The Meniscus is the two wedge-shaped cartilage pieces present between the thighbone and shinbone. They acts as shock absorbers and are tough and rubbery, which helps in cushioning the joint and making it stable.
Meniscal tear is a common knee injury where the meniscus is ruptured. There are different types of meniscal tears and some include the bucket handle, flap and radial tears.
The treatment of the Meniscal tear depends on the type of tear, the size and the location.
The outside one-third of the meniscus has a rich blood supply. A tear in this region might heal on its own or can be repaired by surgery, usually a longitudinal tear.
The inner two-thirds of the meniscus lack blood supply and any tear in this region will not heal due to absence of blood nutrients. The tears here are usually complex and in thin, worn cartilage. As the pieces cannot grow back together, the tears in this region are trimmed away surgically.
The doctor will also consider other factors like the patient’s age, activity level and any related injuries before designing a treatment plan for the patient.
If the meniscal tear is small and lies on the outer edge of the meniscus, surgery might not be needed. As long as the symptoms do not continue and the knee is stable, the following are recommended:
The RICE protocol stands for Rest, Ice, Compression and Elevation and is effective in most sports related injuries.
The doctor will recommend the patient to take rest from the activity that caused the injury and might prescribe crutches to prevent putting weight on the leg.
The patient will also be advised to apply ice packs to the knee for around 20 minutes, three times a day. The ice shouldn’t have direct skin contact.
An elastic compression bandage is recommended to be put over the knee to prevent further swelling and blood loss.
It is suggested to recline during rest with the leg elevated at a higher position than the heart.
Non-Steroidal Anti-Inflammatory Medication are prescribed to reduce pain and swelling.
The doctor will recommend knee arthroscopy if the patient’s symptoms persist even after non-surgical treatment. In the knee arthroscopy procedure, the doctor will insert a tiny camera called the arthroscope through a small incision near the knee. This will give a clear view of the inside of the knee. Then small specialized surgical instruments are inserted through these incisions and are guided by the arthroscope to trim or repair the tear.
The different repair options that are performed to repair meniscal tears using knee arthroscopy are:
In this procedure, the damaged meniscus tissue is trimmed away and healthy meniscal edges are balanced to a smooth surface.
The repair of a tear depends upon the type of tear, as well as the condition of the injured meniscus tissue. Some of the meniscal tears can be repaired by stitching or suturing the torn pieces together. As these stitched meniscus tissues have to heal back together, the recovery time for this repair is longer than a meniscectomy.