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

January 12, 2017

 

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 swelling​Surgical 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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