Meniscus Injury, Meniscal Tear

2023 Author: Wallace Forman | [email protected]. Last modified: 2023-05-24 12:25

Meniscal injury

The two menisci of the knee - the inner and outer meniscus - are cartilaginous discs in the knee joint. They act as shock absorbers, reduce friction when moving, stabilize the knee joint and supply it with synovial fluid. Injury or wear and tear to the menisci can affect the movement and stability of the knee joint. A distinction is made between meniscus tears caused by an accident and meniscus damage caused by wear.

The frequency (incidence) of meniscus injuries in the population increases with age and wear and tear of the knee joint. Meniscus injuries are about three times as common in men than in women.

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The menisci have the shape of a C and are located in the knee joint between the shinbone (tibia) and the thighbone (femur). They are fused with the capsule of the knee joint and anchored with ligaments. The menisci are somewhat mobile and slide back towards the hollow of the knee when the knee is bent. For information on the anatomical structure of a knee joint, see Knee Ligament Injuries.

What are the causes of a meniscus injury?

• (Traumatic) meniscus injuries caused by accidents are usually caused by twisting the knee under load, e.g. in a fall. The menisci can become pinched and tear. Injuries to the inner meniscus are significantly more common than injuries to the outer meniscus.
• Wear -related (degenerative) meniscus damage can result from age-related wear and tear, frequent, excessive use (e.g. during sport) or repeated microtraumas (e.g. from regular crouching). Degenerative tears usually develop over a long period of time.

What are the symptoms?

Typical symptoms of an acute meniscus injury are pain and, as a result, swelling in the knee joint. The knee joint can block and give way repeatedly. Sometimes the patient also feels a "snap" when moving the knee.

How is the diagnosis made?

First, the doctor collects the medical history and asks about complaints, previous illnesses and previous injuries to the knee. In the event of an accident, the doctor will ask how it happened. Then the doctor will conduct a clinical examination and various tests. This can usually be used to assess whether there is a meniscus injury or some other injury. To confirm the diagnosis, the doctor can suggest an MRI or an arthroscopy (joint endoscopy). Of course, MRI imaging is always recommended before surgery is considered. Using an MRI, the doctor can assess whether there are other injuries or wear and tear, e.g. ligament damage, osteoarthritis and whether an operation is indicated. With the help of diagnostics, the shape and location of the meniscus tear and possibly the condition of the meniscus tissue are described.

Which forms can occur?

Meniscus tears due to accidents or wear and tear can appear in different forms. Common forms are:

• Horizontal, vertical or oblique crack,
• Cracks in the shape of a basket handle or parrot beak,
• branched cracks (mostly degenerative cracks),
• Meniscal root tear (tear off of the meniscal root).

How is a meniscus injury treated?

Treatment depends on the shape and extent of the meniscus injury.

Treatment without surgery

For the following injuries, the doctor will usually suggest treatment without surgery (conservative treatment):

• Slight meniscus injury with no evidence of instability and
• degenerative meniscus tear.

In the acute phase, the knee is initially immobilized until the pain and swelling subside. Movements and activities that put strain on the knee joint should be avoided, such as squatting, kneeling, twisting, repeated bending of the knee, running, dancing, etc. To relieve the knee, crutches can also be used for walking. A support bandage helps to stabilize the knee. Ev. the doctor may prescribe anti-inflammatory medication for pain relief. Regular cooling of the knee also relieves pain.

After the symptoms have subsided, the doctor prescribes physical therapy with exercises to strengthen the thigh muscle. The aim is to stabilize the knee joint and restore its function. The doctor checks the healing process in regular examinations.

Treatment with surgery

Serious and complicated meniscal tears due to an acute injury are sutured using arthroscopy or open surgery. Surgery is also indicated for degenerative meniscus tears, in which parts of the meniscus in the joint block and destroy the articular cartilage. In these cases, the broken part of the meniscus usually has to be removed.

After the operation, the doctor prescribes physical therapies with exercises to mobilize and stabilize the knee joint.

Whom can I ask?

If a meniscus injury is suspected, you can contact the following for diagnosis and treatment:

• Emergency doctor or rescue (144) for acute complaints
• Accident outpatient clinic in a hospital
• General practitioner
• Specialist in orthopedics and traumatology
• Specialist in orthopedics and orthopedic surgery
• Specialist in trauma surgery

An inpatient stay in the hospital is necessary for surgical treatment.

Physical therapy or exercise therapy can be carried out by resident physiotherapists or occupational therapists according to a doctor's prescription.

How are the costs going to be covered?

The e-card is your personal key to the benefits of the statutory health insurance. All necessary and appropriate diagnostic and therapeutic measures are taken over by your responsible social insurance agency. A deductible or contribution to costs may apply for certain services. You can obtain detailed information from your social security agency. Further information can also be found at:

• Right to treatment
• Visit to the doctor: costs and deductibles
• What does the hospital stay cost?
• Prescription fee: This is how drug costs are covered
• Medical aids & aids
• Health Professions AZ

and via the online guide to reimbursement of social insurance costs.