What is a meniscus injury in the knee?

By Dr. Raúl Kam

The menisci are two fibrocartilaginous structures that are found in the middle of the knee joint, between the femur and the tibia, on the internal and external surfaces, which are composed mostly of water and collagen that provide them with characteristics. and important functions. Being a soft tissue, they can withstand compression, support the weight of the body and provide stability due to their "C" shape. In addition, the menisci have functions of proprioception (perceiving the position and movement of the knee) and nutrition of the joint. 

Regarding the types of injuries that the menisci can suffer, we could divide them into 2 large groups: Traumatic Injuries and Degenerative Injuries.

Traumatic injuries are those that we find especially in the young population, which are usually accompanied by a sudden movement or twist of the knee and in a high percentage are associated with ligament injuries or cartilage injuries.

While degenerative lesions are more common in an older population, which tends to have slightly more insidious symptoms, often without clear trauma.

What are the symptoms of a meniscus injury?

In traumatic injuries, in their acute or initial period, the patient will report immediate pain, often associated with a crack, with limitation in walking or bending the knee. In addition, the patient may notice an increase in volume or size of the knee in the first 24 hours.

If the injury is chronic traumatic or degenerative, the patient may report intermittent periods of inflammation, pain and a sensation of mechanical blockage, which will not allow them to move the knee on a recurring basis.

How is a meniscus injury diagnosed?

Like any pathology, it is very important to know the clinical history and perform a thorough physical examination, evaluating the patient's appearance, mobility and pain, through specific tests that are done in the medical consultation. In addition, we rely on different imaging studies such as: Magnetic is the best study to evaluate the internal structures of the knee. Magnetic Resonance can also help us determine the type of injury, in order to make a better management decision for the patient's injury.

What are the treatments for meniscus injuries?

Regarding treatments in our specialty, we divide them into conservative treatment and surgical treatment. Conservative treatment, which is usually the initial treatment, will be aimed at managing pain and recovering the mobility and strength of the knee. The different modalities applied are physiotherapy, pharmacological therapy and in some cases infiltrations can be performed, which consists of injecting some medication or biological therapy, such as Platelet Rich Plasma into the joint, seeking to help the healing process of the injury.

Because the greatest pressure is placed on the menisci when the knee is flexed or bent, knee flexion and impact activities are limited in the rehabilitation process.

On the other hand, surgical management is indicated for patients who have received conservative management without improvement, if they present large size or shape lesions on MRI, if they present associated ligament or cartilage lesions or if they present symptoms of blockage of the joint.

Currently, the most used and indicated surgical management for this pathology is knee arthroscopy, which consists of a minimally invasive technique that allows visualization of the knee using a camera, through small wounds.

When having a meniscal injury, in most cases we seek to try to repair the injury using different suturing techniques, in order to achieve adequate healing of the meniscus and reduce the risk of osteoarthritis or wear of the joint in the future. In cases where If repair is not indicated, a partial meniscectomy can be performed, which consists of removing the injured fragment, trying to preserve as much of the meniscus as possible.

After surgery, adequate rehabilitation must be performed to achieve the best results and avoid future relapses.

Let's talk a little about prevention: how can we take care of our knees to avoid injuries, how are you?

In terms of prevention, we must emphasize that it is an injury that occurs in large numbers in sports activities, which is why it is very important to use the appropriate footwear, perform strengthening and progressive loading exercises, in order to have the best performance when doing sports.

If the patient presents any symptoms that may suspect a knee injury, evaluation by a specialist is recommended to provide the best management for prompt recovery.