Meniscal (cartilage) tear

Who does this affect?

The knee is a complex joint, and is commonly injured during activity. The menisci, or "cartilages" can be injured in sportsmen and women, particularly in twisting activities.

This can also occur in less active patients in association with degenerative arthritis.

Symptoms

• Pain - A torn meniscus typically presents with pain
• Locking - A torn meniscus may become trapped between the joint surfaces in the knee causing a sensation of "locking". This often presents as difficulty in fully extending the knee. Such episodes may be associated with worsening pain, and sometimes swelling. Locking is often temporary, the knee spontaneously unlocking itself - but sometimes the knee remains "locked" and urgent surgical intervention is required to relieve symptoms.
  • Clicking - If there is a torn meniscus the knee joint may tend to click with movement.
  • Giving way - A torn meniscus may lead to a sensation of "giving way" in the knee joint.

Diagnosis

The diagnosis of a meniscal tear is made on history and physical examination and usually confirmed with investigations.

When a torn meniscus is suspected, an MRI (magnetic resonance) scan is often useful.

Non- surgical treatment

A torn meniscus is not amenable to non-surgical treatment - if symptoms are significant a "key-hole" operation (arthroscopy) is usually recommended.

Surgical treatment

• Arthroscopy - This condition can usually be treated with a "key-hole" procedure known as arthroscopy. The knee joint is thoroughly inspected using a telescope and camera.
• Some tears in the meniscus may be suitable for surgical repair, but more commonly the torn section of meniscus need to be removed. The amount of cartilage tissue removed is kept to a minimum to reduce the risk of later degenerative arthritis
• This operation can usually be done on a day-case basis (you go home the same day)
• See section on Arthroscopy for details of the operation

Torn meniscus

Normal meniscus

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