Injuries of Meniscus
Injuries of the Cartilage
Different types of meniscal injuries.
Meniscal tear if traumatic in origin requires twisting of the knee as a specific mechanism. If we cannot find twisting component in patient’s history, meniscal tear is pretty unlikely.
Meniscal tear is even more often in patients with:
During the examination of the knee we look for certain signs and symptoms.
Knee is usually swollen with tenderness over the meniscus and positive sign for meniscal injury or instability. We will often find signs of ligamentous instability. Patient with Locking symptoms Will confirm the diagnosis of unstable meniscal tear.
Bucket handle meniscal tear will present with flexion contracture which is usually not greater than 10°.
In case of any doubt MRI scan and will be requested.
The next step would usually be knee arthroscopy, either diagnostic or therapeutic where meniscal tear can be repaired if possible. If the meniscus is damaged beyond the repair, edges can be trimmed using small nibblers.
We tend to repair the meniscus with all inside technique. If this is not possible other techniques can be used to repair the meniscus.
Post operatively patients will quite often need a brace to protect the meniscus during the healing period which usually takes six weeks. Particularly during the healing period of the lateral meniscus we want to restrict deep flexion beyond 90° for six weeks to minimise the risk for repair failure.
Meniscal tear is even more often in patients with:
- cruciate ligament deficiency,
- patients with significant varus/valgus stress during the incident.
During the examination of the knee we look for certain signs and symptoms.
Knee is usually swollen with tenderness over the meniscus and positive sign for meniscal injury or instability. We will often find signs of ligamentous instability. Patient with Locking symptoms Will confirm the diagnosis of unstable meniscal tear.
Bucket handle meniscal tear will present with flexion contracture which is usually not greater than 10°.
In case of any doubt MRI scan and will be requested.
The next step would usually be knee arthroscopy, either diagnostic or therapeutic where meniscal tear can be repaired if possible. If the meniscus is damaged beyond the repair, edges can be trimmed using small nibblers.
We tend to repair the meniscus with all inside technique. If this is not possible other techniques can be used to repair the meniscus.
Post operatively patients will quite often need a brace to protect the meniscus during the healing period which usually takes six weeks. Particularly during the healing period of the lateral meniscus we want to restrict deep flexion beyond 90° for six weeks to minimise the risk for repair failure.
