Meniscus Tears & Treatment Options

With football season returning and training camps well underway, we’re seeing a number of players such as San Diego Chargers’ wide receiver Stevie Johnson, who recently underwent season-ending surgery to repair his torn meniscus, sustaining injuries that I think are important for the public and media to learn more about. As is often the case with sports-related articles, the focus is primarily on what the injury will do to the team’s prospects for the season, rather than the injury itself and how the player will recover from it. When it comes to meniscus injuries, we’ve got to dig deeper.

Meniscus tears are among the most common knee injuries in athletes, especially those who play contact sports. The meniscus is a thick protective cartilage that separates the thigh and shin bones, and allows for a soft and shock absorbing cushion between the two, making it possible to run, jump, and move without pain. When the knee is twisted or stretched outside of its flexibility range however, the surrounding tissue can rip or tear, rendering the knee unstable.

Most athletes are able to immediately tell when they have suffered such an injury to the knee. Sometimes there will be a “popping” sound and sensation, followed by pain, stiffness and inflammation. In the case of a torn meniscus, it is common to feel weakness in the knee and an inability to move the knee comfortably through a normal range of motion.

Treatment for a meniscus tear is dependent on the type of tear, the size, and its exact location. Use of X-rays, MRIs and other diagnostic tests are used to determine the severity of the injury and aid the orthopedic surgeon in developing the best treatment plan. Not all tears will require surgery, and it is important to communicate with a trusted orthopedic expert to discuss treatment goals. After examining the injury and viewing the results of the tests, a tailored treatment plan can then be prescribed and implemented.

In cases where a tear is small and the injury is not causing persistent pain or knee instability, non-surgical treatment can be utilized. This type of treatment involves rest, ice, compression and elevation (R.I.C.E.). Keeping weight off of the injured knee is typically recommended, and one may need to use crutches to give the knee a full rest from activity. Intermittent icing of the affected area will minimize pain and swelling, and promote quicker healing. An elastic compression bandage can also help with controlling swelling, as well as elevating the knee above the level of the heart when lying down.

For patients who have persisting symptoms that do not subside with rest, arthroscopic surgery may be suggested to repair the tear and restore stability to the knee. The surgery for repair of the meniscus is common, and involves only a small incision in the knee, in which the surgeon will insert a camera to clearly view the inside of the knee while using small surgical instruments to repair the tear.

Depending upon the type of tear and also the overall strength of the meniscus, the surgeon will decide to either remove the damaged portion of cartilage, or will be able to sew the two torn ends back together. If the two pieces of meniscus are repaired, the patient must take caution to allow ample time for complete healing, as the pieces need to fully fuse back together to become strong and functional again. This typically requires the patient to remain on crutches for some time after surgery to keep weight off of the knee while it heals. The total healing time for a repaired meniscus is approximately 3 months, while a meniscectomy (removing the damaged cartilage) will usually require only about 3-4 weeks for full recovery.

Casts and braces are sometimes utilized after surgery to keep the knee from moving, which will also help to facilitate quicker healing time. Post-surgery, physical therapy exercises play a key role in gradually improving range of motion and rebuilding strength to safely return to normal activity. Meniscus tears are very common in athletes, yet with proper diagnosis and following proper treatment protocols, your favorite athlete has excellent odds of quickly and safely returning to their normal level of play.

Sources: http://orthoinfo.aaos.org/topic.cfm?topic=a00358