{"id":2143,"date":"2017-04-04T20:03:25","date_gmt":"2017-04-04T19:03:25","guid":{"rendered":"https:\/\/www.myhealthspecialist.com\/blog\/?p=2143"},"modified":"2022-06-21T09:27:00","modified_gmt":"2022-06-21T08:27:00","slug":"the-meniscus-much-misunderstood","status":"publish","type":"post","link":"https:\/\/www.myhealthspecialist.com\/blog\/2017\/04\/04\/the-meniscus-much-misunderstood\/","title":{"rendered":"The meniscus &#8211; much misunderstood"},"content":{"rendered":"<p><img loading=\"lazy\" class=\"alignnone wp-image-2145\" src=\"https:\/\/www.myhealthspecialist.com\/blog\/wp-content\/uploads\/2017\/04\/shutterstock_246780622.jpg\" alt=\"meniscus\" width=\"600\" height=\"400\"><\/p>\n<p>As a dedicated knee surgeon with an interest in sports injuries, I am passionate about helping my patients return to full sporting function. In my experience, this is best achieved by working as part of a wider multi-disciplinary team that includes physiotherapists and primary care. Our goal is always to understand the exact nature of any injury, manage the acute phase of the injury, start physiotherapy rehabilitation, and intervene surgically, only when absolutely necessary.<\/p>\n<p>Our surgical goals are to preserve, and reconstruct where needed, as much of the knee\u2019s structural anatomy as possible. A critical structure, about which there is often much discussion and debate, is the meniscus \u2013 one of a pair of horse-shoe shaped cartilage structures within the knee which acts as a \u2018shock absorber\u2019 and helps to provide stability to the knee joint.<\/p>\n<p>I am often asked about <strong>meniscal tears<\/strong>. The most frequent questions are:<\/p>\n<ul>\n<li>\u201cHow should we manage meniscal tears?\u201d<\/li>\n<li>\u201cWhich ones need surgery?\u201d<\/li>\n<li>\u201cThe MRI found an unexpected tear, what should we do?\u201d<\/li>\n<\/ul>\n<p>My aim in this blog is to explore some of these questions and bring a little structure and clarity to how we approach this common knee injury.<\/p>\n<p><strong>Diagnosis and treatment of meniscal tears<\/strong><\/p>\n<p>A tear to the meniscus can be diagnosed upon history and clinical examination, and confirmed by MRI scanning.<\/p>\n<p>There are many misconceptions around meniscal tears, and how best to treat them &#8211; this is not helped by the many classifications and descriptions of this common injury. In my practice, I find it most helpful to think of meniscal tears as three types:<\/p>\n<ol>\n<li><strong>Asymptomatic <\/strong>(show no symptoms)<\/li>\n<li><strong>Painful symptoms only<\/strong><\/li>\n<li><strong>Painful and mechanical symptoms<\/strong><\/li>\n<\/ol>\n<p><strong><em>Asymptomatic<\/em><\/strong><\/p>\n<p><em>Asymptomatic meniscal<\/em> tears are very common and approximately 30-40% of people over the age of 40 years have been shown to have meniscal tears that are asymptomatic. The rate of tears increases with age and approaches 100% in the presence of osteoarthritis.<\/p>\n<p>An asymptomatic tear is picked up by an MRI scan for another knee complaint. The tear itself does not give the patient any pain at the site of the tear, nor does it result in any mechanical symptoms (such as clicking, catching, locking, or popping sensations).&nbsp;&nbsp;<\/p>\n<p>These tears never require surgery, and a combination of conservative treatment and rehabilitation can be used to target the original knee problem the MRI scan was performed for, such as patellofemoral pain, tendonitis etc.<\/p>\n<p><strong><em>Painful symptoms only<\/em><\/strong><\/p>\n<p>Painful symptomatic tears are either fresh new tears or are asymptomatic meniscal tears that have been aggravated and made to become symptomatic. In either case, the first line of treatment is usually not surgery, but non-operative treatment that includes rest, ice and physiotherapy rehabilitation. Only if a concerted effort at this non-operative treatment fails, and pains persist, should surgery be considered.<\/p>\n<p>Surgery, following appropriate assessment, discussion, and counselling, would take the form of a knee arthroscopy where the tear is assessed and, if feasible, the meniscus is repaired, or alternatively debrided (where part of the torn meniscus is removed \u2013 known as a meniscectomy). This would then be followed by an appropriate course of rehabilitation.<\/p>\n<p><strong><em>Painful and mechanical symptoms<\/em><\/strong><\/p>\n<p>Once again, painful and mechanically symptomatic tears are either fresh new tears or are asymptomatic meniscal tears that have been aggravated and made to become mechanically symptomatic. While non-operative treatment may be considered for those cases where the meniscus, although torn, is sitting in an anatomical position (non-displaced) it is likely to be unsuccessful as the mechanical symptoms are unlikely to resolve. Therefore early surgical intervention may be necessary.<\/p>\n<p><strong>Key points:<\/strong><\/p>\n<ul>\n<li><strong>Meniscal tears are common<\/strong><\/li>\n<li><strong>Rehabilitation is very important<\/strong><\/li>\n<li><strong>Surgery is a last resort and often dependant on the type of tear<\/strong>:\n<ol>\n<li>Asymptomatic: Never need surgery<\/li>\n<li>Painful symptoms only: Sometimes need surgery<\/li>\n<li>Painful and Mechanical symptoms: Often need surgery<\/li>\n<\/ol>\n<\/li>\n<\/ul>\n<p><a class=\"popmake-the-meniscus-much-misunderstood\" href=\"#\">References<\/a><\/p>\n<h6 class=\"p1\"><span style=\"color: #808080;\"><span class=\"s1\">This article is for information only and should not be used for the diagnosis or treatment of medical conditions. myHealthSpecialist makes no representations as t<\/span><span class=\"s2\">o the accuracy or completeness of any of the information in this article, or found by following any&nbsp;link from this article<\/span><span class=\"s1\">. Please consult a doctor or other healthcare professional for medical advice.<\/span><\/span><\/h6>\n<hr>\n<p><img loading=\"lazy\" class=\"alignnone wp-image-2144 size-full\" src=\"https:\/\/www.myhealthspecialist.com\/blog\/wp-content\/uploads\/2017\/04\/101_profile.jpg\" alt=\"Mr Adil Ajuied, Consultant Orthopaedic Surgeon\" width=\"100\" height=\"100\"><br \/>\n<a href=\"https:\/\/www.myhealthspecialist.com\/patient\/specialist\/101\/Adil+Ajuied?cid=1\" target=\"_blank\" rel=\"noopener noreferrer\">Mr Adil Ajuied, Consultant Orthopaedic Surgeon<\/a><\/p>\n<p><a href=\"https:\/\/www.myhealthspecialist.com\/patient\/specialist\/101\/Adil+Ajuied?cid=1\">Book an appointment with Mr Adil Ajuied<\/a><\/p>\n<!-- AddThis Advanced Settings generic via filter on the_content --><!-- AddThis Share Buttons generic via filter on the_content -->","protected":false},"excerpt":{"rendered":"<p>As a dedicated knee surgeon with an interest in sports injuries, I am passionate about helping my patients return to full sporting function. In my experience, this is best achieved by working as part of a wider multi-disciplinary team that includes physiotherapists and primary care. Our goal is always to understand the exact nature of&hellip; <a class=\"continue\" href=\"https:\/\/www.myhealthspecialist.com\/blog\/2017\/04\/04\/the-meniscus-much-misunderstood\/\">Continue Reading The meniscus &#8211; much misunderstood<\/a><!-- AddThis Advanced Settings generic via filter on get_the_excerpt --><!-- AddThis Share Buttons generic via filter on get_the_excerpt --><\/p>\n","protected":false},"author":29,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v18.1 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>The Meniscus - Much Misunderstood - myHealth bytes<\/title>\n<meta name=\"description\" content=\"Meniscal tears are common. 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