Meniscus Tear

The human knee joint has a medial meniscus and a lateral meniscus. Each meniscus is made up of an elastic collagen fiber tissue. The menisci are present between the sliding surfaces of the upper tibia and lower femur. They move within the joint during knee flexion and knee extension, as well as in external or internal rotation movements in the same direction. The lateral meniscus is smaller than the medial meniscus and also more flexible. The menisci serve to offset the mismatch between the upper tibia and lower femur, to increase the contact surface and for power transmission. During the transfer of power, the menisci lead to a stress distribution of 30-70% of the total load (after a total meniscectomy increases the load on the cartilage). The meniscus is also responsible for shock absorption, joint lubrication, and also contributes to the stability of the entire knee joint with. Meniscal tears can be traumatic or degenerative reasons. They are on the inside 3x frequently than on the outer side of the knee joint. Knee top view Symptoms of a meniscal tear The most common symptoms of a meniscal tear are pain on the outside or inside of the knee joint, especially under loads and rotational movements, the “blocking / catching” of the joint, i.e. the temporary inability to bend the knee or stretch out completely. It is a specific reference to an impacted bucket handle or flap tear of the meniscus. It can sometimes also lead to swelling and warmth of the knee joint due to the acute stimulus condition of the knee affected. Cause Often a rotational injury to the knee leads to a meniscus tear. It also occurs frequently, however, due to the premature aging of the meniscal tissue without adequate trauma, usually due to overloading and / or angular deformity or due to repetitive microtrauma. buckethandle_tear Diagnosis The clinical diagnosis of meniscal lesion is confirmed by the clinical examination of the inspection and palpation, by specific function and pain tests and the radiographs in 2 planes, possibly MRI. Treatment The treatment of meniscal damage depends on the severity of the symptoms. It can be treated conservatively or surgically. In a largely asymptomatic, stable meniscus tear, which allows everyday activities, conservative treatment is possible. It is usually combined with medication and physical therapy. In symptomatic tears, however, surgery is indicated. Meniscal repair The meniscus surgery is performed arthroscopically. Due to the known the long-term sequelae after meniscectomy, we try to conserve as much meniscus as possible in young patients. With bucket-handle tears of the meniscus, we try to suture the meniscus as far as possible. There is a good chance of healing if the cracks are in the grassroots, well-perfused region of the meniscus. Meniscus repair sutures     Meniscectomy If a meniscus cannot be repaired, a partial meniscectomy is usually performed. In this case, the meniscus tissue is removed as little as possible and as much as necessary in order then to obtain a stable functional residual meniscus. Although the contact area is reduced slightly, this approach does not damage the joint as much as complete meniscus removal.