EXPLORING MENISCAL TEARS
What is the role of the meniscus?
The knee joint contains the meniscus structure, comprised of both a medial and a lateral component situated between the corresponding femoral condyle and tibial plateau. The meniscus withstands many different forces such as shear, tension, and compression. It also plays a crucial role in load-bearing, load transmission, shock absorption, as well as lubrication and nutrition of articular cartilage.
If you want to learn more about this topic, you can watch Prof. Jonas Thorlund's lecture here:
How do meniscal tears occur?
In young patients, sports-related (football, basketball, soccer, baseball, and skiing in particular) injuries are the most common cause of meniscal lesions, accounting for more than 1/3 of all cases. The underlying mechanism of these injuries usually involves cutting or twisting movements, hyperextension, or actions of great force.
In middle-aged or older individuals, meniscal tears occur due to long term degeneration.
Types of meniscal tears
The 6 common types of meniscal tears are:
- Incomplete tear
- Radial tear
- Horizontal tear
- Bucket handle tear
- Flap tear
- Complex tear
What are the symptoms of meniscal tears?
Some of the common symptoms of meniscal tears include:
- Pain over centre or side of the knee
- Tenderness on palpation
- Popping or locking within the knee
- Range of motion maybe limited
- Swelling maybe present over knee
Assessment in patients with meniscal tears
In the clinic, the diagnosis is typically based on:
- Clinical history
- Symptoms
- Clinical findings:
- Inspection
- Palpation
- Clinical tests
- Imaging (MRI)
Three common clinical tests for meniscal tears include:
- McMurray's test
- Apley's test
- Thessaly’s test
Meniscal tears in older adults
Meniscal tears findings on MRI SCAN ranges from ~5 % in young ages and up to 67 % in older ages. The older the patient is and the more osteoarthritic findings, the higher the prevalence. In middle-aged and older adults, a degenerative meniscal tear with knee pain and mechanical symptoms is indicative of osteoarthritis.
If you want to learn more about this topic, you can watch Prof. Jonas Thorlund's lecture here:
Source:
1. Eleftherios A. Makris, Pasha Hadidi and Kyriacos A. Athanasiou;The knee meniscus: structure-function, pathophysiology, current repair techniques, and prospects for regeneration; Biomaterials Volume 32, Issue 30, Pages 7411-7431
2. Lecture ‘Meniscal Tears’ by Prof. Jonas Thorlund