Meniscal tears : diagnosis, causes and treatment

Meniscal tears : diagnosis, causes and treatment

Diagnosis of meniscal tears

Painful knees, often swollen, blocking suddenly in certain positions, a catching sensation in the knee, are all signs indicating a meniscal tear. Symptoms vary from patient to patient, and depend particularly on the meniscus affected: medial, much more frequently affected, or lateral.

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The specialist will examine your knee and confirm the diagnosis with the help of x-rays. The latter are necessary, as it is not always very easy to distinguish meniscal tears from other knee disorders, in particular a sprain or osteoarthritis.

The menisci, essential components of the knee

Each knee has two menisci, which are c-shaped cushions of cartilage. The medial meniscus is located on the inner side of the leg, and the lateral meniscus is located on the outer side.

The menisci are essential in numerous ways for the proper functioning of the knee. They form the joint between the top of the tibia, which is flat, and the bottom of the femur, which is rounded, and thus protect the cartilage on these bones. Due to their elastic structure, they also act as shock absorbers in the joint, and as a lubricant to help the bones in the knee (femur, tibia and patella) slide over each other.

Main causes of meniscal tears

Meniscal tears can result from a trauma or simply due to ageing. In young subjects, tears can occur following an abnormal movement of the knee. Meniscal tears often occur during skiing accidents when the knee is twisted.

Degenerative damage is a combination of micro-traumas that occur throughout life resulting in the progressive wear of the meniscus. In this case, we talk of degenerative meniscal tears that are generally encountered in “genu varum” (bow-legged) or “genu valgum” (knock-kneed) subjects, patients suffering from osteoarthritis, or certain professionals who often work in a crouching position or carry heavy loads.

From the first measures to surgery: a treatment for each lesion

Some good habits following a trauma or as soon as the symptoms flare up, such as stopping the physical activity immediately and resting the knee, applying ice to the joint, or elevating the leg in case of swelling, can help limit the severity of the damage.

Bearing in mind the importance of the meniscus, once a meniscal tear has been clearly identified, conservative treatment will always be chosen first, whenever possible. Regarding degenerative tears, when not all daily activities are affected, a simple medical treatment is prescribed: painkillers and anti-inflammatories, even injections. In the event of a trauma, if the lesion is likely to heal easily, we will choose to immobilize the knee with a brace, followed by rehabilitation sessions.

Finally, in cases where surgery is necessary, we will choose a procedure that will enable as much of the meniscus to be conserved as possible. A “partial meniscectomy” consists in removing only the damaged part and the tear is repaired with a simple suture. Whatever the nature of the operation, it is performed using a minimally invasive arthroscopic technique (through small incisions using a camera to visualize the joint).

Dr Philippe Paillard

Article written by Dr Philippe Paillard

Specialist in orthopedic surgery and sports surgery, Dr. Philippe Paillard operates on patients with hip, knee, shoulder, elbow or ankle disorders or injuries.

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