Meniscal injury

Question 1

What are the functions of the menisci in the knee joint?

Answer 1

Help the tibia and femur to fit together and move smoothly across each other.
Stabilise the joint
Shock absorber

Question 2

What is the common mechanism behind meniscal tears?

Answer 2

Twisting movements in the knee

• young people playing sports
• elderly - minor twisting movements

Question 3

How does a meniscal tear in the knee present?

Answer 3

Initial injury - popping sound or sensation

Sudden onset pain (may be referred to hip or lower back)
Swelling
Stiffness
Restricted range of movement
Locking of the knee
Instability of the knee

Question 4

What investigations are done for meniscal tears?

Answer 4

MRI scan (first line)

Arthroscopy - gold standard. Can also be used to repair / remove damaged sections.

Question 5

What is the management for meniscal tears?

Answer 5

RICE - rest, ice, compression and elevation
(as small tears will normally heal themselves)

Analgesia - normally NSAIDs

Physiotherapy after initial symptoms have settles

Surgery may be needed - arthroscopy (keyhole) involving

• repair of meniscus if possible
• resection of affected portion of the meniscus

Question 6

What special tests can be used for meniscal tears of the knee?

Answer 6

McMurray’s Test
Apley’s Grind test

• not commonly used though as cause pain + may worsen the injury

Question 7

What are some differentials for an acutely swollen knee?

Answer 7

Fracture
Cruciate ligament injury
Collateral ligament injury
Meniscal tear

Question 8

What is the main complication of a meniscal tear?

Answer 8

Secondary oesteoarthritis

Question 9

What are the risks of knee arthroscopy?

Answer 9

DVT

Damage to local structures