The meniscus is a shallow cup-shaped hunk of cartilage that cushions the knee joint, absorbing the impact when your foot hits the ground. Its shape guides the motion of the two bones of the knee and stabilizes the joint in motion. The meniscus also acts as a ‘wedge’ between the bones. This serves to tighten the ligaments holding the joint together further increasing the stability of the joint.
Meniscus tear symptoms can range from no pain at all to a painful ‘locking’ of the knee and a feeling as if the knee is ‘stuck’. It is often difficult clinically to tell the difference between a knee sprain vs tear. Sometimes they are both present as when the medial meniscus is torn as part of the injury complex that results in a sprain of the ACL.
As we age, a meniscus tear is probably as common as wrinkles on your face. Knee meniscus tears in older patients without a history of knee injury are thought to be a wear and tear type injury. They are found so commonly in association with other degenerative findings that there is some question as to whether they are painful at all.
‘Repair’ of a knee tear generally means that the surgeon removes cartilage from the meniscus until the tear is no longer visible. The removal of cartilage reduces knee cushioning and also decreases joint stability. Data shows that when this is done, the incidence of knee arthritis increases with time.
The only proper indication for surgery on a tear is if the tear creates a ‘flap’ of cartilage that can get stuck between the two bones of the knee ‘locking’ it or otherwise interfering with the ability to bend or straighten the knee. It is true that the meniscus, like most cartilage, has a limited ability to repair itself. The reason is that cartilage has a very poor blood supply; especially the cartilage deeper in the knee.
The approach to repair of a knee meniscus tear here at Interventional Orthopedics CT is to deliver highly concentrated blood or stem cells through needles directly into the tear. Instead of removing or destroying cartilage, this technique brings powerful repair hormones that support and stimulate the local cartilage cell population and maximizes the body’s ability to effect repair on its own.
It is important to note that a knee meniscus tear is generally a sign of advancing knee instability. It is highly likely that it is this instability which is the main source of a patient’s pain. If your physician just focuses on the meniscus tear, this instability will be missed. If the instability is not treated, the knee will continue to degenerate and continue to be painful. This is why we always treat instability and never treat just the tear alone.