The meniscus is a horseshoe-shaped cartilage in the knee joint. The knee joint has three main bones, the femur, the fibula, and the tibia. The meniscus, although it is considered as a single unit, is actually split into the lateral and medial meniscus. The medial one is on the inside of the knee, and the lateral one is on the outside. A tear in either the medial or the lateral meniscus depends on the kind of injury that caused the tear. In young people, it is usually a traumatic injury that causes a tear. Most often the tear is caused by a twisting action of the knee when it is partially bent. In older people, a meniscus tear is caused due to a hardening of the cartilage. Invariably the tear is not clean and has frayed edges.
The symptoms are pain and swelling around the knee. The pain usually goes away when the load is removed from the knee. In case there are any pieces broken away, they may lock the joint and prevent the complete extension of the leg. The doctor will question the patient closely on where exactly the pain is as he/she bends and flexes the knee to find out whether it is a medial tear or a lateral one.
Treatment of a meniscus tear depends on two main factors.
The portion of the meniscus that tears is very important in the treatment because the outer red zone of the meniscus is rich in blood supply and heals quickly and easily. The inner white zone does not have much blood supply and relies on the synovial fluid for nourishment. A tear in this zone takes much longer to heal and sometimes does not heal at all.
A tear in the red zone is usually left as is, and rest is recommended for recovery. If the tear is very severe, the torn portion may be stapled together to enable faster healing. A tear in the white portion may or may not require surgery, depending on the state of the tear.
If the edges are frayed or if there are broken pieces floating around, surgery may be required to remove it. The surgeon will be very careful when performing surgery here because any removal of the meniscus always carries with it the danger of future osteoarthritis problems.
The actual surgery is quite simple, and in many hospitals is performed as an outpatient procedure. Very often recovery lasts only a few days, with people being able to walk within 24 hours and a return to complete normalcy within a month's time.
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