Meniscus Tears: A General Overview

With one wrong move, one wrong step, and just like that an athlete's season can vanish before their eyes. For many athletes, their worst nightmare is an injury that will leave them sidelined for months, such as a meniscus tear. In this article, I will be discussing the various details about meniscus tears and what the recovery process looks like.

**Knee Anatomy**

The menisci are located in between the femoral condyles and the tibial plateau. The collateral ligaments are located on the outer portions of the knee.

Introduction

What is a meniscus tear? Well, to understand what a meniscus tear is, we first have to understand what the meniscus is.

The meniscus is a C-shaped piece of cartilage located between the femur and tibia. Every person has both a medial (Inner part of the knee) and a lateral (Outer part of the knee) meniscus. Its primary function s to help stabilize the knee and serve as a sort of shock absorber. That means that even when you're performing daily tasks such as walking or running, your menisci are actively involved in making sure your knees don't buckle!

Because of its major role in everyday life, a meniscus tear is the most common major knee injury, especially in athletes involved in contact sports. Within this subset of athletes, the data showed that athletes were more likely to tear their medial meniscus than their lateral meniscus. This is due to the fact that during activity, a valgus force (A force pushing the knee inward, creating a knock-kneed position) is more common in athletic motions than a movement that pushes the knee outward.

Etiology and Symptoms

A meniscus tear is a serious injury for many athletes. It can occur through a variety of methods such as...

Direct blunt force that pushes the knee either inward or outward
Repetitive microtrauma
Applying force to the leg and pushing it into the ground while rotating

As a result, an athlete may experience the following symptoms...

Localized pain around the area of the meniscus and the joint line
Inability to fully bear weight
Clicking and popping of the knee
Inability to fully extend or bend the knee joint
Extreme swelling

Types of Meniscus Tears

2. Radial Tear - A tear originating from the central region of the meniscus that extends out towards the periphery. This disrupts the protein fibers along the edge, compromising the meniscus's ability to absorb energy. This particular tear will require surgery in all cases as it is in a location with limited blood flow.

3. Horizontal Tear - A tear occurring in the middle or outer portion of the meniscus. Depending on how close to the center it is, this tear may not require surgery.

4. Bucket Handle Tear - While similar to a horizontal tear, a bucket handle tear affects a much larger portion of the meniscus. This type of tear will require surgery as the torn portion of the meniscus blocks the normal movement of the knee.

5. Complex Tear - This tear has qualities that resemble both a horizontal and radial tear. Because of the severity of the tear, surgically repairing the meniscus isn't always possible, meaning that it may need to be partially or fully removed.

6. Flap Tear - A flap tear is an unusual tear pattern to the meniscus, causing the patient to feel their knee is "catching". This is because of the flap that was created during the injury.

Diagnosis

The meniscus is an extracapsular ligament, meaning that it lies inside the joint capsule. As with other knee injuries, an MRI or an X-ray is typically required to properly diagnose a meniscus tear. Below is an MRI of a meniscus tear.

Besides this, some special sports medicine tests can help an athletic trainer in getting a better picture of the scenario and refer them to a doctor for an MRI if it is warranted. These are the McMurray's, Apley's Distraction, and Apley's Compression Tests. Overall, these tests help an athletic trainer determine if there is a possible meniscus tear by applying or removing pressure on the meniscus. To learn more about these tests, follow this link to a YouTube video by Arcadia Sports Medicine (Fast forward to 2:42 for meniscus special tests). https://www.youtube.com/watch?v=hojXCzdAkgw

Treatment

Every meniscus tear is a different case. Whether you're a 50-year-old office worker or a 15-year-old active high schooler or if you have a small horizontal tear or a large bucket handle tear matters. All these factors affect what course of treatment is the best for you.
In this article, we will primarily be focusing on athletes and their rehabilitation process. Typically, athletes will want to return to their respective sport as soon as possible. Therefore, for many, the best course of action is to undergo surgery. Depending on the severity of the tear, two different surgeries are available. In both surgeries, a surgeon will often perform arthroscopic surgery in order to minimize damage to the surrounding tissues.
For less severe tears, a partial meniscectomy provides the athlete with the quickest return. In this case, a surgeon will go into the knee and debride the area by trimming and removing the damaged cartilage. For more severe tears, a full meniscus repair is warranted, meaning that the athlete will be out of their sport for a longer period of time. For certain tears such as bucket handle tears, the surgical technique slightly differs.

Athlete Interview

Having a meniscus tear is a tough experience. This is something well-known to Kaya Chung, a recent graduate and former soccer player at Arcadia High School. Chung tore her right lateral meniscus during her freshman year and her left lateral meniscus during her senior year. In both cases, she had different recovery times. To read more about her experience, check out the link to the article below.

Conclusion

Meniscus tears are no joke. Like other major knee injuries, meniscus tears require extensive rehabilitation and can cause athletes to miss months of their sports. However, with proper support and guidance, athletes can return to the playing field and perform better than ever. This article serves as something to help give you a better idea about what a meniscus tear is and what the treatment process looks like. As always, consult a medical professional before making any decisions about treatment.

Sources

Hirsch, Alex. “6 Types of Meniscus Tears.” Orthopaedic Associates of Central Maryland, 18 June 2020, www.mdbonedocs.com/6-types-of-meniscus-tears/.

“Radial Meniscus Tear Chicago, IL.” Dr. Jorge Chahla, 7 June 2022, www.jorgechahlamd.com/knee/radial-tears-chicago-il/.

“Torn Meniscus.” JHM, 11 Feb. 2022, www.hopkinsmedicine.org/health/conditions-and-diseases/torn-meniscus#:~:text=What%20You%20Need%20to%20Know,used%20to%20treat%20meniscal%20tears.

“Types of Meniscal Tears.” Jacksonville Orthopaedic Institute, www.joionline.net/trending/content/types-meniscal-tears. Accessed 19 July 2023.