Medial Meniscus Tear - Knee: Causes, Symptoms, and Treatment

What Is a Medial Meniscus Tear?

The medial meniscus is a cartilage structure in the knee joint that helps to absorb shock, stabilize the knee, and facilitate smooth movement. A tear in the medial meniscus occurs when the cartilage is damaged, often due to a traumatic injury or repetitive stress over time. These tears can vary in severity, ranging from small, partial tears to large, full-thickness tears that extend across the entire cartilage.

Causes of a Medial Meniscus Tear

Medial meniscus tears can happen for a variety of reasons, most commonly as a result of:

Trauma or Injury

• Twisting Movements: Sudden twisting or pivoting motions, such as when playing sports like football or basketball, can cause the meniscus to tear. The knee may rotate while the foot is planted on the ground, placing excessive stress on the meniscus.

• Direct Impact: A direct blow to the knee, such as during a fall or collision, can cause the meniscus to tear.

• Repetitive Stress: Overuse of the knee joint in sports or activities that require frequent bending and squatting can lead to gradual wear and tear on the meniscus, eventually resulting in a tear.

Degenerative Changes

As people age, the meniscus becomes more brittle and less flexible, making it more susceptible to tears from normal daily activities, especially when combined with other factors like osteoarthritis.

Previous Knee Injuries

If you’ve had a prior knee injury, such as an anterior cruciate ligament (ACL) tear, this can increase the risk of developing a meniscus tear, as the knee becomes more vulnerable to instability.

Symptoms of a Medial Meniscus Tear

The symptoms of a medial meniscus tear can vary depending on the size, type, and severity of the tear, but the most common symptoms include:

• Pain on the Inner Side of the Knee: Pain is often felt on the inner (medial) side of the knee, where the medial meniscus is located. This pain may worsen with activity, particularly when twisting or pivoting.

• Swelling: Swelling may develop in the knee joint within hours or a day after the injury. The swelling may be more noticeable after physical activity.

• Stiffness: Limited range of motion in the knee, making it difficult to fully straighten or bend the leg.

• Locking or Catching Sensation: The knee may feel as if it is “catching” or “locking” when you try to move it. This can occur if a piece of the torn meniscus moves into the joint space and interferes with smooth motion.

• Instability: The knee may feel unstable, as though it might “give way” when walking or during certain movements.

• Popping Sound: Some individuals report hearing a popping sound at the time of the injury.

Diagnosing a Medial Meniscus Tear

To diagnose a medial meniscus tear, a healthcare provider will typically begin with a clinical examination, which may involve the following:

Physical Examination

The doctor will assess the knee for tenderness, swelling, and range of motion. Specific tests, such as the McMurray Testor Apley’s Compression Test, may be performed to check for signs of a meniscus tear.

Imaging Studies

• X-rays: X-rays are used to rule out other possible conditions such as fractures or arthritis. However, they cannot show a meniscus tear.

• MRI: An MRI is the gold standard for diagnosing meniscus tears. It provides detailed images of soft tissues, including the cartilage, and can reveal the size, location, and severity of the tear.

Treatment for a Medial Meniscus Tear

Non-Surgical Treatment

In many cases, conservative treatments can be effective in managing a medial meniscus tear, particularly for smaller tears or in patients who are not candidates for surgery.

1. Rest and Ice

   • Resting the knee and applying ice can help reduce inflammation and relieve pain. Ice should be applied for 15-20 minutes at a time, several times a day, especially after activity.

2. Physical Therapy

   • Strengthening Exercises: Focused on strengthening the muscles around the knee, especially the quadriceps and hamstrings, which provide support and stability to the knee joint.

   • Stretching: Stretching exercises can help improve flexibility and range of motion, especially if stiffness is present.

   • Manual Therapy: Hands-on techniques, such as joint mobilizations, can help improve knee function and decrease pain.

3. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

   • NSAIDs like ibuprofen can be used to reduce pain and inflammation in the knee joint.

4. Bracing or Supportive Devices

   • A knee brace can provide additional stability to the knee and help limit movements that could exacerbate the tear.

5. Injections

   • Corticosteroid injections can help reduce inflammation and provide temporary pain relief.

   • Platelet-Rich Plasma (PRP) Therapy may be considered in some cases to promote healing of the torn meniscus.

Surgical Treatment

If conservative treatment does not provide adequate relief or if the meniscus tear is severe, surgical intervention may be necessary. The type of surgery depends on the nature of the tear and the overall health of the knee joint.

1. Arthroscopic Meniscus Repair

   • Arthroscopy is a minimally invasive procedure where small incisions are made, and a tiny camera (arthroscope) is used to view the knee joint. Small surgical instruments are then used to either repair the meniscus or remove the damaged portion. Repairing the meniscus is often preferred, as it can preserve the cartilage and improve long-term knee health.

2. Meniscectomy

   • If the tear is too large or located in a part of the meniscus that cannot be repaired, part or all of the damaged meniscus may be removed in a procedure called meniscectomy.

3. Meniscus Transplantation

   • In rare cases, when the meniscus is extensively damaged or removed, a meniscus transplant may be considered. This involves replacing the damaged meniscus with a donor meniscus from a cadaver.

Recovery and Prognosis

• Non-Surgical Recovery: For smaller tears, most people can manage symptoms with physical therapy and rest, with a gradual return to activity. Full recovery can take several weeks to months, depending on the severity of the tear.

• Post-Surgery Recovery: After surgical treatment, recovery times vary. For a meniscus repair, recovery may take 4-6 months, with rehabilitation focused on restoring strength and range of motion. After a meniscectomy, recovery may be quicker, but the long-term risk of osteoarthritis may be higher due to the loss of cartilage.

Preventing Medial Meniscus Tears

While some degree of wear and tear is inevitable as we age, certain precautions can help prevent medial meniscus tears:

• Warm-up Properly: Stretching and warming up before physical activity can help prepare the knee for movement and reduce the risk of injury.

• Strengthen Muscles Around the Knee: Strong quadriceps, hamstrings, and calf muscles help absorb forces and reduce the strain on the meniscus.

• Avoid Sudden Twisting Movements: Try to avoid sudden, jerky movements or changes in direction, especially in high-impact sports.

• Use Proper Footwear: Wearing shoes that provide adequate support and cushioning can help reduce the stress placed on your knees.

A medial meniscus tear is a common knee injury that can be managed effectively with the right treatment plan. If you are experiencing knee pain, difficulty moving, or suspect a meniscus tear, contact Palms Physiotherapy & Allied Health to schedule a consultation. Our team of experts can help you recover and return to the activities you enjoy.