Tales of a Torn Meniscus
Posted 5/21/2018 by UHBlog
Don’t let knee injuries of any kind keep you from the sports you enjoy. We can help you manage and treat painful knee problems.
One of the most common knee problems affecting athletes and casual exercisers alike are meniscal injuries. The menisci act as shock absorbers and secondary stabilizers of the knee, says sports medicine specialist Michael Salata, MD.
“The meniscus are crescent-shaped and there are two in each knee, a medial – or inside – meniscus and a lateral – or outside – meniscus,” Dr. Salata says. “Meniscal tears are probably one of the more common things we see in the office.”
Meniscal tears can happen during a rotational movement while bearing weight, such as when twisting the upper leg while the foot stays in one place during sports and other activities. For example, catching a cleat, getting hit from the outside, dribbling a basketball around an opponent or turning to hit a tennis ball can cause you to suffer a torn meniscus. Other times, the reason is less clear and occurs from repetitive stress to the menisci over time.
According to Dr. Salata, what's important to note is that the way a meniscus tear is treated depends on the type and orientation of the tear and your age. A number of factors can influence treatment, including:
How the injury occurred. Your doctor will classify your meniscal tear as either acute or chronic. For instance, is it secondary to an injury or has it developed over time due to a degenerative process like osteoarthritis? A torn meniscus that is degenerative is more common in middle-aged people and may be just a part of the breakdown of the knee joint and not an isolated injury.
Severity. Tears can be minor, with the minimal instability of the fragment, or more severe with near complete detachment of the meniscus leading to significant instability of the torn portion.
Pain level. Acute meniscus tears are most often accompanied by sharp stabbing pain on the inside or outside part of the knee – called the joint line – where the meniscus is located. When the problem is degenerative, there is often a dull pain that gets worse the more you move throughout the day. This pain is more due to the concomitant arthritis that may be present, Dr. Salata says.
Age of athlete. “In younger kids, the treatment options are different,” Dr. Salata says. “If the tear is in a location with a good blood supply, we will go in and surgically repair the meniscus. The goal is always to preserve the meniscus whenever possible.”
In fact, some young athletes with a severe tear that is irreparable may require replacement of the damaged meniscus with an allograft (or donated) meniscus transplant, which Dr. Salata has performed successfully numerous times.
One Northeast Ohio athlete describes how this procedure helped him return to playing football.
With older patients, treating a torn meniscus surgically may or may not be the best option. The most successful outcomes from meniscal surgery are when the tear occurs in isolation. If there is associated arthritis, the results of meniscus surgery may not be as successful.
“It is incumbent on the surgeon you see to be able to help differentiate what is the main pain generator in your knee,” Dr. Salata says. “If surgery is not recommended, there are other options for treatment that exist.”
These treatment options may include:
- Medicine to relieve pain and reduce inflammation, such as ibuprofen
- Muscle-strengthening exercises
- Injections (like cortisone or lubricant)
If conservative treatment doesn't help, you may be a candidate for arthroscopic surgery, which normally consists of debriding – or removing – just the torn tissue out of the damaged area. Afterwards, you'll likely be on crutches for a couple of days with a three- to six-week healing period.
“If the muscles around the knees are strong and the swelling has gone down, your doctor will decide if you can return to your regular activities,” Dr. Salata says.
Michael Salata, MD is an orthopaedic surgeon, director of the Joint Preservation and Cartilage Restoration Center at University Hospitals Cleveland Medical Center and associate orthopedist team physician for the Cleveland Browns. You can request an appointment with Dr. Salata or any other doctor online.