Does your knee hurt, pop, lock up or “catch”? Is your knee swollen at the end of the day? Do you have limitations when trying to completely bend or straighten your knee?
If you have answered yes to any of the above, you may have a torn meniscus in your knee. Often times the meniscus is torn when you twist your knee the wrong way. But sometimes it can wear out and tear.
The official name is meniscus, most people call it “cartilage” and as seen in the illustration above it is a cushion in the knee between the two bones.
There are two “C” shaped structures, the medial meniscus on the inside of your knee and the lateral meniscus on the outside of your knee.
Initial Treatment
- Ice, anti-inflammatory medications, exercises to regain strength and motion.
- An orthopedic surgeon will examine the knee, obtain x-rays and based on your complaints diagnose your problem. An MRI scan can usually confirm the diagnosis of a meniscus tear.
Other problems that can cause similar pain are:
- Arthritis
- Torn ligaments
- Loose fragments of bone or cartilage
- Inflamed knee tissue (synovitis)
If you have all of the classic signs of torn cartilage and things have not improved over time, your doctor may recommend surgery. In my office, I usually tell patients to call when they are ready for surgery.
It is not an emergency. Most people are ready for surgery when they are tired of the swelling, popping, pain, and stiffness. They usually continue the sports that they enjoy but notice the knee is stiff and swollen after working out or after a long day at work. Patients usually have surgery during the “slow season” at work, and athletes wait until the “end of the season.”
Arthroscopy
This is a surgical procedure that allows the surgeon to look inside the knee using very small incisions to repair or remove torn cartilage in the knee. Through three small incisions (about 3-4 millimeters each) a small camera is inserted in the knee. This camera is attached to a video monitor and the doctor can look inside the knee. The second and third incisions are used to insert small instrument used to repair or shave the torn cartilage. Surgery to shave or remove torn cartilage takes about 30 minutes. Most patients have the procedure done at an outpatient surgery center where they can go home the same day.
After Surgery
“RICE” Rest. Ice. Compression ( an ace wrap). Elevation.
After several days the large surgical bandages are replaced with smaller ones. Exercises to move the knee are often started right away. Crutches are used for the first few days, but most people are off of crutches after 4-5 days. If the meniscus is sewn together (repaired) patients are on crutches for 4 weeks. Pain medication is often necessary for a few days. For you work-a-holics you can return to “light duty ” in about 4-5 days.
Some people need physical therapy. I usually wait to make this determination on a case by case basis. Full movement is obtained by 4 weeks, and normal activities (sports) can be resumed by 6-8 weeks. Surgical risks of routine arthroscopy are minimal but include bleeding, infection, persistent swelling. For the majority of people the benefits outweigh the risks. Removal of the torn cartilage often allows individuals to return to the sports and activities that they enjoy.
