Meniscal Damage, Tears, Cysts, And Injuries
Damage to the knee’s shock-absorbing cartilage causing pain
The meniscus is a C-shaped piece of cartilage in your knee that acts as a cushion between the thigh bone (femur) and the shin bone (tibia). Each knee has two menisci – one on the inner side (medial meniscus) and one on the outer side (lateral meniscus). These structures help distribute weight and stabilise your knee joint. When the meniscus is damaged, it can lead to pain, swelling, and impaired knee function.
While it may not be possible to completely avoid meniscal injuries, especially if you’re active in sports, there are several steps you can take to reduce your risk.
Dr Liddell specialises in diagnosing and treating meniscal injuries, ensuring you receive the most effective care to restore knee stability and function.
COMMON CAUSES OF MENISCAL INJURIES
Meniscal injuries can affect people of all ages and may result from sudden trauma, gradual wear and tear, or repetitive strain over time. Understanding the cause of your injury is important, as it often influences the type of tear and the most appropriate treatment.
Common causes include:
Sudden twisting or pivoting movements: Rapid direction changes while your foot is planted often seen in sports like football, tennis, or basketball can place intense strain on the meniscus, leading to acute tears.
Trauma during high-impact activity: Forceful impacts or awkward landings, especially in contact sports or activities with abrupt stopping and starting, can cause immediate meniscal damage.
Age-related degeneration: As we age, the meniscus becomes more brittle and prone to tearing. Even simple movements like kneeling or squatting can cause a tear in an already weakened meniscus.
Repetitive stress or overuse: Jobs or hobbies that involve frequent squatting, kneeling, or lifting can put ongoing pressure on the meniscus, resulting in gradual wear and small tears that worsen over time.
Recognising the likely cause of your meniscal injury helps guide diagnosis and treatment, ensuring a more targeted approach to pain relief and long-term knee health.
DIFFERENT TYPES OF MENISCAL TEARS AND INJURIES
Meniscal injuries can vary significantly in type, severity, and impact on knee function. Acute tears typically result from sudden trauma, such as twisting or pivoting movements, which are common in sports or high-impact activities. Athletes and younger individuals are often more prone to these injuries due to the intense demands on their knees, leading to sudden pain, swelling, and difficulty moving the joint.
In contrast, degenerative meniscal tears develop gradually as the meniscus becomes weaker and more brittle with age, often affecting older adults. These tears may occur from even minor movements and are commonly linked to the natural wear and tear on the knee joint over time, which can cause persistent discomfort and swelling.
Meniscal tears are categorised by their shape and location within the meniscus, each type impacting knee function uniquely. Some common types include:
- Bucket handle tears: A large tear causing a segment of the meniscus to flip into the joint, potentially leading to ‘locking’ of the knee where bending and straightening become difficult.
- Radial tears: Tears extending from the inner edge of the meniscus outward, which can significantly disrupt knee stability as they often compromise the structural integrity of the meniscus.
- Flap tears: Small, loose flaps of torn meniscal tissue that may catch in the knee joint, causing sharp pain and a sensation of ‘catching’ during movement.
In addition to these tears, meniscal cysts can form near a torn meniscus, causing a visible lump, pain, and increased swelling. These cysts develop when joint fluid accumulates in pockets near the damaged meniscus, creating further discomfort and pressure in the knee.
Identifying the type, size, and location of a meniscal injury is essential for determining the best course of treatment, as each variation requires a tailored approach to restore knee function and alleviate symptoms.
RECOGNISING THE SYMPTOMS OF MENISCAL DAMAGE
Meniscal injuries can cause a range of symptoms, from mild discomfort to more severe knee instability. Symptoms may develop immediately after an injury or progress gradually over time, depending on the nature and severity of the damage. Being aware of these signs can help you seek appropriate care early and reduce the risk of further knee problems.
Common symptoms include:
Pain in the knee joint: This may present as a dull ache or sharp pain, especially when bearing weight or twisting the knee.
Swelling and stiffness: Swelling typically occurs within the first 24 hours after an injury, although it may be delayed in some cases. The knee may also feel stiff or tight.
A popping or tearing sensation at the time of injury: Many people describe feeling or hearing a distinct pop when the meniscus tears.
Reduced range of motion: Difficulty fully straightening or bending the knee can affect daily tasks like squatting, climbing stairs, or getting out of a chair.
Locking or catching: The knee may temporarily “lock” or “catch” during movement, often caused by a loose fragment of the torn meniscus interfering with joint function.
Instability or giving way: Some individuals feel as though the knee might buckle or give out, particularly during turning or twisting movements.
Ongoing discomfort with daily activities: In degenerative tears, symptoms may start subtly and worsen over time, with increasing stiffness, tenderness, and swelling that make routine activities more difficult.
Recognising these symptoms early and seeking professional assessment can help prevent further damage and support a more effective recovery.
HOW MENISCAL INJURIES ARE DIAGNOSED
COMPREHENSIVE TREATMENT OPTIONS FOR MENISCAL TEARS
Treatment for a meniscal tear depends on several factors, including the type, location, and severity of the tear, as well as your age, activity level, and overall knee health. Dr Liddell will recommend a personalised approach to help relieve symptoms, restore knee function, and prevent further damage.
Treatment options may include:
Rest and activity modification: For minor tears, reducing activities that aggravate the knee such as squatting, twisting, or prolonged standing can allow inflammation to settle and symptoms to improve.
Physiotherapy: A structured rehabilitation program may help strengthen the muscles around the knee, improve joint stability, and support long-term recovery. This is often used alongside or instead of surgery for smaller or degenerative tears.
Medications and injections: Anti-inflammatory medications or corticosteroid injections may be used to reduce pain and swelling, particularly in the early stages or in cases involving joint inflammation.
Surgical repair: If the tear is located in an area with good blood supply, a meniscal repair may be performed. This involves suturing the torn edges together to promote healing. It’s often recommended for younger or more active patients when the tear is repairable.
Partial meniscectomy: In cases where the torn portion of the meniscus cannot be repaired, a partial meniscectomy may be performed to remove the damaged tissue and smooth the area. This can help relieve symptoms and restore knee movement.
Arthroscopic surgery: Most surgical procedures are performed arthroscopically using small incisions and a camera to guide treatment. This minimally invasive approach typically allows for quicker recovery and less post-operative pain.
The goal of treatment is to reduce pain, improve function, and help you return to your daily activities or sports as safely and efficiently as possible. Dr Liddell will guide you through your options and recommend the most suitable path for your condition.