Can result from playing sport or normal activities of daily living. The athletic population is at greatest risk, especially those who participate in twisting sports (commonly football and basketball).
Common complaints include catching, locking, or buckling of the knee, knee pain, or any combination of these symptoms.
MRI scan considered most accurate and non-invasive method of diagnosis. Meniscal tears are mainly either traumatic or degenerative.
Most tears do not heal spontaneously and are treated arthroscopically by meniscus repair (if torn in a clear, clean pattern) or, less commonly, partial meniscectomy (if torn in a complex pattern).
Successful outcome requires close follow-up and adherence to physiotherapy.
The medial and lateral menisci are shock absorbers and force distributors located between the femur and the tibia. Consequently, menisci can tear due to traumatic injury or degenerative wear (e.g., in knee joint arthritis), and can compromise force distribution across the knee joint. A meniscal tear occurs in 2 primary planes, vertical and horizontal. Tears can cause knee pain, swelling, limited range of motion, and catching, locking, and buckling of the knee joint. Tears may lead to degenerative, arthritic changes if not already present.
History and exam
Key diagnostic factors
- presence of risk factors
- knee swelling
- sensation of knee instability or buckling/catching
- knee pain
- tenderness at joint line and joint line crepitation
- positive McMurray's test
- positive Apley's test
- positive hyperextension test
Other diagnostic factors
- popliteal (Baker's) cyst in chronic cases
- limited range of motion
- acute trauma (twisting injury)
- knee joint arthritis
- knee instability
- history of anterior cruciate ligament injury
- malalignment of the knee joint
- rough or uneven playing surface
- poor ground/weather conditions
- construction work and manual labour jobs
- discoid meniscus
1st investigations to order
- MRI scan
- plain film radiographs: AP x-ray, lateral knee x-ray, 45° PA flexion, and skyline views
Investigations to consider
- Anterior cruciate ligament tear
- Medial collateral ligament sprain
- Posterior cruciate ligament sprain
- Arthroscopic meniscal surgery: a national society treatment guideline and consensus statement
- National consensus on the definition, investigation, and classification of meniscal lesions of the knee
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