Summary
Definition
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.
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Anatomical structures around the menisci
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History and exam
Key diagnostic factors
- hx of knee trauma
- hx of knee arthritis, instability, or malalignment
- knee swelling
- sensation of knee instability or buckling/catching
- knee pain
- tenderness at joint line and joint line crepitation
- positive McMurray test
- positive Apley test
- positive hyperextension test
Other diagnostic factors
- popliteal (Baker) cyst in chronic cases
- limited range of motion
Risk factors
- acute trauma (twisting injury)
- knee joint arthritis
- knee instability
- hx of anterior cruciate ligament injury
- malalignment of the knee joint
- rough or uneven playing surface
- poor ground/weather conditions
- construction work and manual labor jobs
- discoid meniscus
Diagnostic investigations
1st investigations to order
- MRI scan
- plain film radiographs: AP x-ray, lateral knee x-ray, 45° PA flexion, and skyline views
Treatment algorithm
Contributors
Authors VIEW ALL
Orthopedic Surgeon
Department of Sports Orthopedics
Toshiba Hospital Tokyo
Tokyo
Japan
Disclosures
HT declares that he has no competing interests.
Dr Hideki Takeda would like to gratefully acknowledge Dr Lars Engebretsen and Dr Kevin R. Stone, previous contributors to this monograph. LE declares that he has no competing interests. KRS is an author of several references cited in this monograph.
Peer reviewers VIEW ALL
Co-Director of Orthopedic Sports and Shoulder Service
Department of Orthopedic Surgery
Naval Medical Center San Diego
San Diego
CA
Disclosures
DS declares that he has no competing interests.
Orthopedic Surgeon
Department of Orthopedic Surgery
Seoul Veterans Hospital
Seoul
South Korea
Disclosures
JRY declares that she has no competing interests.
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