Logan Steele
The meniscus is a C-shaped or crescent-shaped fibrocartilaginous anatomical structure that acts as a shock absorber between the shinbone and the thighbone. It is present in the knee, wrist, acromioclavicular, sternoclavicular, and temporomandibular joints. In the knee, there are two menisci: the medial meniscus on the inside and the lateral meniscus on the outside. The meniscus is commonly injured through sports, with tears occurring during twisting movements. Treatment options for a torn meniscus include conservative management, such as rest and physical therapy, or surgery, depending on the severity and location of the tear.
| Characteristics | Values |
|---|---|
| Shape | Crescent-shaped or C-shaped |
| Location | Knee, wrist, acromioclavicular, sternoclavicular, and temporomandibular joints |
| Function | Provides structural integrity to the knee, disperses friction in the knee joint, deepens the tibial plateau, improves articulation of the femur on the tibia, stabilizes the knee, and assists with shock absorption |
| Composition | Fibrocartilaginous tissue |
| Blood Flow | From the periphery (outside) to the central meniscus; blood flow decreases with age |
| MRI Appearance | Low-intensity |
| Treatment for Tears | Conservative management (activity modification or physical therapy), surgical repair, or removal (meniscectomy) |
| Recovery | May involve physical therapy to strengthen and increase the range of motion |
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What You'll Learn
Meniscus tears
A meniscus tear is a very common knee injury, especially among athletes. The meniscus is a C-shaped piece of cartilage in the knee. It is a crescent-shaped fibrocartilaginous anatomical structure that partly divides a joint cavity. The meniscus acts as a shock absorber between the shinbone and the thighbone, dispersing friction in the knee joint. It is also known as a "semi-lunar" cartilage, referring to its half-moon, crescent shape. The word "meniscus" comes from the Ancient Greek word "meniskos", meaning "crescent".
Any activity that causes a person to twist or rotate their knee, especially when putting their full weight on it, can lead to a torn meniscus. The risk of a torn meniscus is particularly high for athletes, especially those who participate in contact sports such as football, or activities that involve pivoting, such as tennis or basketball. As people age, the cartilage in their knees wears down and gets weaker, making it more prone to tearing. Arthritis, a breakdown of cartilage in the joints, can also lead to a meniscus tear.
The main symptoms of a torn meniscus are pain, swelling, and stiffness in the knee. It might take 24 hours or more for these symptoms to begin, especially if the tear is small. Other symptoms include a feeling of the knee giving way, an inability to move the knee as usual, and persistent knee pain. A torn meniscus can also increase the risk of developing osteoarthritis in the injured knee.
To diagnose a meniscus tear, a doctor will first discuss symptoms and medical history, then examine the knee for tenderness along the joint line. One of the main tests for meniscus tears is the McMurray test, where the doctor bends, straightens, and rotates the knee, which may cause pain, clicking, or a clunking sensation within the joint if the meniscus is torn. MRI is the preferred method of diagnosing acute meniscus tears due to its high accuracy, but if MRI is unavailable, a CT arthrogram or ultrasound may be used.
Treatment for a meniscus tear depends on the patient's age, symptoms, activity level, type, size, and location of the injury. Conservative treatment, such as rest, ice, and medication, may be enough to relieve pain and allow the injury to heal on its own. Physical therapy may also be used to strengthen the knee and increase its range of motion. However, in some cases, surgery may be required to repair or remove the torn meniscus.
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Treatment
A torn meniscus is a common knee injury, especially among athletes. The meniscus is a C-shaped piece of cartilage in the knee that acts as a shock absorber. It can be torn if you suddenly twist your knee while bearing weight on it. This can happen when performing activities that involve aggressive twisting and pivoting of the knee, such as tennis or basketball. The risk of a torn meniscus is also higher in older people due to wear and tear, and in people with arthritis in their knees.
Meniscus tears can be treated in several ways, depending on the severity of the injury. Small tears often heal on their own with conservative treatment such as rest, ice, compression, elevation, and medication. Wearing a knee brace and physical therapy are also common non-surgical treatments.
If the tear is large or these treatments are ineffective, surgery may be required to fix the problem. There are two main types of surgery for meniscus tears: repair and removal (meniscectomy). Repair involves surgically fixing the tear, while removal involves taking out the damaged part of the meniscus. The type of surgery performed depends on various factors, including the type and location of the tear, the patient's age, and the physician's preference.
It is important to work with healthcare providers to develop a treatment and rehabilitation plan that allows a safe return to normal activities. Most people fully recover from a torn meniscus with appropriate treatment.
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Causes
A meniscus is a C-shaped piece of cartilage in the knee. It is a crescent-shaped fibrocartilaginous anatomical structure that provides structural integrity to the knee when it undergoes tension and torsion. The two menisci act as shock absorbers and provide cushioning between the shinbone (tibia) and the thighbone (femur).
Meniscus tears are a common knee injury, especially among athletes. They are usually caused by sudden, twisting movements, like pivoting to catch a ball, or running and changing direction suddenly. These movements can tear the meniscus, especially when the knee bears weight. Sports that involve twisting motions, such as tennis, carry a high risk of meniscus tears.
Age is another factor that increases the risk of meniscus tears. As people get older, the cartilage in their knees wears down, gets thinner, and weaker, making it more susceptible to tears. More than 40% of people aged 70 or older have had a torn meniscus. Obesity also increases the risk of meniscus tears.
Arthritis, a breakdown of cartilage in the joints, can also lead to meniscus tears. People with arthritis in their knees are more prone to this type of injury.
Meniscus tears are often the result of accidents and may occur alongside other knee injuries, such as an anterior cruciate ligament (ACL) injury.
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Symptoms
A meniscus is a C-shaped piece of cartilage in the knee. It acts as a shock absorber, providing cushioning between the bones in the knee joint. Meniscus tears are a common knee injury, especially among athletes. They can occur when the knee is twisted or rotated, especially when the individual's full weight is on that knee.
Meniscus tears can be acute or chronic. Acute tears are often the result of trauma or a sports injury and can take various shapes and sizes. Chronic tears are caused by wear and tear and are treated symptomatically.
If an individual suspects a meniscus tear, they should contact their doctor, especially if their knee is painful or swollen, or if they cannot move their knee in the usual ways.
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Anatomy
A meniscus is a crescent-shaped fibrocartilaginous anatomical structure. In humans, they are present in the knee, wrist, acromioclavicular, sternoclavicular, and temporomandibular joints. The term "meniscus" generally refers to the cartilage of the knee, either the lateral or medial meniscus. Both are cartilaginous tissues that provide structural integrity to the knee when it undergoes tension and torsion. The menisci are also known as "semi-lunar" cartilages, referring to their half-moon, crescent shape. The menisci of the knee are two pads of fibrocartilaginous tissue that serve to disperse friction in the knee joint between the tibia (lower leg bone or shinbone) and the femur (thigh bone). They are concave on top and flat on the bottom, articulating with the tibia.
The menisci act to disperse the weight of the body and reduce friction during movement. They also provide stability and shock-absorbing protection to the precious knee cartilage lining the joint, also known as the hyaline cartilage. Loss or damage to this hyaline cartilage, for whatever reason, is known as arthritis, so the meniscus is essential to the health of the knee and the prevention of arthritis.
The medial meniscus sits on the inside of the knee and covers a smaller part of the tibial plateau. It is a definitive crescent "C" shape, has less variability with size and thickness, and is approximately 1.4 inches (3.5 cm) in length. Anteriorly, it is attached to the lateral meniscus by the transverse ligament and patella directly or by anterior capsular thickenings called patellomeniscal ligaments. The lateral meniscus sits on the outside of the knee.
The vascular supply of the menisci originates predominantly from the medial, lateral, and middle genicular arteries. These three arteries are branches of the popliteal artery. The primary areas of vascularity are the superior and inferior portions of the meniscus, making only 10-30% of the meniscus a recipient of direct blood supply. The remaining portion of the medial meniscus is replenished with nutrients via diffusion of the synovial fluid. Due to the lack of direct blood supply to most of the structure, the medial meniscus has difficulty healing after an injury or during the post-operative process. Blood flow to the meniscus decreases with age and the central meniscus is avascular by adulthood, which slows healing.
Meniscus tears are a very common knee injury, affecting approximately 1 million people in the US each year. They are especially common among athletes and older people. Any activity that causes a person to forcefully twist or rotate their knee, especially when putting their full weight on it, can lead to a torn meniscus. The risk is particularly high for athletes who participate in contact sports or activities that involve pivoting, such as football, tennis, or basketball. Wear and tear on the knees as a person ages also increases the risk of a torn meniscus. Meniscus tears can also occur as a result of a lateral blow to the knee.
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