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Meniscus Tears Specialist
Dr Poh Seng Yew
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
What are Meniscus Tears
Meniscus tears are injuries to the menisci, which are two pieces of C-shaped cartilage located in each knee joint. These structures provide cushioning and stability, distributing body weight evenly across the knee. Meniscus tears can vary in type, including radial, horizontal, and complex tears, each differing in severity and implications for knee function.
The injury often occurs during activities that involve twisting or turning quickly, particularly when the foot is planted and the knee is bent. This can result in a tear in the meniscus, leading to knee pain, swelling, and limited movement.
Causes of Meniscus Tears
Meniscus tears arise from both traumatic incidents and degenerative processes.
Traumatic Causes
These are common in active populations, particularly athletes. Sports that involve quick turns, jumps, or direct contact, such as football, basketball, and soccer, often lead to these types of injuries.
It involves a forceful twist or rotation of the knee while the foot is planted, sometimes accompanied by a sudden change in direction or speed. In younger people, whose meniscal cartilage is tougher and more resilient, force is required to produce a tear.
Degenerative Causes
As individuals age, the meniscus undergoes natural wear and tear. The cartilage becomes thinner and weaker, making it more susceptible to tearing even with minor strain. Simple activities like squatting, lifting, or stepping incorrectly can result in a tear.
This type of meniscus tear is more prevalent in the older population, reflecting the cumulative effect of years of knee movement and stress.
Symptoms and Signs
Identifying the symptoms and signs of a meniscus tear can aid in timely diagnosis and treatment.
- Knee Pain: This is often the first indication of a meniscus tear. The pain may be sharp and located at the side or centre of the knee, depending on the tear’s location.
- Swelling: This usually occurs within the first 24 hours of the injury. Swelling is a result of inflammation and fluid accumulation in the knee joint.
- Popping Sensation: This may occur during the movement of the knee.
- Restricted Movement: A limited range of motion in the knee joint is common, where individuals find it hard to fully straighten or bend the knee.
- Knee Locking or Catching: In some cases, torn cartilage can interfere with knee joint movement, causing the knee to get stuck or locked during movement.
- Feeling of Instability: A feeling that the knee might give way under stress or during regular activities.
Diagnosis
The process of diagnosing a meniscus tear involves a combination of clinical evaluation and imaging studies.
- Medical History and Physical Examination: Diagnosis usually begins with a detailed medical history, focusing on the onset, nature, and duration of symptoms. The physical exam involves assessing knee tenderness and range of motion to detect meniscus injury.
- Imaging Tests: MRIs are used to provide detailed images of both soft and hard tissues, including the meniscus. Though X-rays do not show meniscus tears, they can help rule out other causes of knee pain, such as osteoarthritis.
Non-Surgical Treatment Options
For many individuals with meniscus tears, non-surgical treatment can be an effective option, especially when the tear is small and the knee is stable.
Rest |
Limit activities to reduce stress on the knee joint. This may involve avoiding activities that exacerbate knee pain and swelling. |
Ice Therapy |
Applying ice to the knee can help reduce swelling and pain. This is particularly effective during the first few days post-injury. |
Medications |
Pain relievers such as acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs) can help manage pain and reduce inflammation. |
Physical Therapy |
A structured physical therapy program can strengthen the muscles around the knee, improving stability and function. Exercises are tailored to individual needs, focusing on enhancing range of motion and reducing pain. |
Surgical Treatment Options
Surgery may be considered for meniscus tears that do not respond to non-surgical treatments, particularly in cases where the tear is large, the knee is unstable, or the individual is highly active.
- Knee Arthroscopy
This technique involves small incisions (keyholes) through which a camera and surgical tools are inserted. It allows the surgeon to view the knee interior and perform repairs or removal of the damaged meniscus. - Meniscus Augmentation or Transplant
Augmentation involves reinforcing the damaged meniscus, while transplantation involves replacing it with donor tissue. These procedures are considered when the meniscus is too damaged to be repaired, aiming to restore knee functionality and alleviate symptoms. - Knee Osteotomy
This is used primarily for patients with uneven knee wear, often due to meniscus tears leading to arthritis. The procedure involves cutting and reshaping the bones to redistribute weight away from the damaged area, thereby reducing pain and improving function. - Knee Replacement Surgery
In cases of severe joint damage, partial or total knee replacement may be considered. This involves replacing the damaged knee joint with artificial components. The extent of the replacement (partial or total) depends on the degree of damage and the patient’s overall knee health.
Prevention Strategies
Preventing meniscus tears involves measures aimed at reducing the risk factors and strengthening the knee.
- Exercise and Strength Training - Regular exercise focusing on strengthening the leg muscles, particularly the quadriceps and hamstrings, can provide better support and stability to the knee.
- Flexibility Training - Incorporating stretching exercises into a regular fitness routine can improve flexibility, reducing the risk of injuries to the knee.
- Proper Technique and Equipment - Athletes and individuals engaging in sports should ensure they use the correct technique and appropriate equipment to minimise the risk of knee injuries.
- Avoiding High-Risk Activities - Understanding and being cautious of activities that pose a higher risk for knee injuries, particularly those involving sudden changes in direction or intense pivoting, can help prevent meniscus tears.
- Maintaining a Healthy Weight - Excess body weight can increase the stress on knee joints. Maintaining a healthy weight can reduce this pressure and decrease the risk of meniscus injuries.
Dr Poh Seng Yew
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
With over 18 years of experience, Dr Poh Seng Yew is an orthopaedic surgeon specialising in hip, knee, shoulder and elbow surgery, sports medicine, and trauma surgery.
- Former Director of Sports Service, Department of Orthopaedic Surgery, Singapore General Hospital
- Clinical Hip and Sports Medicine Fellow, Orthopädische Chirurgie München (OCM), Germany
- Fellow, Royal College of Surgeons of Edinburgh, FRCSEd (Orthopaedic Surgery)
- Master of Medicine (Orthopaedic Surgery), National University of Singapore
- Member, Royal College of Surgeons of Edinburgh (MRCSEd)
- Bachelor of Medicine, Bachelor of Surgery (MBBS), National University of Singapore
Insurance
Shield Plans
Corporate Partners
Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Weekdays: 9.00am – 5.00pm
Saturdays: 9.00am – 1.00pm
Sundays and Public Holidays: Closed
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Frequently Asked Questions (FAQ)
What are the common symptoms of a meniscus tear?
Common symptoms include knee pain, swelling, restricted movement, locking or catching of the knee, and a sensation of instability.
Can a meniscus tear heal on its own?
Some small meniscus tears, particularly those on the outer edges where the blood supply is better, can heal on their own with rest and conservative treatment. Larger or more complex tears often require medical intervention.
How long does a meniscus tear take to heal?
Recovery time depends on the severity of the injury. Mild meniscus injuries typically heal in 6-8 weeks, but sometimes take a few months. Knee arthroscopy recovery takes about 4-6 weeks, but may be longer if extensive repair is needed. Meniscus augmentation or transplant recovery often takes several months, up to a year for full physical activity. Knee osteotomy recovery is around 3 months, while full knee replacement takes 6 months to a year. Partial knee replacements usually recover in 4-6 weeks.
Can meniscus tears be prevented?
While not all meniscus tears can be prevented, risks can be reduced through regular exercise and strength training, maintaining flexibility, using proper techniques during sports, avoiding high-risk activities, and maintaining a healthy weight.
Is it possible to return to sports after a meniscus tear?
Many individuals can return to sports after a meniscus tear, though the timeline and likelihood depend on the severity of the tear, the chosen treatment, and adherence to a rehabilitation program.