Your meniscus is the crescent shaped fibrocartilage that sits within your knee joint between the Femur (thigh bone) and the Tibia (shin bone). It acts to increase the stability of the knee and absorb load.
Injuries to the meniscus can occur through an acute injury or degeneration. An acute tear occurs because of trauma often during sport and commonly following loaded twisting or bending motions. A degenerative meniscal tear occurs over time with gradual everyday load and age-related degeneration.
Symptoms of a meniscal tear can include:
- Pain
- Swelling
- Loss of range of motion
- Locking or catching within the knee
- Instability
The severity of a meniscal tear can depend on the length of tear, the depth of tear and the pattern. A more severe tear, such as a bucket handle tear, generally presents with more severe symptoms. In some tears the torn flap of the meniscus can cause locking of the knee.
Diagnosis: Do I need a scan?
Your Physiotherapist will take a detailed history and perform a series of tests to help to rule a meniscal tear in or out. An MRI scan is generally the imaging of choice but is not always required.
Horga et al (2020) looked at 115 individuals without knee pain and completed a 3.0 T MRI knee scan. 97 % of these individuals showed some abnormality and 30% of had meniscal tears yet they were asymptomatic. This shows that MRI results alone should not form a diagnosis and that it is important to have a detailed clinical assessment.
Treatment:
Physiotherapy:
In most circumstances Physiotherapy will be appropriate and effective in treating this condition, improving symptoms and progressing function. The aim is to restore range of motion, build strength though out the lower limb and improve balance.
Surgery:
Generally, surgery is not the first line of treatment. However, in some circumstances surgery, with the aim of preserving as much of the meniscus as possible, may be indicated.
If you have any questions regarding meniscal tears or you would like guidance on how to manage a meniscal tear, please contact the team at Bend + Mend Physiotherapy.
References:
Horga, L., Hirschmann, A., Henckel, J., Fotiadou, A., Di Laura, A., Torlasco, C., D’Silva, A., Sharma, S., Moon, J. and Hart, A., 2020. Prevalence of abnormal findings in 230 knees of asymptomatic adults using 3.0 T MRI. Skeletal Radiology, 49(7), pp.1099-1107.
