is normally completed within 30 seconds, after which a plaster is applied and post-injection advice is given. The patient is advised to look out for any signs of infection, specifically to check whether the local area becomes red, hot, tender, swollen or if they develop a fever. If this occurs then the patient is asked to contact the clinic immediately at which time a formal reassessment will occur and if needed oral antibiotics can be prescribed. The patient is also warned that following this particular injection they may notice a short-term worsening or flare in their symptoms after the local anaesthetic has worn off (4-5 hours). This may last for 3-5 days and the patient is advised to consider icing of the area using an ice pack for 10-15 minutes every hour as required.
Arthroscopic surgery is a minimally invasive procedure that is performed using a small camera and surgical instruments inserted through tiny incisions in the skin. The aim of surgery is either to fix and repair the tear or to debride and remove the damaged bit of meniscal tissue.
Recovery from Surgery The recovery time from surgery for a meniscal tear varies depending on the severity of the tear and the patient's individual healing process. Most people are able to resume their normal activities within a few weeks of surgery.
