Considerations

The meniscus is a C-shaped piece of cartilage located in the knee. Cartilage is found in certain joints and forms a buffer between the bones to protect the joint. The meniscus serves as a shock-absorption system, assists in lubricating the knee joint, and limits the ability to flex and extend the joint.

Causes

Meniscal tears are most commonly caused by twisting or over-flexing the knee joint.

Symptoms

• A "pop" may be felt at the time of injury
• Knee joint pain when walking
• Knee pain in the space between the bones; gets worse when gentle pressure is applied to the joint
• Locking of the knee joint
• Recurrent knee-catching
• Difficulty squatting down
• Swelling in the knee joint

First Aid

The health care provider will perform a physical examination. This will include a knee examine called the McMurray's test. For this test, you lie on your back while the health care provider holds the heel of your injured leg with your leg bent. Pressure is placed to compress the knee while the leg is rotated in and out to generate discomfort or pain. Pain or a click over the inner part of the joint means an inner (medial) meniscal tear.

For an Apley's compression test, the health care provider will have you lie on your stomach with your knee bent at a 90 degree angle. The provider will hold your foot with both hands and rotate it to the outside (lateral rotation), while a downward force is applied to the foot. The provider's knee and thigh may be used to stabilize your thigh. Pain in the inner part of the joint may indicate an inner (medial) meniscal tear.

A test for excess joint fluid is positive in meniscal tears, indicating swelling with fluid around the joint.

Other tests that show meniscus tears may include:

• Knee MRI
• Knee joint x-ray

The goal of treatment is to reduce symptoms and protect the joint from further injury while it heals.

You should not put your full weight on the knee. You may need to use crutches. You may have been given a knee brace. This helps keep your knee from moving and to help you recover.

Other treatments include:

• Ice to reduce swelling
• Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce swelling and pain

Physical activity is allowed, as tolerated. Physical therapy is recommended to help regain joint and leg strength.

If the injury is acute or if you have a high activity level, knee arthroscopy (surgery) may be necessary. Age has an effect on treatment. Younger patients are more likely to have problems without surgery.

DO NOT

Do NOT put all your weight on your leg if it is painful.

Do not put all your weight on your leg if your health care provider told you not to do so.

When to Contact a Medical Professional

Call your health care provider if symptoms of a meniscus tear occur after an injury to the knee.

Call your health care provider if you are being treated for a meniscus tear and:

• Pain and swelling returns
• You have increased instability in your knee
• You do not think your injury is getting better

Call your health care provide if your knee locks and you cannot straighten it.

Prevention

Use proper technique when exercising or playing sports. Many cases of meniscus tears may not be preventable.

Alternative Names

Tear - meniscus; Knee injury - meniscus; Knee cartilage tear

References

De Carlo M, Armstrong B. Rehabilitation of the knee following sports injury. Clin Sports Med. 2010 Jan;29(1):81-106.

Brockmeier SF, Rodeo SA. Knee: Meniscal injuries. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez’s Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 23;sect B.

Update Date: 4/13/2012

Reviewed by: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.