Meniscus Tear: When is Surgery Needed?
A meniscus tear is a rather common trauma for athletes, but can also happen to non-athletes and elderly people suffering from degenerative joint disease such as osteoarthritis. This trauma can occur as a result of injury or simply due to prolonged stress to the knee. HMC’s leading orthopedic surgeon – dr. Steven Velkes, explains the treatment options for a meniscus tear.
What is a Meniscus?
The meniscus is a fibrous cartilage in the form of the letter “C”. The meniscus functions as a shock-absorber and a soft layer separating the bones of the knee joint. Each knee has two menisci between the femur and the tibial bone, named medial and lateral. A tear in the meniscus causes movement restriction and pain.
Meniscus Tear Treatment Options
The decision regarding the treatment of the tear is made by the orthopedic surgeon based on a thorough diagnosis, including imaging of the joint (X-ray, MRI). Whether or not surgery is necessary depends on the tear’s severity, type and location.
The outer third of the meniscus has very good blood supply, therefore the chances that a tear in that part will heal on its own are quite high, but surgery might still be necessary. If, however, the tear is in the inner two thirds of the meniscus it is not likely to heal without surgical intervention.
In any case, when deciding upon a surgery type the orthopedist takes into consideration the patient’s medical history, age, daily physical activity level, etc.
Surgical Repair of a Meniscus Tear
Young patients will usually undergo an arthroscopic procedure to repair the tear. During the procedure a small camera is inserted into the joint helping the surgeon to navigate the tools. He can either repair the tear or remove the damaged meniscus all together. If it is possible the undamaged part of the cartilage will be left untouched in order not to impair the movement range of the joint.
For older patients, suffering from a meniscus tear due to degenerative joint disease, such as osteoarthritis, nonsurgical treatment is the preferred approach.
Nonsurgical Treatment of a Meniscus Tear
Nonsurgical treatment of a meniscus tear is indicated when the following conditions are met:
- The tear is small and is located in the outer tip of the meniscus
- The symptoms of the trauma seem to be passing on their own
- The knee is stable and the movement range of the joint is not damaged
- The patient’s ability to perform his daily activities is not impaired
In the abovementioned cases treatment comes down to fixating the knee and abstaining from physical activity. For pain and swelling management non-steroidal inti-inflammatory drugs are prescribed (i.e. aspirin, ibuprofen).
The conservative treatment for a meniscus tear can be summed down to four main actions:
- Rest. Take a break from the activity that caused the injury. Your doctor may recommend that you use crutches to avoid putting weight on your leg.
- Ice. Use cold packs for 20 minutes at a time, several times a day.
- Compression. To prevent additional swelling and blood loss, wear an elastic compression bandage.
- Elevation. To reduce swelling, recline when you rest, and put your leg up higher than your heart.
The orthopedic department at the “Herzliya Medical Center” is home to Israel best specialists. We can offer you top-of-the-notch personalized care. For more information, please, fill in the contact form and we’ll get back to you as soon as possible.