Meniscus damage, such as meniscus tears or meniscal contusions, is one of the most common knee injuries. Meniscus injuries can have a variety of causes, including sudden twisting movements, excessive exercise or daily activity, and age-related wear and tear. Depending on the extent of the injury, the meniscus can be treated surgically or conservatively.
1. femur
2. patellar tendon
3. kneecap
4. cartilage
5. cruciate ligaments
6. medial ligaments
7. meniscus
8. lower leg bone
The meniscus at a glance
The menisci are crescent-shaped discs of cartilage that lie in the knee joint. Their purpose is to enlarge the joint surface to distribute the load evenly throughout the joint. Through this role, they support the stability and mobility of the knee. In addition, the menisci act as shock absorbers, absorbing shocks and stresses that occur during walking, running, jumping and other activities.
There are two menisci in the knee joint: the inner meniscus (medial meniscus) and the outer meniscus (lateral meniscus). Meniscus injuries can affect both the inner and outer menisci. However, the inner meniscus tends to be affected by injuries slightly more often than the outer meniscus.
Causes and risk factors
The most common causes of meniscus damage include sudden twisting of the knee joint under heavy strain. This can occur during sports, especially in those involving rapid changes of direction such as football, basketball or skiing, but also in everyday activities such as turning the body quickly when the knee is bent. Meniscus injuries can also result from excessive strain, for example through long-lasting, repetitive movements. Meniscus damage can also occur slowly and gradually as a result of degenerative wear and tear in old age.
The following risk factors may increase the risk of meniscus injuries:
- previous injury to the knee joint
- insufficient time spent warming up before sports
- muscular imbalances
- misalignment of the legs, which can lead to unequal strain on the knee
- external factors (e.g. poor training conditions or wearing unsuitable shoes)
Course of the disease
The course of the disease of a meniscal lesion depends on its type and cause, with a distinction being made between traumatic and degenerative forms. Traumatic meniscal lesions, such as tears or bruises, are usually the result of sudden injuries or accidents, such as twisting the knee under load. However, damage to the meniscus can also be chronic, referred to as a degenerative meniscal lesion. This damage is caused by the gradual wear of the meniscus over a longer period of time, mainly due to natural ageing or prolonged overloading of the knee joint.
Symptoms
Symptoms of traumatic meniscal lesions
When the meniscus is torn or bruised by trauma, pain is typically felt in the knee immediately after the incident. Meniscus pain in the knee joint is often intensified by moving or straining the knee. In addition, the knee joint may swell, be tender and occasionally lock up.
Symptoms of degenerative meniscal lesions
The symptoms of a degenerative meniscal lesion develop gradually over a longer period of time. The pain is usually non-specific and can get progressively worse over time. It can radiate into the hollow of the knee and is often exacerbated during exertion such as climbing stairs or squats. In advanced stages, the knee joint might become constricted or lock up. These symptoms can also occur when at rest or at night.
Diagnosis
To diagnose a meniscus injury, a specialist in orthopaedics or accident surgery will perform a specific clinical examination of the knee. If suspected meniscus damage is confirmed, magnetic resonance imaging (MRI) of the knee is usually arranged. This imaging technique allows for a detailed visualisation of the knee joint and helps to identify and assess the exact extent and type of meniscus injury.
Treatment
The treatment of a meniscus injury is individually tailored to the type and extent of the damage. Depending on this, conservative and operative approaches can be taken, supplemented by post-treatment rehabilitation and physiotherapy.
Conservative treatment for minor injuries
Minor injuries to the meniscus or signs of wear and tear that cause only minor discomfort for the person affected can be treated conservatively. The conservative treatment of meniscus damage includes:
- immobilisation and relief of the knee using a splint or bandage
- cold treatment to relieve pain and reduce swelling
- medication therapy to relieve pain and reduce inflammation
Surgical treatment for more serious injuries
Surgical treatment is usually required in the case of major meniscus tears or if torn meniscus parts are stuck in the joint. This involves knee arthroscopy, a minimally invasive procedure which involves inserting a camera and special instruments into the knee joint via small incisions. This allows damaged meniscus parts to be removed (meniscectomy) or the torn or completely torn meniscus to be stitched up (meniscus refixation), depending on the type and location of the tear.
Rehabilitation and physiotherapy for meniscus injuries
Both after conservative treatment and after meniscus surgery using knee arthroscopy, targeted rehabilitation and physiotherapy are essential to restore the mobility, strength and function of the knee. An individually tailored exercise programme can help to strengthen the muscles, improve mobility and stabilise the knee joint.
Prevention
Various preventive measures can be taken to prevent meniscus injuries:
- strengthening the (thigh) muscles through targeted muscle training
- extensive warm-up and stretching before sporting activities
- avoiding excessive strain
- choosing suitable footwear
- allowing for sufficient recovery and healing phases
Centres 9
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Hip and Knee Surgery Center
Avenue de Beau-Séjour 6
1206 Genève
Dr Saudan +41 22 702 24 24
Dr Corsat +41 22 702 24 27 -
Outpatient Clinic Permanence
Bümplizstrasse 83
3018 Bern
