Meniscal Injuries and Degeneration: Causes, Symptoms, and Treatment

Reviewed By – Dr. Sameer Gohir
^{PhD, MSc, PG Cert MSK ultrasound, PG Cert. Non-Medical Prescribing, MCSP, MAPPN}

What Is Meniscal Injuries?

Meniscal injuries are common knee problems affecting the menisci—two C-shaped pieces of cartilage that act as shock absorbers between your shinbone (tibia) and thighbone (femur). Tears can occur suddenly due to trauma or develop over time due to degeneration.

If knee pain or locking from a meniscal injury is affecting your movement, expert care is available. With clinics near Kent and Essex, Joint Injection Clinic offers advanced treatments to help you recover and stay active.

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Meniscal Injuries Treatment near kent and essex

Common Causes of Meniscal Injuries

Meniscal injuries can be broadly categorized by their cause:

Traumatic Tears: These often occur during sports or activities involving forceful twisting or rotation of the knee, especially when the foot is planted. Sudden stops, pivots, or deep squats can also lead to traumatic tears. This type is more common in younger, active individuals.
Degenerative Tears: These tears are not typically caused by a single event but result from the gradual wear and tear of the meniscus over time. As we age, the meniscus becomes less resilient and more prone to tearing with minimal force or even during everyday activities like getting out of a chair. Degenerative tears are often associated with osteoarthritis, a condition where the protective cartilage in the knee joint wears down.

Risk Factors of Meniscal Injuries

Several factors can increase the risk of meniscal injuries:

Age: The risk of degenerative tears increases with age.
Osteoarthritis: The presence of osteoarthritis significantly increases the likelihood of degenerative meniscal tears.
Activities: Sports that involve pivoting, twisting, or forceful impact increase the risk of traumatic tears.
Obesity: Excess weight puts additional stress on the knee joint.
Anatomical Factors: Certain variations in knee anatomy may predispose individuals to tears.

Symptoms of Meniscal Injuries

Symptoms of a meniscal injury can vary depending on the size, location, and type of tear. Common symptoms include:

Pain: Often felt in the knee joint, particularly when twisting or bearing weight.
Swelling: The knee may become swollen, sometimes hours after the injury.
Stiffness: Difficulty bending or straightening the knee.
Mechanical Symptoms: Catching, popping, or locking sensations in the knee. Locking occurs when a piece of torn meniscus gets caught in the joint, preventing full movement.
Tenderness: Pain when pressing on the joint line where the meniscus is located.
Decreased Range of Motion: Inability to fully extend or flex the knee.

It’s important to note that some degenerative tears, especially smaller ones, may be asymptomatic.

How Is Meniscal Injuries Diagnosed?

Diagnosing a meniscal injury typically involves a combination of assessing your medical history, conducting a physical examination, and using imaging tests:

Medical History and Physical Exam: Your doctor will ask about your symptoms, how the injury occurred, and your activity level. During the physical exam, they will assess the range of motion, stability, and tenderness of your knee. Specific tests like the McMurray test or Thessaly test may be performed to help identify a meniscal tear.
Imaging Tests:
X-rays: While X-rays don’t show the meniscus itself, they can help rule out other causes of knee pain, such as fractures or signs of osteoarthritis.
Magnetic Resonance Imaging (MRI): MRI is considered the gold standard for diagnosing meniscal tears. It provides detailed images of the soft tissues in the knee, including the menisci. However, it’s crucial to interpret MRI findings in the context of your symptoms, as some tears seen on MRI, particularly degenerative ones, may not be the source of pain.
Arthroscopy: In some cases, if the diagnosis remains uncertain or as part of a surgical treatment, a minimally invasive procedure called arthroscopy may be performed. A small camera is inserted into the knee joint to visualize the meniscus directly.

Treatment Options

The treatment approach for a meniscal injury depends on several factors, including the type, size, and location of the tear, your age, activity level, and overall health. Treatment options range from conservative management to surgical intervention.

Non-Surgical Treatment for Meniscal Injuries

This is often the initial approach, especially for smaller, stable tears or degenerative tears without significant mechanical symptoms. It includes:

Rest: Avoiding activities that aggravate the pain.
Ice: Applying ice packs to reduce swelling and pain.
Compression: Using a compression bandage to help control swelling.
Elevation: Keeping the leg raised to reduce swelling.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Medications like ibuprofen or naproxen can help reduce pain and inflammation.
Physiotherapy: A tailored physical therapy program is crucial. It focuses on strengthening the muscles around the knee, improving flexibility, restoring range of motion, and enhancing stability.
Injections: Corticosteroid injections can reduce inflammation and provide temporary pain relief. Hyaluronic acid injections (viscosupplementation) may help lubricate the joint and meniscus.

Surgical Treatment for Meniscal Injuries

Surgery may be recommended if conservative treatment does not relieve symptoms, if there are mechanical symptoms like locking, or for certain types of tears that are less likely to heal on their own (e.g., larger or unstable tears, tears in the avascular “white zone”). Surgical options include:

Arthroscopic Partial Meniscectomy: This is the most common surgical procedure for meniscal tears. Through small incisions, the surgeon removes the damaged portion of the meniscus. This can relieve symptoms but does remove some of the shock-absorbing capacity of the knee.
Arthroscopic Meniscus Repair: If the tear is in the outer, well-vascularized “red zone” of the meniscus, it may be repairable. The surgeon stitches the torn edges together to allow them to heal. Repair aims to preserve the meniscus and its function, but it has a longer recovery period than meniscectomy.

Prognosis and Long-Term Outlook

The prognosis for a meniscal injury depends on the treatment received and individual factors.

Conservative Management: Many individuals with small or degenerative tears can achieve good outcomes with conservative treatment and physical therapy, often regaining function and reducing pain.
Meniscectomy: While meniscectomy can provide rapid symptom relief, removing part of the meniscus can alter the biomechanics of the knee and increase the long-term risk of developing osteoarthritis due to reduced shock absorption.
Meniscus Repair: Successful meniscal repair has the potential for a more durable long-term outcome by preserving the meniscus, but it requires a longer and more restricted rehabilitation period to allow for healing. The success rate of repair depends on factors like tear type, location, and size.

Regardless of the treatment, a structured rehabilitation program is essential for regaining strength, mobility, and function and for preventing future problems.

Prevention Tips

While not all meniscal injuries are preventable, particularly degenerative ones, certain strategies can help reduce the risk of traumatic tears:

Warm-up Properly: Prepare your muscles and joints before physical activity.
Strengthen Leg Muscles: Building strong quadriceps, hamstrings, and calf muscles can help stabilize the knee.
Improve Flexibility: Good flexibility can help prevent injuries.
Use Proper Technique: Learn and use correct form for sports and activities, especially those involving pivoting or jumping.
Wear Appropriate Footwear: Ensure your shoes provide good support and traction.
Listen to Your Body: Avoid pushing through pain.
Maintain a Healthy Weight: Reduces stress on the knee joints.

Conclusion

Understanding the causes, symptoms, and treatment options for meniscal injuries and degeneration is the first step towards effective management and recovery. Consulting with a healthcare professional is crucial for an accurate diagnosis and personalized treatment plan.

Get Help for Meniscal Injuries at Joint Injection Clinic

If a meniscal injury is causing knee pain, swelling, or restricted movement, you don’t have to manage it alone. At Joint Injection Clinic, our experienced team offers evidence-based treatments to reduce pain and improve knee function.

We welcome patients at all three of our clinics:

From ultrasound-guided assessments and injections to individualised physiotherapy plans, our specialists can help you manage knee pain effectively and return to your normal activities with confidence.