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The knee has two pads of cartilage cushioning the movements of the joints. These C-shaped pads of cartilage are called meniscus. Whenever your knee joint moves when walking or during other activities the impact of the shock is absorbed by the menisci. If the knee joint is over extended it could result in a tear in either meniscus. This is usually accompanied by a host of symptoms apart from pain such as the inability to fully extend the joint and swelling.
Types of Meniscus Tear
Determining the type of meniscus tear is an important factor in drawing up a treatment plan that is specific not just to the individual’s health but also to the injury. In general, there are six common types of meniscus tears.
-Intrasubstance or Incomplete Tear: This type of tear is the most common where the meniscus is only partially torn. This type of tear is seen as a natural occurrence due to wear and tear as the body ages. Incomplete tears start appearing around the age of 20 and 30. These tears usually do not need any surgical intervention and are termed as stable injuries.
-Radial Tear: This type of tear is the most common that requires surgery. The tear occurs in the avascular zone, or the area that does not receive any blood supply. This makes healing of the tear near impossible and the only option is to remove the damaged parts of the meniscus.
-Horizontal Tear: A horizontal tear can be repaired surgically depending on its location. If it is located in the vascular region, then it can be simply stitched together and the tear will heal. However, of the tear is located in the avascular region then healing will not be possible and the damaged portion will have to be removed.
-Flap Tear: This type of tear is rare. A portion of the meniscus comes away as a flap and gets caught in the knee. The offending flap can be removed surgically to ease movement in the joint.
-Complex Tear: This type of tear is a combination of different types of tears and hence is hard to repair. This tear is usually a combination of a radial tear and a horizontal tear and is usually not repaired.
-Bucket-Handle Tear: This a large type of horizontal tear that required urgent medical care. Because a large portion of the meniscus is torn, it could result in limited motion of the knee or even cause the knee to get stuck. To restore movement to the knee, immediate surgical attention will be required.
What are some of the causes of meniscus tears?
A meniscus tear is usually caused by sudden movement that twists the knee beyond its capability. This can be a sudden turn while pivoting too far on the knee or due to an injury caused while playing sports. Some types of meniscus tears can be caused due to degeneration of the tissue as a result of ageing. Cartilage weakens as the body ages, and even a simple movement can cause a tear in the meniscus.
Diagnosis of Meniscus Tear
The first line for diagnosing a meniscus tear is a physical examination of the knee. Your doctor will first take your history and the details of the injury. She will then check for any swelling along the joint where the cartilage sits. If present, it is generally indicative of a meniscus tear. Other meniscus tear symptoms include pain, stiffness, and low mobility. Another test that is part of the physical examination is the McMurray test. The doctor will bend the knee, straighten and then rotate it. A tear in the meniscus will produce a clicking sound as the joint is rotated.
Your doctor will also ask for imaging tests for better clarity on the issue. Though an X-ray cannot show up a meniscus tear, it can be used to rule out other afflictions such as osteoarthritis which is common in older patients. An MRI will give your doctor the full nature of the meniscus tear which is vital for the treatment and recovery plan.
There are different lines of treatment available depending upon the nature and extent of the injury to the meniscus. The treatments are broadly divided into two types – surgical and non-surgical.
Non-surgical treatment is opted for if the tear is confined to the vascular region of the cartilage as the rich blood supply allows for healing. Your doctor will ensure that your knee is stable and will check to ensure that your symptoms abate with rest. You can follow the RICE protocol which stands for Rest, Ice, Compression, and elevation. Your doctor might recommend that you use crutches to remove any weight on the knee. You should ice the joint for 20 minutes at a time and keep the knee compressed with an elastic band at other times. Keep the joint elevated above your heart level to reduce swelling. Your doctor might also prescribe anti-inflammatory non-steroidal medicines to regulate pain and swelling.
Surgical treatment involves either stitching the torn parts if the tear can be healed or removing the damaged portion to allow for movement.
Part of some types of meniscus tear treatment is performing meniscus tear physiotherapy. It involves performing gentle exercises that do not exacerbate the pain while also being enjoyable. Meniscus tear physical therapy is important for restoring mobility to the knee joint while also establishing the correct way to move without straining the muscles and other tissues. Meniscus tear exercises speed up the recovery process by increasing blood flow and maintaining good movement and muscle strength around the knee. This is where Portea can help with our in-home doctor and physiotherapy service. Our doctors assess and diagnose your condition from the comfort of your home and suggest the best course of action to ensure a complete recovery.
How we can help
Our physiotherapists can assist you with your physical therapy for meniscus tears. They can assess and develop a treatment plan that is tailored to your specific needs. The right exercises can help with strengthening the muscles surrounding the joint and help relieve the pressure. Incorrectly executed exercises can worsen the problem and lead to further complications.
Meniscus tear treatment is entirely dependent on the type and extent of the tear. An orthopaedic surgeon will walk you through the recovery and treatment plan. Due to the nature of the injury, meniscus tear physiotherapy will most likely be a part of your recovery plan.
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