Diagnosis

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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. 

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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

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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.

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.

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Non-surgical Management

 

Meniscal injuries with no pain, locking or catching symptoms, can be observed. Small tears may not need any other active treatment. Meniscal tears in the outer most (red-red) zone of meniscus may self heal over a period of time. However, majority of symptomatic tears may not heal. 

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ACL + Meniscal Injury

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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.

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Meniscal Surgery

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Meniscal surgery is an arthroscopic (key hole ) surgery which can by done as a day care procedure. There are various types of surgeries undertaken for the meniscus depending on the type and location of the tear. 

• Meniscal repair

  • All inside meniscal repair

    • All suture meniscal repair

    • Peek meniscal repair

  • Inside out meniscal repair

  • Outside in meniscal repair

• Meniscal root repair

• Meniscal transplanation

• Partial Meniscectomy (meniscal balancing) - removal of part of the meniscus which is loose and not viable.

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Meniscal Repair Rehabilitation

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Post-surgery, you are allowed to walk on the same day evening. In patients with meniscal repair, partial weight bearing on the front of the foot and use of walker or a stick is advised for upto 4 weeks. In patients with partial meniscectomy, full weight bearing on the leg is allowed within first few days as the pain settles. Physiotherapy 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.

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