MENISCUS

WHAT IS MENISCUS

• Meniscus is a “C”-shaped specialized structure present in knee.
• They are triangular in cut section, thick on outside, curved on the top and flat on the bottom.
• Each meniscus has 2 roots, anterior and posterior, and a body. Roots attach the meniscus to underneath bone (tibia)
• Each knee has a lateral and a medial meniscus

FUNCTION

• The menisci act to disperse the weight of the body and reduce friction during movement
• Meniscus provides structural integrity to the knee when it undergoes tension and torsion.

SYMPTOMS OF TEAR

1. Pain, swelling
2. Difficulty in using affected knee
3. the feeling of your knee locking, catching or giving way.

DIAGNOSIS

Examination

1. Swelling, tenderness
2. McMurray’s test
3. Apley’s grinding test

Imaging tests

1. Knee X-ray: This test won’t show a meniscus.
2. MRI: GOLD STANDARD-NON INVASIVE test to diagnose meniscus lesions although they aren’t considered 100 percent reliable.
3. Arthroscopy: Gold standard- Invasive : If above modalities are unable to determine the cause of your knee pain, arthroscopy will be needed to study the joint.

TREATMENT

Non-surgical treatment

1. Non-surgical treatment is often considered for a smaller or chronic tear.
2. RICE method:

1. Rest your knee. Use crutches to avoid any weight bearing on the joint. Avoid any activities that worsen your knee pain.
2. Ice your knee every three to four hours for 15-20 minutes.
3. Compress or wrap the knee in an elastic bandage to reduce inflammation.
4. Elevate your knee to reduce swelling.

1. Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and swelling around your knee.

Surgical treatment

          Depending on the type and location of the tear, the patient's age, and physician's preference injured menisci, will be either repaired or removed.

1. Repair

• Any attempt to repair when possible is desirable.
• The meniscus has precarious blood supply, and, therefore, healing can be difficult.
• Meniscal surgeries are arthroscopy assisted procedures.
• Non-absorbable fiber sutures are used to stitch the meniscus in various configurations.
• Various techniques used to repair are inside-out, outside–in and all inside.

      2. Excision or removal (Meniscectomy)

      When the torn meniscal fragment is small, shredded or irreparable, then arthroscopic removal of torn fragment seems a reasonable choice.

REHABILITATION

Meniscus repair aims at healing and so follows a stringent post op rehabilitation. It is advised to follow rehabilitation under a trained, competent physiotherapist for desirable results.