Meniscus tears

• Alternative Names

  Tear - meniscus; Knee injury - meniscus; Knee cartilage tear

• Considerations

  The meniscus is a C-shaped piece of cartilage. Cartilage is found in certain joints and forms a buffer between the bones to protect the joint. The meniscus serves as a shock-absorption system, assists in lubricating the joint, and limits the ability to flex and extend the joint.

• Causes

  Meniscal tears are most commonly caused by twisting or over-flexing the joint.

• Symptoms
  • A "pop" may be felt at the time of injury
  • Joint pain
  • Knee pain in the space between the bones; gets worse when gentle pressure is applied to the joint
  • Locking of the joint
  • Recurrent knee-catching
• First Aid

  The health care provider will perform the McMurray's test. For this test, you lie on your back while holding the heel of your injured leg with your leg bent. Pressure is placed on the outside of the knee with the doctor hand, and the leg is straightened with the foot turned in (internally rotated). Pain or a click over the inner part of the joint means an inner (medial) meniscal tear.

  For an Apley's compression test, the health care provider will have you lie on your stomach with your knee bent at a 90 degree angle. The provider will grab your foot with both hands and rotate it to the outside (lateral rotation), while a downward force is applied to the foot. The provider's knee and thigh may be used to stabilize your thigh. Pain in the inner part of the joint may indicate an inner (medial) meniscal tear.

  A test for excess joint fluid is positive in meniscal tears, indicating swelling with fluid around the joint.

  Other tests that show meniscus tears may include:

  • Knee MRI
  • Knee joint x-ray

  The goal of treatment is to reduce symptoms and protect the joint from further injury while it heals.

  You should not put your full weight on the knee. You may need to use crutches. A knee immobilizer is often applied to prevent further injury to the joint.

  Other treatments include:

  • Ice to reduce swelling
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce swelling and pain

  Physical activity is allowed, as tolerated. Physical therapy is recommended to help regain joint and leg strength.

  If the injury is acute or if you have a high activity level, knee arthroscopy (surgery) may be necessary. Age has an effect on treatment. Younger patients are more likely to have problems without surgery.

• Do Not

  Do NOT put all your weight on your leg if it is painful.

• Call immediately for emergency medical assistance if

  Call your health care provider if symptoms of meniscus tears occur after an injury to the knee.

  Call your health care provider if you are being treated for a meniscus tear and you notice increased instability in your knee, if pain or swelling return after they initially subsided, or if your injury does not appear to be resolving with time.

  Also call if you reinjure your knee.

• Prevention

  Use proper technique when exercising or playing sports. Many cases of meniscus tears may not be preventable.

Review Date: 5/12/2008

Reviewed By: Thomas N. Joseph, MD, Private Practice specializing in Orthopaedics, subspecialty Foot and Ankle, Camden Bone & Joint, Camden, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.