Knee Meniscus Injury: What Treatment Options Should You Consider?
A meniscus is a fibrous cartilage structure that is situated between the femur (thigh bone) and tibia (lower leg) which acts to absorb shock that the body sustains during movement and activity. This ensures that the knee joint surfaces remain healthy and undamaged. The meniscus of the knee consists of a medial meniscus and lateral meniscus portion. It is common for individuals to suffer a meniscus injury during an activity such as twisting the knee while it is slightly flexed. Given this, sports players or recreational athletes common experience meniscus injuries. As with many musculoskeletal related problems, as we age our meniscus becomes more susceptible to degeneration and tears due to knee joint arthritis. In situations like this surgical intervention may be warranted to repair the knee joint surface and meniscus injury.
WHAT ARE THE SIGNS & SYMPTOMS OF A MENISCUS INJURY?
Characteristically an individual will present to a musculoskeletal therapist such as a Chiropractor or Physiotherapist and report that they experienced the onset of knee pain following activity. During discussion it may be noted that they noticed a twisting injury while bending, landing or jumping. Associated symptoms of meniscus injury include:
- Knee pain during walking, running, landing or jumping
- A sensation of clicking or popping within the knee joint during movement
- The knee may become locked or stiff during extension and flexion
- Generalized knee swelling may be present
- Tenderness upon palpation of the medial and lateral knee joint surfaces
If you’re experiencing any of these symptoms than it is highly likely that you have suffered a meniscus injury and/or a knee ligament injury. Clinical examination is recommended.
WILL IT HEAL BY ITSELF?
Injuries require adequate blood supply to provide nutrition and healing properties. Unfortunately, meniscus have an extremely poor bloody supply meaning there healing potential is very limited. The meniscus has two distinct portions which influence their ability to heal which include:
- Red Zone
- Has poor blood supply from the synovial capsule
- White Zone
- Has no blood supply, therefore requires intervention to assist management
TREATMENT STRATEGIES FOR MENISCUS INJURY
Depending upon the severity of your meniscus injury, treatment will generally aim to:
- Reduce pain and inflammation of the knee joint
- Return normal knee joint movement and range of motion as promptly as possible
- Balance muscle strength and symmetry
- Improve patellofemoral function if required
- Return to usual activity or sport
In particular cases surgical intervention may be required to repair the damaged meniscus and surrounding knee joint. It is important to discuss this procedure with your health care practitioner and recognize that appropriate post-surgical rehabilitation will be required.
WHAT DOES THE RESEARCH TELL US?
- Middle-aged patients who have suffered meniscus injury may benefit from surgical intervention in addition to a structured exercise program. Gauffin, H. (2014). Knee arthroscopic surgery is beneficial to middle-aged patients with meniscal symptoms: a prospective, randomized, single blinded study. Osteoarthritis & Cartilage, 22(11); 1808 – 1816.
- The menisci of the knee are complex structures with various important functions within the knee joint. Loss of the menisci leads to a significantly increased risk of developing degenerative changes in the long term. McDermott, I. (2008). Biomechanics of the menisci of the knee. Orthopaedics & Trauma, 22(3); 193 – 201.