Pop goes the knee

Meniscal tears may have lifelong consequences

Imagine you are playing basketball with the boys or running in the park on a Saturday morning or burning off hundreds of calories with Zumba at the gym. A sudden turn, a bad landing after a jump, repetitive pounding on concrete, and you hear a loud pop and a surreal tearing sensation in your knee. It gives out and you are on the floor and in excruciating pain. Chances are you have just experienced one of the most common knee injuries: a torn meniscus.


The meniscus is a C-shaped cartilage in the knee that acts as a shock absorber to disperse the friction between the thigh and lower leg. There are two menisci in each knee, a lateral (outer) and medial (inner) meniscus, and one or both can be damaged by sudden pivots (like in basketball and tennis), direct contact (American football, anyone?), squatting and kneeling, trauma, and—the curse of the human body—age.


The most obvious sign of injury to the meniscus is pain that often gets worse when straightening the leg. There may also be some swelling in the area. And if you find that you cannot put full weight on your knee, it is probably time to see a doctor. 


Small meniscal tears may require only rest and anti-inflammatory medication. Larger tears, depending on location and severity, may heal better after arthroscopic meniscus surgery, where a thin tube with a camera and light is inserted into the knee to examine the tear, and then repairs are made using surgical instruments that are inserted into that same incision. (Probably not something you want to watch if you have a delicate stomach.) Severe tears that cannot be repaired often require a meniscectomy, the partial or complete removal of the meniscus.

A partial meniscectomy can be performed under local anesthesia, using an arthroscope. The damaged parts of the meniscus are removed and the edges of the healthy cartilage are smoothed out to relieve pain and swelling. Studies have shown that 78% to 88% of those who have undergone this procedure had decreased symptoms and were able to return to normal activities.

A complete meniscectomy is a drastic measure and done only when all options are exhausted because without the meniscus protecting the knee joint, it degenerates much faster. Those who undergo a complete meniscectomy will likely not be able to return to all physical activities they previously enjoyed, such as running and other knee-stressing sports.

Sources:

• http://orthoinfo.aaos.org/topic.cfm?topic=a00358
• http://www.webmd.com/a-to-z-guides/meniscus-tear-topic-overview

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