What in the Name of Human Anatomy is a Meniscus?
If you were a meniscus, where in the body would you be? You might not know it, but you would be in a knee!
Menisci are half-moon shaped pads of fibro-cartilage inside your knees. They are flat on the bottom, where they attach to your Tibia (the big bone in your lower leg), and concave on the top where they articulate with your femur (your thigh bone). Each knee has two meniscal pads, one on the outside surface of the tibia (the lateral meniscus) and one on the inside surface of the tibia(the medial meniscus). These very useful structures serve to provide your knees with more stability and act as buffers which help absorb shock, disperse your body weight, and reduce friction during movement.
The Menacing Meniscus
While menisci are very useful to have, they are also one of the most commonly injured parts of the knee. There are two main types of meniscal tears: “Acute tears” and “Degenerative tears”. Acute tears are usually traumatic and associated with a twisting injury to the knee while your foot is firmly planted on the ground. This type of injury usually affects the medial meniscus on the inside of your knee, and is sometimes associated with a tearing sound at the time of injury. The meniscus can tear in many different ways, sometimes creating a flap of cartilage that “catches” when you move your knee. Degenerative tears occur over time as a result of wear and tear, and are usually associated with some degree of knee arthritis. These tears generally occur as a sort of “fraying” along the inside edge of the meniscus.
- Swelling of your knee
- Clicking and locking sensations in your knee
- Knee Pain
- Inability to move your knee through it’s full range of motion
- Inability to fully bear weight on your knee
Mending your Meniscus
The management of meniscal tears depends on a variety of factors. Small, degenerative tears are initially treated conservatively and monitored to assess healing or progression; where as large, traumatic, “flapping” tears usually require immediate surgical intervention. Of course, most tears will fall somewhere in the middle of these extremes. In such cases, the decision of whether to go under the knife will be based on the severity of symptoms as well as your lifestyle demands.
Below are a few factors that indicate a meniscal tear will likely respond well to conservative treatment:
- Symptoms only develop 24-48 hrs after your injury
- You only experienced a minor trauma or have no recollection of injuring your knee at all
- You are able to weight bear
- Your knee can go through it’s full range of motion with pain only at the end-range
- You have previously recovered quickly from a similar injury
- X-Rays show only minor signs of degeneration
Another important factor to consider when deciding on the appropriate treatment for a meniscal tear is it’s location and orientation. Only the outer third of the meniscus rim has a blood supply and is able to properly heal. These tears are good candidates for surgery if it is deemed necessary. On the other hand, degenerative flaps and other complex types of tears that are not in an area with a good blood supply do not respond well to surgery and will likely benefit more from a conservative approach.
In the event of a severe twisting injury where surgery is required immediately, the surgeon will aim to preserve as much meniscus as possible, usually cutting away only the flapping bits, or attempting to suture the meniscus back together. If surgery is required, it is advisable to undergo a rehabilitation program before surgery as well as after.
Take Home Meniscus Message
Meniscal injuries are common and can be extremely painful, however the severity of pain does not correlate well to the severity of damage or injury to the internal structure. If you suspect you have injured your meniscus, get it checked by a professional and take the necessary steps to ensure your knee heals up as best as possible. We use our knees every day, and we only get two! It is well worth looking after them!
Move Well. Live Well.