by Dr. Al DeSimone, M.D.
Meniscal tears have become an extremely common injury due to the higher level of competition seen in our younger athletes. Acting as a load bearing cartilaginous structure that is located on both the inner and outer aspect of the knee, it serves to provide stability and acts the major shock absorber for the knee when playing sports. Having multiple purposes, the meniscus also provides the joint with lubrication as well as nutrition.
Injuries to the meniscus usually occur during twisting and colliding sports, and may also be associated with other ligamentous injuries to the knee such as (anterior cruciate ligament). On occasion, a meniscal tear can also occur during a deep squatting motion to the knee joint. Symptoms will usually consist of pain, swelling, and diminished range of motion. The knee may feel unstable and often a catching sensation will occur when walking or running. Diagnosis of the meniscus tear is usually made during an orthopedic clinical examination. MRI’s have become extremely helpful in determining the size and location of the tear, which becomes of vital importance when considering treatment.
Treatment usually consists of arthroscopic surgery as this is a minimally invasive approach that will allow for evaluation of the meniscus and the potential for repair. If the tear is degenerative in nature or too complex to repair, a partial meniscectomy is usually recommended. From a surgical standpoint, it is extremely important to consider repair, especially in the younger patient. It is also prudent to avoid any prolonged conservative treatment when considering surgery as tears can occasionally propagate and become larger, rendering them irreparable. In the younger athlete who has had a significant injury to his meniscus and has undergone an extensive meniscectomy because of the degree of damage, the meniscal transplant has now become a viable treatment option.