Meniscus Injury

Tear of a meniscus is a rupturing of one or more of the fibrocartilage strips in the knee, called menisci. When doctors refer to "torn cartilage" in the knee, they are actually referring to an injury to a meniscus at the top of one of the tibiae. Menisci can be torn during activities such as walking. They can also be torn by traumatic force encountered in forms of physical exertion. The traumatic action is most often a twisting movement at the knee while the leg is bent. In adults, the meniscus can be damaged following prolonged 'wear and tear'. This is called a degenerative tear.
Tears can lead to pain and/or swelling of the knee joint. A tear of the medial meniscus can occur as part of the unhappy triad, together with a tear of the anterior cruciate ligament and medial collateral ligament.


Symptoms

Most complaints from patients are usually knee pain and swelling. These are worse when the knee bears more weight. Another typical complaint is joint locking. This can be accompanied by a clicking feeling. Sometimes, a meniscal tear also causes a sensation that the knee gives way.
A tear of the meniscus commonly follows rotation of the knee while it was slightly bent. These also excite the pain after the injury; for example, getting out of a car is often reported as painful.
A physician performs clinical tests to determine if the pain is caused by compression and impingement of a torn meniscus. The knee is examined for swelling. In meniscal tears, pressing on the joint line on the affected side typically produces tenderness.

Diagnosis

X-ray images can be obtained to rule out other conditions or to see if the patient also has osteoarthritis. The menisci themselves cannot be visualized with plain radiographs. If the diagnosis is not clear from the history and examination, the menisci can be imaged with MRI scan (Magnetic Resonance Imaging).This technique has replaced previous arthrography, which involved injecting contrast medium into the joint space. Recent survey shows that MRI and clinical testing are comparable in sensitivity and specificity when looking for a meniscal tear.

Surgery

If this does not resolve cases of a locked knee, then surgical intervention may be required. Depending on the location of the tear, a repair may be possible. In the outer third of the meniscus, required blood supply exists and a repair will likely heal.
The meniscus has fewer vessels and blood flow towards the unattached, thin interior edge. In most of the cases, the tear is far away from the meniscus' blood supply, and a repair is unlikely to heal. In these cases arthroscopic surgery allows for a partial meniscectomy, removing the torn tissue and allowing the knee to function with some of the meniscus missing. In situations where the meniscus is damaged beyond repair or partial removal, a total menisectomy is performed.
For more details please contact:
Dr. Prateek Gupta (Senior Surgeon)
Arthroscopy Surgery Clinic
C2/5 Safdarjung Development Area (SDA),
Aurobindo Marg, New Delhi - 110016
INDIA
Telephones: +91 9810852876, +91 11 26517776
24 x 7 Helpline & Appointment: +91 9810633876
Email: sportsmedicinedelhi@yahoo.com,
sportsmedicineclinics@gmail.com
Website: http://www.sportsmedicineclinicdelhi.com/arthroscopy.htm,
http://www.sportsmedicineclinicdelhi.com,
http://www.arthroscopysurgeryindia.com