Anatomy

Three bones meet to form your knee joint: your thighbone (femur), shinbone (tibia), and kneecap (patella).
Two wedge-shaped pieces of cartilage act as “shock absorbers” between your thighbone and shinbone. These are called meniscus. They are tough and rubbery to help cushion the joint and keep it stable.

Causes

Sudden meniscus tears often happen during sports. Players may squat and twist the knee, causing a tear. Direct contact or deaccelerations, like a tackle, is sometimes involved.
Older people are more likely to have degenerative meniscus tears. Cartilage weakens and wears thin over time. Aged, worn tissue is more prone to tears. Just an awkward twist when getting up from a chair may be enough to cause a tear, if the menisci have weakened with age.

Symptoms
  • Some patients describe feeling a “pop” in the knee when the meniscus tears
  • Knee will become stiff and swollen 2-3 days following the accident
  • Pain to the outer (lateral) or inner (medial) knee
  • Catching or locking of the knee
  • Sensation of “giving way”
Treatment

Nonsurgical Treatment

  • Initially:
    • Rest. Avoiding movements that exacerbate your pain.
    • Ice can be applied to reduce pain and swelling. Apply for 20 minutes at a time, several times a day, to keep swelling down. Do not apply directly to the skin.
    • Compression
    • Elevation
  • Bracing
    • Stabilizing knee brace
    • Offloading knee brace if there is also osteoarthritis
  • Physiotherapy
    • Quad Strengthening
    • Ultrasound
    • Massage
  • Medications
    • Nonsteroidal anti-inflammatory medicines. Drugs like ibuprofen and naproxen reduce pain and swelling. Like any over the counter medication, please read and follow the label. If you have a history of stomach ulcers, bleeding ulcers or heart conditions, these medications might not be right for you. Consult your physician if you have any questions.
    • Topical anti-inflammatories
      • Compound Topical Creams
      • Voltaren
  • Injections
    • Steroid (Depo-Medrol, Kenalog, Decadron)
    • Gel – Hyaluronic acid (Viscosupplementation)
    • Blood (PRP – Platelet Rich Plasma)

New research demonstrates no role for surgical intervention for meniscal tears, especially for patients greater than 50 years old. It is still common for orthopaedic surgeons to offer arthroscopic debridement of meniscal tears; however, conservative management has demonstrated the same benefits without risk or complication of surgery.