Meniscus tears of the knee

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The knee has two menisci: the inner meniscus and the outer meniscus.

Menisci are a fibrocartilaginous structure that have several functions in the knee:

  • a cushioning role and load spreading role
  • a stabilising role
  • a lubricating role, managing the absorption and secretion of synovial fluid (articular fluid) in the knee.
  • A protective role against arthritis

There are two types of Meniscus tears

Either traumatic, during a direct or indirect shock, most frequently after the twisting of the knee,

Or degenerative, over time, linked to micro-trauma during sports or natural wear on a badly aligned knee (varus or valgum).

A very varied range of tears may be seen on the crescent-shaped meniscus. They are classified according to their location: anterior horn, medial, posterior horn and the type of tear, longitudinal, vertical or oblique, radial or horizontal.

The circumstances in which the tear occurred

Traumatic or chronic, but always during effort, even though a predisposition may exist or if age and the number of years of practice can cause degenerative lesions of the menisci such as rheumatism

Clinical signs

They are simple and clear

Sudden or progressive pain on the internal or external side of the knee

Joint effusion, known as hydarthrosis or water on the knee

Flexum of the leg that remains slightly bent (impossible to fully straighten it).

Pain on hyper flexion or hyper extension of the leg

Pain on palpation of the inside (inner meniscus) or outside (outer meniscus) of the joint.

Grinding test: pain on twisting of the lower leg (not always easy to find or do)

Diagnosis: the best examination: MRI scan of the knee

Meniscus tears are classified according to their location (anterior horn, medial, posterior horn and the type of tear, longitudinal, vertical or oblique, radial or horizontal).

An effusion or cyst may also occur

Checking the condition of ligaments is also important

Treatment

Several possibilities

Wait and complete or partial resting if the tear is small of very peripheral.

The minimum action to take is to remove the damaged part of the meniscus, leaving the healthy part in place.

Repairing the meniscus consists in stitching the meniscus using anchors or absorbable sutures

Removal of the meniscus is rare and is only used for extensive damage with associates flaps and fragments 

Docteur Patrick Bacquaert

Médecin chef de l'IRBMS

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