“Cycling about 300 miles a month and a hill walking holiday within 12 months of a knee osteotomy following a torn meniscus fifteen years previously.”
There are two meniscal cartilages in the knee that act as shock-absorbers – one on the inner and one on the outer side. They are made up of a different type of cartilage to joint surface cartilage and sit between the thigh bone and the shin bone. Their job is to evenly distribute forces across the knee, allowing the bones to glide smoothly without friction. They also provide stability in the joint.
Loss of meniscal tissue means that there is uneven weight distribution and force between the joint surfaces in the knee, which can lead to arthritis.
Meniscal tears are more common in people aged over 45. It’s more common to damage the inner meniscus than the outer meniscus.
- Acute tears: these can be caused by an injury, often as a result of twisting on a bent knee during rugby or football or other sports. Around 60% of patients who tear their anterior cruciate ligament (ACL) also damage one or both menisci at the same time
- Degenerative tears: these can happen during a simple everyday activity such as bending down or going upstairs
- Pain and swelling in the area, particularly in the area where the meniscus has torn
- A sensation of ‘clicking’ in the joint
- Difficulty walking or bending
- A sensation of the knee locking
Adrian will discuss your symptoms with you and examine your knee to check for tenderness, stiffness, swelling and check your range of movement. In most cases, he will arrange for you to have a magnetic resonance imaging (MRI) scan to confirm the diagnosis.
- Acute tears: most acute meniscal tears that are the result of an injury are treated with keyhole surgery to repair the torn meniscus. It’s a complex procedure with a success rate of around 65% for a single tear and 80% where there are also ligament injuries. If it’s not possible to repair the tear, then you may be offered meniscal debridement to remove damaged fragments and preserve as much healthy tissue as possible so that the meniscus can still act as a shock-absorber
- Degenerative tears: when these are caused by wear and tear, it is often not possible to repair the torn tissue. This type of injury doesn’t usually need surgery and, in most cases, the symptoms settle down over time. However, if your knee continues to catch and cause problems then surgery can be very successful. In a degenerative tear where the meniscal root tears away at the back, causing extreme pain, Adrian can carry out ‘root reconstruction surgery’ which, although it is complex, is highly successful
- In some cases, you may also be offered adipose tissue therapy to help treat a tear.