Diagnosis

​

With good physical examination meniscal (cushions in the knee joint) tear can be identified. However, to establish the extent and grade of injury, further investigations would be helpful. 

​

X-ray. X-ray is performed and is useful to rule out any bone injuries. Menisci are not visible on the X-ray. 

 

MRI Scan. MRI Scan is the gold standard investigation to identify the type and extent of the meniscus injury. In addition, it helps to assess the condition of the cartilage and ligaments. Often these structures are also affected and may need attention.

 

Treatment

​

First Aid for the acute meniscal injuries involves the typical R.I.C.E therapy for the first week.

Rest. It is important to minimize walking around in the first week.

Icepacks. Cold packs 3 to 4 times a day helps reduce the swelling.

Compression. Crepe bandage is sufficient to help with compression.

Elevation. Keeping it elevated on a pillow when resting helps.

​

Non-surgical Management

 

Meniscal root tears cannot be managed with non-surgical modes of treatment. Meniscal root repair effectively makes the meniscus completely non-functional. Hence it needs surgery to reattach the meniscal root. 

​

​

ACL + Meniscal Injury

​

In patients with ACL and meniscal tear, at the time of ACL reconstruction surgery, meniscus surgery is undertaken as well to help stabilise the knee.

​

​

Meniscal Root Repair Surgery

​

Meniscal root repair surgery is an arthroscopic (key hole ) surgery which can by done as a day care procedure. Firstly the meniscal root tear is identified. A fiberwire stitch is passed through the root. A small bone tunnel is drilled from outside part of the shin bone to the meniscal root footprint area using a special jig. The fiberwires are retrieved out through the bone tunnel. Using a titanium button, the threads are tightened so that the meniscal root gets firmly fixed to the bone. 

​

Meniscal Root Repair Rehabilitation

​

Post-surgery, you are allowed to walk on the same day evening. In patients with meniscal root repair, partial weight bearing on the front of the foot and use of walker or a stick is advised for upto 4 weeks. Physiotherapy ROM exercises start early. In the first 6 weeks the focus is mainly on getting the full ROM and help regain the muscle strength. The whole rehabilitation process will take about 4 to 5 months before returning back to playing sports on the ground or court.

​