What is a traumatic meniscus injury?
Each knee has two menisci. The medial meniscus sits between the tibia and the femur in the part of the knee closest to the midline (middle) of the body. The lateral meniscus sits between the tibia and femur in the part of the knee furthest away from the midline. The meniscus serves the important function of transmitting forces across the knee evenly when performing the weight-bearing activity. Due to their crescent shape and the fact that they are triangular in cross-section, they allow the rounded part of the bottom of the femur to fit better on the flat part of the top of the tibia. In addition, the meniscus helps to maintain the stability of the knee, improves lubrication of the knee, and absorbs some of the forces when performing weight-bearing activity.
There are two broad types of tears: Traumatic and Degenerative. Traumatic tears occur when there is a twisting or hyperflexion (deep bend) injury to the knee. These occur when playing sports such as football, skiing, squash or netball.
What are the symptoms of a traumatic meniscus injury?
The symptoms from a torn meniscus can be similar whether traumatic or degenerative. Usually, there is swelling and well-localised pain in the knee. The pain is made worse by twisting or squatting motions. Sometimes a fragment of the torn meniscus can displace inside the knee in such a way as to “lock” the knee. This can be thought of as being similar to something being caught in the hinge of the door, stopping it from moving.
How is it diagnosed?
A clinical assessment is very important, followed initially by an examination. An MRI scan will be performed to confirm the diagnosis.
What are my options for treatment?
Because the meniscus has a poor blood supply that comes from the periphery of the meniscus, it has poor healing potential. This means that it is unlikely to heal on its own. In addition, because the knee movement will move the injured meniscus, the environment of the knee is not conducive to healing.
The British Association for Surgery of the Knee (BASK) has very clear guidelines on who should and should not have an operation on their meniscus. When the meniscal tear is merely causing pain, then a period of physiotherapy plus injections is recommended for the first three months, followed by reassessment. An operation may be suitable at that point.
Some meniscal tears are amenable to repair. The factors that predict success from surgical repair of the meniscus include patient factors and factors related to the tear itself. In non-smokers who are not overweight and are under the age of 40, success rates of repair are higher.
Tears that occurred within a few weeks of the operation, that are in the periphery of the meniscus (where the blood supply is greatest) have the greatest chances of success of the repair. Studies show that repairs are successful in up to 80% of patients. In the remainder, a second operation may be necessary to remove the torn part of the meniscus that has not healed.
If you or someone you know has suffered an injury or is experiencing pain across their lower limbs or difficulty with mobility and would like a consultant-led review, please contact us. Grosvenor Orthopaedics have extensive experience in the treatment of knee-related injuries with excellent patient outcomes.
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Grosvenor Orthopaedics have extensive experience in the treatment of knee-related injuries with excellent patient outcomes.
KNEE CONDITIONS
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KNEE TREATMENTS
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our KNEE SURGEONS
The Knee Service at Grosvenor Orthopaedic Partners is led by Mr Luke Jones and Mr Chethan Jayadev, both Oxford PhD educated knee surgeons with London Teaching Hospital NHS consultant posts. They provide a comprehensive range of knee procedures as part of a multidisciplinary team of healthcare professionals including highly specialised physiotherapists, all committed to returning you to optimal function.
Our team are well placed to manage and treat a diverse range of knee problems utilising cutting edge diagnostic technology and treatment approaches, both surgical and conservative. Below is an overview of some of the knee conditions we treat but for a more thorough understanding please contact our team here
MR LUKE JONES
Consultant Orthopaedic Knee Surgeon
MR CHETHAN JAYADEV
Consultant Orthopaedic Knee Surgeon
MR MARK WEBB
Consultant Orthopaedic Knee Surgeon
What some of our patients say
Miss NN
Thank you and please accept my gratitude for a successful knee surgery and overall a very positive experience. This gold medal is for you!