Meniscus Tear and Knee Arthritis Symptoms & Treatment

The knee joint consists of bones, ligaments that connect the bones, and two types of cartilage. The meniscus consists of two wedge-shaped pieces of cartilage that sit between the two major bones of the knee joint: the femur (thigh bone) and the tibia (shinbone). The meniscus serves as a shock absorber and provides stability to the knee. The medial meniscus is located on the medial or inner part of the knee, and the lateral meniscus is located on the lateral or outer side of the knee. Torn meniscus injuries can be acute (due to an injury) or degenerative (due to wear and tear). Three bones meet at the knee joint. Covering the ends of these bones is a different type of cartilage, a strong, smooth, rubbery substance that allows the bones to glide over one another when you bend or straighten your knee.

The most common type of arthritis in the knee, osteoarthritis, is caused by a gradual breakdown of cartilage. As the cartilage erodes, the bones ultimately rub against each other, causing pain, swelling, and stiffness. In older patients, meniscus tears and knee arthritis can occur at the same time. The treatment of a meniscus tear in an arthritic knee may be challenging due to the presence of a degenerative knee joint.

Generally, torn meniscus cases occur suddenly as the result of an injury, like twisting of the knee while the foot is firmly planted on the ground. As we age, the meniscus accumulates wear and tear and therefore can be injured more easily. In this case, tears can occur even with minimal movement, like getting up from a chair awkwardly and twisting the leg.

Meniscus tears and knee arthritis are common in these sports:

• Basketball
• Football
• Soccer
• Tennis

You may have a tear of the meniscus and knee arthritis if you are over the age of 40 and have had symptoms of knee arthritis in the past, such as activity-related pain, joint stiffness, and swelling of the knee, and you experienced an injury to the knee and have the following symptoms:

• Swelling of the knee
• Tenderness
• Locking or the inability to fully extend the knee
• A sense of catching, popping, or grinding with the movement of the knee

If you have these symptoms, consult with your doctor. During your visit, you will be asked to provide a medical history, including your level of physical activity (both before your symptoms began and current activities). Your doctor will conduct a physical exam, looking for:

• Swelling, redness, and tenderness in the joint
• Range of movement of your knee
• Instability of the knee joint
• Problems with the way you walk, such as a limp or lurch

After the physical examination, your doctor will recommend an X-ray to determine how much arthritis is present. In some cases, an MRI scan may be helpful to further assess the problem.

When a meniscus tear occurs and knee arthritis is also present, the initial treatment should always be non-operative:

• Over-the-counter medications such as Tylenol or a non-steroidal anti-inflammatory (NSAID) medication like ibuprofen
• Limiting activities that aggravate the knee, like climbing stairs, squatting, or pivoting
• Physical therapy to help strengthen the muscles around the knee and extend your range of motion
• Wearing a brace to provide stability and support

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Knee Arthritis

If non-surgical treatment is not effective in relieving your symptoms, your doctor may recommend surgery. Depending on the extent of the knee arthritis, there are different surgical treatment options available. Your doctor will indicate the appropriate surgical option to best meet your needs and the condition of the joint. When minimal arthritis is present, knee arthroscopy may be helpful for both torn meniscus and degenerative knee joint issues. When the wear and tear is severe and significant arthritis is present, knee arthroscopy is not usually helpful. In those situations, when non-operative treatment fails, knee replacement may be an option.

Recovery time after surgery will depend on the type of surgery you undergo. Knee arthroscopy usually takes from 6 weeks to 3 months to recover, while knee replacement surgery may take up to one year to fully recover.

Your doctor may recommend physical therapy after surgery to help restore muscle strength in your knee and expand the range of motion. Temporary use of assistive devices, such as a knee brace, crutches, or a cane, may aid your rehabilitation.