A torn meniscus is one of the most common knee injuries seen by orthopaedic specialists in Singapore. Any activity that requires you to forcefully twist or rotate your knee, especially if you put your full weight on it, can result in a torn meniscus.
Our knee joint is formed with three bones: thighbone (femur), shinbone (tibia), and kneecap (patella). Between the thigh bone and shinbone are two wedge-shaped pieces of fibrocartilage that act as shock absorbers. These two wedge-shaped pieces are referred to as menisci. The menisci help to transmit weight from one bone to another and play an integral role in knee stability.
The meniscus can tear from acute trauma or as a result of degenerative changes with ageing. Tears are often categorised by how they look and where the tear occurs in the meniscus. Sports-related meniscus injuries tend to occur along with other knee injuries such as anterior cruciate ligament (ACL) tears.
Signs and Symptoms
If you have torn your meniscus, then you may experience some of these signs and symptoms in your knee:
- Pain especially when you try to twist or rotate your knee
- Swelling or stiffness
- A popping sensation
- Difficulty in straightening your knee fully
- A locked feeling in your knee when you try to move it
- Feeling weakness in your knee, as though it might give way
While most people can still walk on their injured knee, stiffness and swelling may happen gradually after a couple of days. In some patients, the pain and swelling recurs every time they engage in more vigorous activities. Hence, it is best to contact your doctor or visit an orthopaedic specialist if you are experiencing pain and swelling in your knee, or if you cannot move it in the usual ways.
Causes and Risk Factors
Most acute meniscus tears happen during sports through a contact or non-contact injury like aggressive pivoting or sudden stops as well as turns. Some actions such as kneeling, deep squatting, or lifting a heavy object can also result in a torn meniscus.
Furthermore, as people age, they are more likely to be at risk of degenerative meniscus tears. For instance, an awkward twist when getting up from a chair or sitting position may cause a tear in an ageing meniscus.
During your consult, your orthopaedic specialist will perform a physical examination to identify a torn meniscus. For instance, the doctor may press your knee over the meniscus to check for tenderness, do special tests which involve moving your knee and leg into different positions, check the way you walk, or ask you to squat.
Your orthopaedic specialist may also order for imaging tests like X-rays or an MRI. Since the meniscus is made of cartilage, it will not show up on x-rays; however, X-rays help to determine the alignment of the knee, and rule out other possible problems of the knee, such as arthritis, that may cause similar symptoms.
The ideal imaging test used to diagnose meniscus tears is an MRI scan. Using radio waves and a strong magnetic field, an MRI scan can produce detailed images of both hard and soft tissues within your knee, allowing the doctor to detect a torn meniscus, and check for associated cartilage injuries.
The treatment plan for meniscus tears is dependent on the type, size, and location of your tear, as well as the timing from injury. Treatment usually starts with conservative (nonsurgical) options include resting and avoiding activities that may aggravate your condition. Your doctor may also recommend you ice the area regularly to reduce knee pain and swelling. Medications such as pain relievers or anti-inflammatory medication may also be prescribed to help ease knee pain and reduce joint inflammation. Physical therapy is usually recommended to regain joint motion and strengthen surrounding muscles.
However, if your knee remains painful despite conservative treatment and physical therapy, then your doctor might recommend surgery as a treatment option. The most common surgical procedure for meniscus tears is a keyhole procedure known as knee arthroscopy. Through keyhole incision, the surgeon can repair your meniscus or remove unhealthy parts of the meniscus that will not heal. In cases where the meniscus is severely damaged beyond repair, a meniscus augmentation or transplant can be performed.
However, if the presentation is late, and meniscus tear or cartilage damage has progressed to advanced arthritis, then your surgeon may recommend a knee osteotomy to offload the damaged compartment of your knee, or a partial or total knee replacement surgery, depending on your age and how extensive the damage to your knee is.
Every case is different; hence it is best to consult an orthopaedic surgeon for an accurate diagnosis so that you can obtain the best treatment option that is most suitable for you. Reach out to us today if you suspect that you are suffering from a meniscus tear, and let us design an individualised treatment to help you enjoy a better quality of life.