- Gabriel Ignacio
I MAY HAVE A TORN MENISCUS, WHAT ARE MY OPTIONS?

Meniscus Anatomy:
The meniscus is a soft tissue structure within the knee joint that is comprised of two components, medial and lateral meniscus, that lays between the corresponding femoral condyle and tibial plateau. Several ligaments anchor each menisci from the anterior and posterior horn of meniscus to the tibia and femur. The functions of the menisci are to reduce compressive stress, enhance bony congruency, distribute weight bearing forces, improve joint stability, increase proprioception, and guide knee arthrokinematics. When the meniscus is torn or removed, there is a decrease in contact area between the tibia and femur leading to 2-3x greater contact force, which can lead to cartilage degeneration and early osteoarthritis.
Types of Meniscal Tears:
Red Zone Tears – Vascularized portion of meniscus (25-30% of periphery)
White Zone Tears – Non-vascularized portion of meniscus
Demographics & Mechanism of Injury:
Young individuals: Sports-related – Cutting or twisting with high compression force, Hyperextension
Medial > Lateral Meniscus
>80% of tears involve ACL
Middle-Aged to Elderly (>40 y.o.) – Degeneration
Children (4-12 y.o.) – Discoid meniscus or sports-related
Most are isolated meniscus tear – no ACL involvement
Signs & Symptoms/Clinical Presentation:
Deep & joint line pain/tenderness
Joint swelling – gradual over 24 hours
Catching, Locking, Clicking, or Giving way
Decreased range of motion
Conservative Treatment:
Physical therapy to alleviate current symptoms, prepare for surgery, or post-op rehabilitation
Improve knee range of motion and flexibility
Increase strength and recruitment of quadriceps and other lower extremity muscles
Correct movement patterns
Decrease pain and swellingSurgical Interventions:
Meniscectomy – typical for White Zone tears
Meniscal repair – typical for Red Zone tears
ZAMST Brace:
Knee braces for increased support: ZK-1, EK-3, SK-1
Written by Gabriel Ignacio, University of Southern California Doctorate of Physical Therapy Candidate c/o 2017
ProSport Physical Therapy & ProSport STACK Performance
2777 Bristol Street, Suite B, Costa Mesa, CA 92626
References:
Baldwin, K. University of Southern California lecture on Disorders of the knee. Jan 2015
Makris, E.A., Hadidi, P., & Athanasiou, K.A.. The knee meniscus: structure - function, pathophysiology, current repair techniques, and prospects for regeneration. Elsevier Biomaterials. 2011; 32: 7411-7431.
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