What Is a Meniscus? How Are Diagnosis and Treatment Performed?

What is a meniscus?

Menisci are cartilage-like structures located in the knee joint. Menisci have very important functions such as load transfer, shock absorption, distribution of joint fluid and transmission of deep sensation in the knee. In each knee, there are two menisci, one on the inner side and one on the outer side.

How do meniscus tears occur?

Meniscus tears usually occur when the knee suddenly twists or after a fall. Meniscus tears can occur in anyone; in young people they are caused by high-energy trauma. With advancing age, the menisci undergo wear and degeneration, and tears become more likely.

Medial (inner) meniscus tears are seen more often than lateral (outer) ones. The reason is that the lateral meniscus is more mobile and has a greater ability to avoid trauma. However, tears accompanying anterior cruciate ligament rupture occur more often in the posterior part of the lateral meniscus.

How are meniscus tears named?

Based on the shape of the meniscus tear, they are classified as longitudinal (vertical) tears, horizontal tears, oblique tears, radial tears, and complex tears (flap-type, complex and degenerative tears). The tear shape is among the factors affecting the choice and success of treatment.

What symptoms does a meniscus tear cause?

After the trauma, pain occurs on the inner or outer side of the knee. Swelling may or may not occur immediately after the trauma. If the torn fragment is large and continues to move with knee movement, there may be pain, swelling and a feeling of catching in the knee. Sometimes this catching cannot resolve on its own and urgent surgical intervention may be required.

How is a meniscus tear diagnosed?

During examination, a provisional diagnosis of meniscus tear can often be made, and the tear is confirmed by MRI. MRI also provides information about the location, shape and size of the tear. In addition, ligament and cartilage injuries that may accompany a meniscus tear are also identified.

How are meniscus tears treated?

Treatment of meniscus tears is determined according to the location, shape and size of the tear and the symptoms it causes. Not all tears require surgery. Age and the patient's activity level are very important in decision-making. Generally, tears smaller than 1 cm that do not cause mechanical symptoms are followed with rehabilitation and injections. Large tears and tears causing locking symptoms require surgical treatment.

What is arthroscopy? How is it performed?

Arthroscopy is visualization of the inside of the joint with a camera through small incisions (approximately 0.5 cm). It can be performed under regional or general anesthesia. Pathologies within the knee are identified by visualizing the structures, and treatments for them can be performed without opening the joint. Meniscus tears are trimmed or sutured using various instruments. Accompanying ligament and cartilage problems can also be treated at the same time.

Will my meniscus tear be sutured or removed?

Since the menisci are vital structures for the knee, every effort should be made to preserve them. The meniscus is never removed completely. With some tear types, when the torn fragment is in the non-vascularized part of the meniscus, a small portion is removed, since it is known that this small fragment will not heal even if sutured; the vascularized area is always sutured. Meniscus suture techniques vary depending on the tear type.

What happens after surgery?

After arthroscopy, a one-night hospital stay is generally sufficient. The patient can stand up on the night of surgery. Depending on the procedure performed on the tear, crutches may be needed. This period generally does not exceed four weeks. Movement and rehabilitation begin immediately after surgery. Office workers can return to work after one week. Rehabilitation time and time to return to sport may vary depending on the procedure performed on the tear.