Meniscal Injuries
The Meniscus (also known as cartilage) is a fibrocartilage in the knee that very unique shape, design and purpose. The purpose of the meniscus is to be a shock absorber and space filler for the knee. The menisci are of a “C” shape. This shape corresponds to the surface of the femur. They also have a wedge shape to them that helps with stability. This would be similar to the wedges used as door stops.
As stated, the meniscus is a shock absorber. It helps to dissipate the forces in the knee caused by all activities such as sitting, walking, running, jumping, etc. The goal is to disperse the forces over a greater area as opposed to isolating them.
If you look at the meniscus, you can see both the “C” shape and the wedge shape of the meniscus.
Evaluation and Treatment of Meniscal Injuries
Meniscal tears are fairly common. The typical mechanism of injury is a twisting and flexing motion of the knee. There are several different types of tears that can occur, degenerative, front to back or bucket handle. These injuries must be addressed, due to the fact that if left untreated, further damage to the meniscus or end of the femur (articular cartilage) can occur.
Symptoms of a meniscus tear may include but are not limited to the following:
Pain along the joint line, swelling, popping, clicking and even locking of the knee joint.
Evaluation
Accurate diagnosis starts with the history of the injury and the physical examination. Dr. Lowe will ask a series of questions to get an idea as to how your injury occurred and what symptoms that you are having. He will then perform specific tests to try and determine the diagnosis. Many times this alone will not reveal any injury to the meniscus. An MRI may be ordered to help rule out a tear or other injury to the knee joint.
Treatment
The majority of the time, tears of the meniscus need to be taken care of surgically. This is due to the fact that the meniscus has a limited blood supply. Only the outside 1/3rd of the meniscus is supplied with blood. This is considered the red zone. Tears in this area can heal if repaired. Tears on the inner 1/3rd of the meniscus (white zone) is not supplied with blood and will not heal.
Surgical treatment of Meniscal tears involves an arthroscopic procedure. This is where Dr. Lowe inserts a small camera and instruments into the joint and performs the procedure through 2 small incisions. Dependant upon the location and type of tear, Dr. Lowe will then decide if he can repair the tear or if removal of the bad area has to be done. Removal of the involved areais known as a partial menisectomy. The goal is to leave as much of the healthy meniscal tissue as possible.
Examples of Meniscus Injuries
Below are some operative photos of various meniscal tears and their treatment(s).
Normal Meniscus Torn Meniscus
Torn section shaved out Meniscus repaired
