Meniscus Tear

A meniscus is a crescent-shaped cartilage in the knee that acts as a cushion between the thigh bone (femur) and the shin bone (tibia). Each knee has two menisci: the medial meniscus on the inner side and the lateral meniscus on the outer side. These structures provide stability, absorb shock, and facilitate smooth knee movement. 

A meniscus tear is particularly common among athletes who engage in sports such as basketball, soccer, and football. However, it can also affect older adults due to age-related degeneration of the cartilage. Meniscus tears are common in patients who suffer ACL tears. Some studies report up to 50% of cases where the meniscus in torn when the ACL is injured.

Meniscus tears can result from both acute injuries and degenerative changes over time. The primary causes include:

• Trauma or sports injuries: A sudden twisting motion, deep squatting, or direct impact to the knee can cause a meniscus tear. This is common in contact sports or activities that involve sudden stops and directional changes.
• Age-related degeneration: As people age, the cartilage in the knee naturally wears down, making it more susceptible to tearing with minimal trauma.
• Improper lifting or bending: Everyday movements, such as lifting heavy objects with improper technique or sudden deep bending, can strain the meniscus and lead to injury.
• Weak muscles or joint instability: Poor muscle strength or instability in the knee joint can increase the likelihood of injury.

A meniscus tear can cause varying degrees of discomfort and functional limitations depending on the severity and location of the injury. Common symptoms include:

• Pain: Typically felt along the joint line of the knee, pain may worsen with movement, squatting, or twisting motions.
• Swelling: Fluid accumulation in the knee joint often occurs within hours of the injury, leading to stiffness and discomfort.
• Locking or catching: The knee may feel like it gets stuck or catches during movement, making it difficult to fully extend or bend.
• Instability: A feeling that the knee is giving way or is unable to support weight properly can indicate a significant tear.
• Limited range of motion: Difficulty bending or straightening the knee may occur due to swelling or mechanical obstruction caused by the torn cartilage.

While some mild meniscus tears may improve over time with conservative management, persistent or severe symptoms require medical evaluation to prevent further joint damage. If the tear occurs along with an ACL tear, repair will typically involve both structures.

A thorough evaluation by the experienced orthopedic specialist Dr. David Gazzaniga is essential for diagnosing a meniscus tear accurately. The diagnostic process typically involves:

Medical history and symptom review

Understanding the nature of the injury, the onset of symptoms, and any past knee conditions helps guide the diagnostic approach.

Physical examination

Dr. Gazzaniga will perform specific knee tests to assess for pain or clicking, indicating a meniscus tear.

Imaging studies

• X-rays: While X-rays do not show soft tissues like the meniscus, they can rule out fractures or other bone-related conditions that may contribute to knee pain.
• MRI: The most effective imaging tool for detecting meniscus tears, an MRI provides a detailed view of the knee’s cartilage, ligaments, and soft tissues.
• Ultrasound: In some cases, ultrasound imaging may be used to evaluate soft tissue injuries in real time.

Arthroscopy

If the diagnosis remains uncertain or if surgical intervention is being considered, a minimally invasive procedure called arthroscopy may be performed. During this procedure, a small camera is inserted into the knee joint to directly visualize the meniscus and other structures.