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Lateral Meniscus Tears

The meniscus is a wedge-shaped cushion made of cartilage that sits between the two bones that make up the knee: the femur (thigh bone) and the tibia (shin bone). The meniscus serves as a shock absorber and provides stability to the knee. The lateral meniscus is located on the lateral or outer part of the knee. The most common tears are radial, bucket-handle, and flap tears. Meniscus tears range from small tears to larger ones.

Lateral Meniscus Tears Hero Image 2

The meniscus is a wedge-shaped cushion made of cartilage that sits between the two bones that make up the knee: the femur (thigh bone) and the tibia (shin bone). The meniscus serves as a shock absorber and provides stability to the knee. The lateral meniscus is located on the lateral or outer part of the knee.

There are six different types of meniscus tears:

• Radial
• Longitudinal (vertical)
• Horizontal
• Parrot beak
• Bucket handle
• Flap

The most common tears are radial, bucket-handle, and flap tears. Meniscus tears range from small tears to larger ones.

What causes Lateral Meniscus Tears?

Generally, lateral meniscus tears occur suddenly as the result of an injury, like twisting of the knee while the foot is firmly planted on the ground. In addition, as we age, meniscus tears can occur with minimal trauma.

Lateral meniscus tears are common in these sports:

• Basketball
• Football
• Rugby
• Soccer
• Tennis

Symptoms

You may have a tear of the lateral meniscus if you have experienced an injury to the knee and have one or more of the following symptoms:

• Swelling of the knee
• Pain on the outside of your knee
• Locking or the inability to fully extend the knee

When to see a doctor

If you have an injury to the knee and experience symptoms of a meniscus tear, such as pain on the outside of your knee, swelling, or locking, make an appointment to see an orthopedic specialist. During your appointment, your doctor will ask you to describe your symptoms. He/she will examine the knee for symptoms of a meniscus tear. If there is tenderness over the area of the meniscus, this may indicate a tear. Your doctor may also perform a McMurray test. During the McMurray test, your doctor will gently bend, extend, and twist your knee. If during this test, you hear a clicking sound, this indicates a tear in the meniscus.

[IMAGE: McMurray test]

In order to make a diagnosis, your doctor may prescribe the following imaging tests:

• MRI to make a precise diagnosis
• X-rays to check for arthritis or other damage to the bones of the knee

Non-operative treatment

If the tear is small or you have degenerative changes in your knee, such as arthritis, your doctor will recommend conservative, non-operative treatments, like:

• Icing the knee
• Resting the leg
• Non-steroidal anti-inflammatory medications
• Using a brace to stabilize the knee
• Physical therapy with a licensed professional to strengthen the knee

You can also try these exercises at home to stretch and strengthen the muscles surrounding the knee:

Lateral Meniscus Tears

Surgical Treatment

If your symptoms do not improve using non-operative treatments, or if the tear cannot be treated using non-operative treatments, surgical repair or removal of the damaged portion of the lateral meniscus may be suggested. The type of surgery performed will depend on the type of tear that occurred as well as the severity of the tear. For example, if the tear is located on the peripheral (outer) rim of the meniscus, and there is good blood supply to the area, then it can be repaired. If the tear is not peripheral or not amenable to repair then the piece is removed. In older athletes, most tears are not amenable to repair.

There are two types of surgical procedures:

• Meniscus repair surgery: During meniscus repair surgery, the torn portion of the meniscus is stitched together. Recovery from a meniscus repair requires more time than a meniscectomy procedure, as the repaired tissue needs time to heal.

• Meniscectomy: During a meniscectomy, the damaged tissue of the lateral meniscus is carefully trimmed and removed.

These surgeries are performed arthroscopically, meaning that they are done in a minimally invasive fashion. Arthroscopic surgery uses several tiny incisions to access the damaged part of the meniscus. Through one of these incisions, a tiny camera attached to the end of a thin, flexible tube, called an arthroscope, is inserted and displays video image on a screen that allows your orthopedic surgeon to locate the tear. Through the remaining incisions, special instruments are inserted that are used to repair or remove the damaged tissue. In the case of a meniscus repair, sometimes a small incision is needed to tie the sutures.

Recovery

The time it takes you to recover from a lateral meniscus tear depends on the type of tear, the severity of the tear, and the treatment methods needed to repair the damaged tissue.

Using non-operative treatments, recovery can take six to eight weeks. If you require surgery, recovery can take up to three months for a repair and roughly three to four weeks for a meniscectomy.

Following surgery, you will be instructed to do minimal effort exercises to move and stretch the knee. Once the meniscus has healed, your doctor will start you on a physical therapy program to stretch and strengthen the knee while regaining mobility. You can return to play when you have regained full range of motion and strength without any pain.

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