What is the meniscus?
The meniscus is a hard but at the same time elastic structure composed mainly of water and collagen fibers. Each knee has two menisci, the medial and the external. The menisci have an extremely important role in the function of the knee by increasing the contact surface between the two bones, while at the same time stabilizing the knee and at the same time absorbing shocks during loading, making the movement of the joint smoother. A meniscus tear is one of the most common knee conditions.
How does a meniscus tear happen?
Meniscal tears are classified into acute and degenerative. Acute lesions usually occur in young patients, mainly athletes. Usually these patients experience acute pain with swelling of the knee and possibly “locking” of the joint. Degenerative tears concern older patients, due to the “aging” of the tissue with loss of elasticity. Usually patients report a mild mechanism of injury (simply standing or deep sitting), while it is not uncommon for patients to have recurrent episodes of knee edema (swelling) with relatively mild pain without any significant prior injury.
Treatment of meniscal tears
A meniscal tear can be treated conservatively or surgically, depending on whether it is of acute or degenerative etiology. As a rule, small tears of degenerative etiology can be treated conservatively for a period of about 2-3 months. Conservative treatment includes rest, short-term use of nonsteroidal anti-inflammatory drugs, modification of patient activities, cryotherapy, and rehabilitation with physical therapy and muscle strengthening. After this period and appropriate recovery, a large number of patients become asymptomatic. However, a percentage of patients continue to have symptoms despite conservative treatment. If the pain or swelling persists and makes the patient’s daily life difficult, then surgical treatment of the problem is indicated. Acute tears in young patients require, with very few exceptions, surgical treatment with the arthroscopy method. Arthroscopy is a modern surgery, with which the orthopedist, through a small incision of about 5 millimeters, inserts a camera connected to a fiber optic lens (arthroscope) and sees in magnification each intra-articular damage with excellent accuracy. Then, from one or more additional incisions of the same length, with the help of special surgical instruments depending on the occasion and with extreme precision of movements, he intervenes to correct it. During surgery, either an attempt is made to save the meniscus (Save the meniscus!) by suturing the damage, or the injured part of the meniscus is removed (partial meniscectomy). The choice of treatment depends on the location and consequently the blood supply of the torn part of the meniscus, as well as the morphology and age of the lesion.