What is a Meniscus Tear?

A meniscus injury is one of the most common knee injuries. Menisci (the plural form of meniscus) tend to get injured during movements that forcefully twist your knee while bearing weight (this is very prevalent in younger populations) or they tend to grow weaker with age, and tear as a result of minor injuries or movements.

When your meniscus is damaged and/or torn, it starts to move abnormally inside the joint, which can cause it to become caught between the bones of the joint (femur and tibia). Your knee then becomes swollen, painful and difficult to move. These injuries can be difficult to heal because blood supply (which helps your body heal itself) is often limited to the outside edge of the menisci.

Once you have a meniscus tear, you have an increased risk of developing knee arthritis, because these shock absorbers are weakened. They slowly wear away with knee movements and are not able to protect your articular cartilage on the surface of the knee joint as much as before.

In the USA, 61 of 100,000 people experience an acute tear of the meniscus at some point in their life (850,000 meniscus surgeries are performed in the USA each year, estimates indicate that at least twice this number of meniscus procedures are performed internationally). Health professionals used to believe the meniscus had no function and removed it if injured, however we now know it plays an integral role in knee joint mechanics and function.

Typically, a patient will experience knee pain and swelling in the knee joint area. This worsens when the knee bears more weight, especially under high impact activities such as running. Often there is clicking within the joint or even some form of locking, where the patient may be unable to fully straighten their leg.

In some cases of a meniscus tear, the person can remember the specific thing they were doing when the tear occurred (or worsened). Often, the injury will occur when there is a rotation of the knee at the time when the joint is slightly bent. Similarly, for those that have sustained a meniscus tear, this type of activity (rotation of the knee while it is slightly bent) such as getting out of a car - can be quite painful.

Doctors can perfoms tests such as the "McMurray test", "Thessally's test", "Wilson test" and "Bohler's test" to determine a diagnosis. In most cases of a meniscus tear, bending the knee and especially squatting is a very painful movement.

The Function of the Meniscus

The menisci play a very important role in the proper working of the knee. Essentially, they serve as cushions to decrease the stress caused by weight bearing and forces on the knees. They work like shock absorbers, supporting the load by compressing and spreading the weight evenly within the knee. Even while walking, the pressure put on the knee joints can be 2 - 4 times your own body weight; when you run these forces increase up to 6 - 8 times your body weight and are even higher when landing from a jump. By increasing the area of contact inside the joint by nearly 3 times, the menisci reduce the load significantly (dispersing between 30 and 55% of the load).

As weight is applied to the meniscus they are compressed and are forced to extend out from between the femur and tibia. However, the circular design of the menisci provides circumference tension (referred to as 'Hoop Stress') to resist this extension and provide stability as the load compresses. If the meniscus is torn at the peripheral rim, circumference tension is compromised and the meniscus loses its ability to transfer the load and the joint begins to suffer. In fact, if part of the peripheral is removed or the tear extends to the periphery, the load on the knee joint may increase by up to 350% causing stress and pain. However, if the tear remains on the interior without disrupting the periphery of the meniscus, the meniscus is still able to disperse the load without stress and pain.

The menisci also assist with the proper movement (arthrokinematic) of the femur and tibia during flexion and extension. They help stabilize the knees when in motion, reduce friction within the joint, and lubricate and protect the articular cartilage surrounding the tips of the bones from damage due to wear and tear.

What Happens When the Meniscus is Injured?

A meniscus knee injury is one of the most common cartilage injuries. Menisci tend to get injured during movements that forcefully twist your knee while bearing weight (this is very prevalent in younger populations) or they tend to grow weaker with age, and tear as a result of minor injuries or movements. When your meniscus is damaged and/or torn, it starts to move abnormally inside the joint, which can cause it to become caught between the bones of the joint (femur and tibia). Your knee then becomes swollen, painful and difficult to move. Meniscus injuries are difficult to heal because blood supply (which helps your body heal itself) is often limited to the outside edge of the menisci.

Once you have a meniscus tear, you have an increased risk of developing knee arthritis because these shock absorbers are weakened. They slowly wear away with knee movements and are not able to protect your articular cartilage on the surface of the knee joint as much as before.

In the USA, 61 of 100,000 people experience an acute tear of the meniscus at some point in their life (850,000 meniscus surgeries are performed in the USA each year, estimates indicate that at least twice this number of meniscus procedures are performed internationally). Health professionals used to believe the meniscus had no function and removed it if injured, however we now know it plays an integral role in knee joint mechanics and function.

Meniscus Tear Alternate names and/or related conditions:

Cartilage Tear, medial meniscus tear, lateral meniscus tear, acute meniscal tears, meniscus tear, meniscal injury, knee injury, discoid meniscus, torn knee cartilage, cruciate ligament tears, collateral ligament tears, knee dislocations, meniscal cysts, osteochondritis dissecans.

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During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort at the location of your soft tissue injury until the pain and inflammation settle. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!