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Meniscus tears - aftercare

Description

The meniscus is a c-shaped piece of cartilage in your knee joint. You have two in each knee.

• Meniscus cartilage is a tough but flexible tissue that acts as a cushion between the ends of bones in a joint.

• Meniscus tears refer to tears in this shock-absorbing cartilage of the knee.

More About Your Injury

The meniscus forms a cushion between the bones in your knee to protect the joint. The meniscus:

• Acts like a shock-absorber

• Helps distribute the weight to the cartilage

• Helps to stabilize your knee joint

• Can tear and limit your ability to flex and extend your knee

A meniscus tear can occur if you:

• Twist or over-flex your knee

• Quickly stop moving and change direction while running, landing from a jump, or turning

• Kneel down

• Tear one or more ligaments in your knee, like your anterior cruciate ligament (ACL)

• Squat down low and lift something heavy

• Get hit on your knee, such as during a football tackle

As you get older, your meniscus ages too, becoming more brittle and easier to tear.

What to Expect

You may feel a "pop" when a meniscus injury occurs. You also may have:

• Knee pain inside the joint, which gets worse with pressure on the joint

• Knee swelling that occurs the next day after injury or after activities

• Knee joint pain when walking

• Locking or catching of your knee

• Difficulty squatting

After examining your knee, your health care provider may order these imaging tests:

• X-rays to check for damage to the bones and the presence of arthritis in your knee.

• An MRI of the knee. An MRI machine takes special pictures of the tissues inside your knee. The pictures will show whether these tissues have been stretched or torn.

If you have a meniscus tear, you may need:

• Crutches to walk until the swelling and pain get better

• A brace to support and stabilize your knee

• Physical therapy to help improve joint motion and leg strength

• Surgery to repair or remove the torn meniscus

• To avoid squatting or twisting movements

Treatment may depend on your age, activity level, and where the tear occurs. For mild tears, you may be able to treat the injury with rest and self-care.

For other types of tears, or if you are younger in age, you may need knee arthroscopy (surgery) to repair or trim the meniscus. In this type of surgery, small cuts are made to the knee. A small camera and small surgical tools are inserted to repair the tear.

A meniscus transplant may be needed if the meniscus tear is so severe that all or nearly all of the meniscus cartilage is torn or has to be removed. The new meniscus can help with knee pain and possibly prevent future arthritis.

Self-care at Home

Follow R.I.C.E. to help reduce pain and swelling:

• Rest your leg. Avoid putting weight on it.

• Ice your knee for 20 minutes at a time, 3 to 4 times a day. Do not apply ice directly to your skin. Wrap the ice in a clean cloth first.

• Compress the area by wrapping it with an elastic bandage or compression wrap.

• Elevate your leg by raising it above the level of your heart.

You can use ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn) to reduce pain and swelling. Acetaminophen (Tylenol) helps with pain, but not with swelling. You can buy these pain medicines at the store.

• Talk with your provider before using these medicines if you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or internal bleeding in the past.

• Do not take more than the amount recommended on the bottle or by your provider.

Activity

You should not put all of your weight on your leg if it hurts or if your provider tells you not to. Rest and self-care may be enough to allow the tear to heal. You may need to use crutches.

Afterward, you will learn exercises to make the muscles, ligaments, and tendons around your knee stronger, more flexible, and more resistant to injury.

If you have surgery, you may need physical therapy to regain the full use of your knee. Recovery can take a few weeks to a few months. Under your provider's guidance, you should be able to do the same activities you did before.

When to Call the Doctor

Contact your provider if:

• You have increased swelling or pain

• Self-care does not seem to help

• Your knee locks and you can't straighten it

• Your knee becomes more unstable

If you have surgery, contact your surgeon if you have:

• A fever of 100°F (38°C) or higher

• Drainage from the incisions

• Bleeding that won't stop

References

Lento P, Marshall B, Akuthota V. Meniscal injuries. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 72.

Phillips BB, Mihalko MJ. Arthroscopy of the lower extremity. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 51.

Ruzbarsky JJ, Maak TG, Rodeo SA. Meniscal injuries. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 94.

Review Date: 4/24/2023

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.