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8054 Yonge St. Thornhill. Just south of the intersection of Yonge and HWY 7/407

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WILDERMAN MEDICAL CLINIC

About Meniscal Tears

Meniscal tears are a common knee injury that can cause pain and instability in the joints; the condition is frequently seen among athletes and active individuals.

These tears often occur during sports or other physical activities and can be accompanied by a popping sound, swelling, and a limited range of movement. If left untreated, meniscal tears can lead to degenerative joint changes and ultimately osteoarthritis.

Anatomy

The meniscus is a piece of cartilage in the knee that acts as a cushion between the thigh bone (femur) and shinbone (tibia). The medial meniscus sits on the inner portion of the knee and the lateral meniscus sits on the outside of the knee.

The meniscus helps to distribute weight and reduce friction between these two bones and plays an important role in knee stability.

When the meniscus is torn, it can lead to pain, swelling, and difficulty moving the knee (Bhan et al., 2020).

How does ameniscal tear develop?

Meniscal tears can develop due to traumatic injuries or degenerative changes in the knee joint. Traumatic injuries can occur when the knee is forcefully twisted or bent while bearing weight, due to sudden stops or pivots, or as a result of a direct blow to the knee, especially during sports or heavy lifting.

Meniscal tears are common in athletes who participate in contact sports such as football, basketball, or soccer.

Tears can also occur due to adverse events such as a motor vehicle accident, where, for example, the knee can forcefully impact the dashboard. Degenerative changes in the knee joint can occur over time and are commonly seen in older individuals or those with chronic conditions such as osteoarthritis.

Additionally, certain anatomical factors such as abnormal knee alignment or a previous injury to the knee can also increase the risk of developing meniscal tears (Khan et al., 2016).

What are the symptoms of a meniscal tear?

The symptoms of meniscal tears vary depending on the severity of the tear. Common symptoms of meniscal tears include:

• Pain and swelling in the knee
• Difficulty bending or straightening the knee
• A popping or clicking sensation in the knee
• Feeling like the knee is locked or stuck in place
• Loss of range of motion in the knee joint
• Difficulty walking or running
• Instability or a feeling of the knee giving way

How common are meniscal tears?

A meniscal tear is a relatively common knee injury, with over 700,000 meniscal repair procedures performed annually in the United States.

It is estimated that more than 75% of individuals with osteoarthritis suffer from meniscal injuries, and meniscal tears are also one of the most common knee injuries overall.

While they can occur in individuals of all ages, they are more commonly seen in adults over the age of 40 (Wang et al., 2023).

What are the causes of meniscal tears?

Meniscal tears can occur due to sudden trauma or degeneration over time. Some of the most common causes of meniscal tears include:

Sports injuries: Meniscal tears are common among athletes, particularly those who participate in sports that involve sudden stops, twists, or pivots such as basketball, football, soccer, and skiing.
Trauma: Meniscal tears can also occur due to a sudden blow to the knee, such as during a car accident or a fall.
Degeneration: The meniscus can wear down over time, making it more susceptible to tears. This is particularly common in older adults.
Anatomical conditions: Certain anatomical factors such as abnormal knee alignment or a previous injury to the knee can also increase the risk of developing meniscal tears

What are the risk factors associated with meniscal tears

Factors that can increase the risk of developing a meniscal tear include:

Age: As we age, the risk of developing meniscal tears increases due to the natural degeneration of the meniscus
Participating in high-impact sports: Sports that involve sudden stops, twists, or pivots can increase the risk of meniscal tears
Obesity: Excess weight can put additional stress on the knee joint, increasing the risk of meniscal tears
Previous knee injuries: Previous knee injuries, such as a torn ACL, can increase the risk of developing meniscal tears
Family history: A family history of meniscal tears or other knee injuries can increase the risk of developing the condition

How are meniscal tears diagnosed?

Diagnosis of meniscal tears typically involves a physical examination of the knee by a medical professional, followed by imaging tests such as an MRI, X-ray, or Ultrasound.

The physical examination may involve evaluating the range of motion of the knee, assessing for swelling and tenderness, and checking for any clicking or popping sounds during movement.

An MRI or Ultrasound uses a transducer that sends out ultrasonic waves that are reflected back by tissues in the body, creating an image; this image can allow the ultrasound technician to visualize the tissues of the knee which can be helpful in diagnosing possible meniscal tear injuries.

MRI is the gold standard for diagnosing meniscus tears; it uses a strong magnetic field and radio waves to create detailed images of the soft tissues in your knee joint. An X-ray will help to rule out other conditions such as arthritis or a bone fracture.

How are meniscal tears treated?

The treatment for meniscal tears depends on the severity and location of the tear. In some cases, meniscal tears can heal on their own with rest, ice, and anti-inflammatory medications.

However, in more severe cases, surgery may be required to repair or remove the torn meniscus.

Non-Surgical treatment:

  • The RICE protocol is effective for most sports-related injuries. RICE stands for Rest, Ice, Compression, and Elevation.
    • Rest: Avoid activities that exacerbate the pain and swelling
    • Ice: Apply ice to the affected area to reduce swelling and pain
    • Compression: Use a compression bandage or knee brace to support the knee and reduce swelling
    • Elevation: Elevate the affected leg to reduce swelling
  • Non-steroidal anti-inflammatory drugs (NSAIDs) help to reduce pain and inflammation
  • Physical therapy may also be recommended to help improve the range of motion and strengthen the muscles around the knee joint

Surgical Treatment:

Meniscectomy: This is a procedure where the torn portion of the meniscus is removed.
Meniscus repair: In some cases, the meniscus can be repaired using sutures or other techniques to allow it to heal.
Meniscus transplantation: This is a procedure where a donor meniscus is transplanted into the knee to replace the torn meniscus.

Recovery from meniscal tears depends on the severity of the tear and the treatment method used. In some cases, patients can return to their normal activities within a few weeks.

However, in more severe cases, it may take several months to recover fully.

Physical therapy is often recommended to help strengthen the muscles around the knee and improve the range of motion.

What do we offer at WMC

At the Wilderman Medical Clinic, we offer a variety of interventional and non-interventional pain management options, including:

Interventional pain management for meniscal tears:

• Dextrose (prolotherapy) injections for meniscal tears
• PRP (plasma-rich protein) injections for meniscal tears
• nStride injections for meniscal tears

Non-interventional pain management for meniscal tears:

• Psychotherapy
• Kinesiology education sessions

How can we prevent meniscal tears?

While meniscal tears cannot always be prevented, there are steps that can be taken to reduce the risk of injury. Prevention of meniscal tears involves maintaining a healthy weight, staying physically active, and avoiding activities that place excessive stress on the knee joint.

Proper warm-up and stretching before exercise or physical activity can also help to reduce the risk of injury.

Wearing appropriate footwear and protective gear during sports and activities can also help to prevent knee injuries.

References

Bhan K. Meniscal Tears: Current Understanding, Diagnosis, and Management. Cureus. 2020 Jun 13;12(6):e8590. doi: 10.7759/cureus.8590. PMID: 32676231; PMCID: PMC7359983.

Khan HI, Aitken D, Ding C, Blizzard L, Pelletier JP, Martel-Pelletier J, Cicuttini F, Jones G. Natural history and clinical significance of meniscal tears over 8 years in a midlife cohort. BMC MusculoskeletDisord. 2016 Jan 5;17:4. doi: 10.1186/s12891-015-0862-1. PMID: 26728980; PMCID: PMC4700611.

Wang, Hong-De et al. (2023, February 1). Classification of Bone Bruises in Pediatric Patients With Anterior Cruciate Ligament Injuries. Orthopaedic Journal of Sports Medicine, 2023 Feb 11;2, 232596712211447. doi:10.1177/23259671221144780