A meniscus tear is one of the most common sports injuries, but many times it is also a knee injury that is also found in non-athletes. Each knee consists of two fibrocartilaginous elastic structures that look like two crescents and which are inserted between the surfaces of the two articulating bones, the femur and the tibia. There is a medial and an external meniscus, in the medial & external compartment of the knee respectively.
They have an important role in the knee joint and this is because the menisci are inserted between the femoral and tibial condyles in such a way as to significantly limit the direct contact of the articular surfaces and reduce the friction between them produced during knee movements. Also, their shape significantly increases the size and depth of the tibial articular surface, thus offering greater stability to the joint.
Having an elastic structure, they help absorb the shocks produced during knee movements, as well as the uniform distribution of mechanical loads. This is quite important for the protection of the articular cartilage, and therefore the occurrence of arthritis.
When the pressure received by a part of the medial or external meniscus exceeds the strength of the tissue, a tear is created. Even small tears can cause serious symptoms, such as intra-articular fluid collection (hydrarthritis), pain when deep sitting or kneeling, feeling of “blocking” in the knee, etc. There are different types of meniscal tears, depending on the location, extent and the shape of the rupture. More specifically, there is:
- Radial rupture
- Longitudinal tear
- Oblique tear
- Break like a bucket handle.
The tear in younger patients and athletes is usually caused by the application of a large force that acts once on a healthy meniscus, but in older patients, it is the continuous and chronic stress of the menisci due to manual labor that gradually causes wear and tear of the menisci. , and eventually can create the rupture even with a simple injury.
The mechanism of meniscal tears is usually loading of the bent knee accompanied by simultaneous flexion. But it can also be a simpler movement, such as standing up from a deep seat, and this is because during a deep seat, the maximum forces are developed between the thigh and the shin and therefore the pressure exerted on the meniscus is capable of injuring it.
The main symptoms of a meniscus tear are the following:
- Knee pain
- Edema (swelling – hemarthrosis – hydroarthrosis)
- Tenderness on palpation of the meniscus
- Knee extension deficit
- “Blocking” of the knee joint in flexion.
Diagnosing a meniscus tear is relatively easy. Taking the patient’s history well will give information about the mechanism of the injury, while the control of movements and some special evaluation tests will show us the severity of this injury. An MRI can be performed for imaging, which will clearly show the meniscus tear.
