Knee Meniscal Injury

What is it?

Injury to the knee cartilage is often associated with knee pain during weight bearing, knee joint swelling and possibly clicking, locking or giving way of the knee.

The meniscus (cartilage) is the knee’s most important shock absorber. As well as absorbing shock, the meniscus help to stabilise the knee, controlling movement and aiding in joint nutrition and lubrication. 

The most common signs and symptoms of a cartilage injury are:

• Clicking

• Locking of the knee 

• Knee giving way

• Knee effusion (swelling/tightness inside knee) 

• Pain with bending knee and weight bearing 

(Please Note: These signs and symptoms are also common to other knee injuries, it is therefore important to ensure your knee is assessed by your doctor or Physiotherapist). 

Mechanism of Injury

Meniscal tears can occur with both normal activities of daily living or during sporting activities. The meniscus are usually torn when the knee twists while in a weight bearing flexed position, however any sudden twisting of the knee can tear the cartilage, causing pain, swelling and a catching or locking sensation. 

Common Management Techniques

IMMEDIATE CARE

1. Rest

2. Ice (20 minutes on, 1 hour off for the first 3 days) 

3. Elevation (raise body part above heart)

4. Possible anti-inflammatory medication (consult doctor / pharmacist) 

If a meniscus tear is suspected, your physiotherapist will either:

1. Instigate a rehabilitation program;

2. Initiate a referral through your GP to a specialist orthopaedic surgeon or for a MRI. 

The location and size of the meniscal tear will determine the appropriate treatment. 

Conservative Management

• Lifestyle changes

• Exercise – switch from high impact exercises (i.e. running) to low impact exercises (i.e. Swimming, cycling)

• Weight loss – losing some kilograms can cause a 4x reduction of stress on the joint.

• Icing after activity

• Pain Management

• Referral to a doctor for anti-inflammatory medication

• Corticosteroid injection

Surgical management

• Sometimes required in patients who continue to have symptoms regardless of many treatments.

Prognosis

In most cases of surgery is not required. However, if you have tried all non-surgical treatments options without success, and you are still experiencing significant pain and loss of function, then surgery may be an option. 

The most common surgery for a torn meniscus is an Arthroscopy. When considering surgery you should be informed about what it involves, the rehabilitation process, its likely benefits and any potential risks. Arthroscopy is not always recommended for people with meniscal injury.