Meniscus Tear Treatment Options

What is a meniscus tear?

A meniscus tear refers to an injury involving the fibrocartilage discs located within the knee joint. These structures play a crucial role in distributing weight, absorbing shock, and promoting joint stability. Meniscus tears commonly occur due to twisting or forceful rotation of the knee, often during sports or activities that involve sudden stops or changes in direction. Symptoms of a meniscus tear typically include pain, swelling, stiffness, and a sensation of locking or catching in the knee joint. Diagnosis is made through physical examination, imaging studies such as MRI, and sometimes arthroscopic evaluation. Treatment options range from conservative measures such as rest, ice, physical therapy, and anti-inflammatory medications to surgical interventions such as meniscus repair or partial meniscectomy, depending on the tear’s location, size, and severity. Early detection and appropriate management are essential to alleviate symptoms, prevent further damage, and restore knee function.

What nonoperative treatment options are available?

1. Rest: Rest is often the initial step in managing meniscus tears, particularly in the acute phase following injury. Limiting weight-bearing activities and avoiding movements that exacerbate pain can help reduce inflammation and promote healing of the torn meniscus.
2. Ice: Applying ice packs to the affected knee can help alleviate pain and swelling associated with meniscus tears. Ice therapy is typically recommended for short periods, several times a day, especially during the acute phase of injury.
3. Compression: Compression bandages or knee sleeves can provide support to the injured knee and help reduce swelling. These supportive devices may be worn during activities or as needed to alleviate discomfort.
4. Elevation: Elevating the leg above the level of the heart can help reduce swelling and promote fluid drainage from the knee joint. Keeping the knee elevated while resting or sleeping can aid in symptom management.
5. Physical Therapy: Physical therapy plays a crucial role in the conservative management of meniscus tears. A tailored exercise program, supervised by a qualified physical therapist, aims to improve knee range of motion, strengthen surrounding muscles, and enhance joint stability. Therapeutic modalities such as ultrasound, electrical stimulation, and manual therapy techniques may also be utilized to alleviate pain and facilitate recovery.
6. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Over-the-counter or prescription NSAIDs, such as ibuprofen or naproxen, may be recommended to reduce pain and inflammation associated with meniscus tears. These medications should be used cautiously and under the guidance of a healthcare professional, considering potential side effects and contraindications.

What operative options are available?

1. Meniscus Repair: In cases where the meniscus tear is amenable to repair, surgical intervention may be considered. Meniscus repair involves suturing the torn edges of the meniscus together to promote healing and preserve as much of the meniscus tissue as possible. This procedure is typically indicated for younger patients with acute, traumatic tears, particularly if the tear occurs in the vascularized outer rim (red zone) of the meniscus, where blood supply is sufficient for healing.
2. Partial Meniscectomy: Partial meniscectomy is the surgical removal of the torn portion of the meniscus, leaving behind as much healthy tissue as possible. This procedure is commonly performed arthroscopically, using specialized instruments inserted through small incisions around the knee joint. Partial meniscectomy is indicated for patients with symptomatic meniscus tears that are not amenable to repair, particularly in cases of degenerative tears or tears located in the avascular inner region (white zone) of the meniscus, where healing capacity is limited.

Considerations for Treatment Selection: The selection of treatment for meniscus tears depends on various factors, including the patient’s age, activity level, tear characteristics, and underlying joint pathology. In general, younger patients with traumatic tears in the vascularized outer rim of the meniscus are more likely to benefit from meniscus repair, as preserving meniscal tissue can help maintain long-term joint health and function. Conversely, older patients with degenerative tears or tears in the avascular inner region of the meniscus may be candidates for partial meniscectomy or other palliative measures aimed at symptom management.

What does postoperative rehabilitation entail?

Postoperative rehabilitation following meniscectomy and meniscus repair plays a critical role in optimizing outcomes and facilitating the patient’s return to functional activities. After meniscectomy, rehabilitation typically focuses on early mobilization, pain management, and swelling reduction. Physical therapy interventions aim to restore knee range of motion, strengthen surrounding musculature, and gradually reintroduce weight-bearing activities. Emphasis is placed on minimizing joint stiffness, improving gait mechanics, and promoting functional independence. In contrast, postoperative rehabilitation following meniscus repair involves a more cautious approach to protect the healing meniscal tissue. Initially, weight-bearing restrictions and range of motion limitations may be implemented to safeguard the repaired meniscus. As healing progresses, rehabilitation protocols gradually advance to include progressive strengthening exercises, proprioceptive training, and functional activities aimed at restoring knee stability and function. Close collaboration between the patient, Dr. Shane J. Nho, and the physical therapist is essential to ensure adherence to postoperative precautions and optimize rehabilitation outcomes.

Dr. Shane J. Nho is a board-certified fellowship trained sports medicine orthopaedic surgeon who specializes in the treatment of meniscus tears. If you believe you are affected by a meniscus tear, schedule a consultation today with our experienced orthopaedic care team.