Meniscal Injury

The meniscus of the knee joint is a crescentic structure which forms a buffer between the joint surfaces of the upper bone (femur) and lower bone (tibia) in the knee. There are two menisci in each knee. This structure is vulnerable to tearing following an injury in the joint. A tear in this structure typically results from a twisting injury and is often referred to as a "cartilage tear".

The amount of force required to tear the meniscus gradually decreases with age as the meniscus becomes more brittle. This ageing process is referred to as degeneration.

Typically a tear in the meniscus tends to produce mechanical symptoms in the joint with sudden increased pain on twisting and often associated with difficulty squatting. Sometimes patients describe "locking" in the knee which is an intermittent inability to fully straighten the joint.

Meniscal tears often occur following a specific injury; however with increasing age, the meniscus can tear as a result of degeneration only.

In order to accurately identify meniscal problems an MRI scan is required. Recent evidence however has shown that the meniscus may tear spontaneously with arthritis in the joint and therefore if an x-ray confirms significant arthritis in the joint, an MRI scan to identify a meniscal tear may not be appropriate. Simon will be able to discuss the appropriate investigation in your situation.

Treatment for meniscal tears is dependent both on the symptoms the tear produces as well as the overall degeneration (arthritis) in the joint. Recent evidence following extensive study of the outcome of treatment for meniscal tears has confirmed that in situations where a meniscal tear is associated with significant arthritis in the joint, arthroscopic surgery may not be the treatment of choice. Simon will be able to discuss the appropriate management of your meniscal tear.

In the situation where a meniscal tear is clearly causing mechanical symptoms in the joint arthroscopy of the knee could be the appropriate treatment for you. This would involve looking inside the knee with a telescope and removing or repairing the meniscal tear. The exact treatment required will depend on the situation within your knee. The treatment decision is complex and a consultation with Simon will allow you to discuss the risks and benefits of each treatment option.