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Meniscus Injury – Causes, Symptoms and Treatment

A meniscus injury is damage to the cartilage tissue in the knee joint. It is often caused by twisting movements or overuse and leads to pain, swelling, and limited mobility.

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Things worth knowing about "Meniscus Injury"

A meniscus injury is damage to the cartilage tissue in the knee joint. It is often caused by twisting movements or overuse and leads to pain, swelling, and limited mobility.

What Is a Meniscus Injury?

The meniscus is a crescent-shaped piece of cartilage in the knee joint that acts as a shock absorber between the thigh bone (femur) and the shin bone (tibia). Each knee has two menisci: the medial meniscus (on the inner side) and the lateral meniscus (on the outer side). A meniscus injury refers to any form of damage or tearing of this cartilage tissue. It is one of the most common knee injuries and affects both athletes and older individuals in everyday life.

Causes

Meniscus injuries can occur through various mechanisms:

Acute injuries: Sudden twisting or rotating movements of the knee, for example during sports such as football, skiing, or tennis, can cause a meniscal tear.
Degenerative changes: Over time, the meniscus loses elasticity and becomes more prone to tearing, often without a specific traumatic event.
Overuse: Repeated stress on the knee from physical labor or intensive sports weakens the meniscus over time.
Pre-existing conditions: Osteoarthritis or other joint diseases can promote degenerative meniscal damage.

Symptoms

Symptoms of a meniscus injury vary depending on the severity of the damage:

Pain in the knee joint, especially during physical activity, twisting movements, or climbing stairs
Swelling of the knee (often developing within hours of the injury)
A feeling of locking or catching in the knee
Limited range of motion, particularly when fully bending or straightening the knee
Tenderness along the inner or outer joint line of the knee
Clicking or popping sensations when moving the knee

Diagnosis

The following methods are used to diagnose a meniscus injury:

Clinical examination: The physician performs specific provocation tests such as the McMurray test or the Steinmann test to assess for meniscal involvement.
Magnetic Resonance Imaging (MRI): MRI is the imaging method of choice and can accurately show the location, extent, and type of meniscal damage.
Ultrasound: Can be used as a supplementary method to detect swelling and certain structural changes around the knee.
Arthroscopy: In unclear cases or as part of surgical treatment, a joint endoscopy is performed, which can serve both diagnostic and therapeutic purposes simultaneously.

Treatment

Conservative Treatment

Many meniscus injuries, particularly degenerative tears in older patients, can be managed without surgery:

Rest and temporary reduction of weight-bearing on the knee
Ice application to reduce swelling
Anti-inflammatory medications (e.g., ibuprofen, diclofenac)
Physiotherapy to strengthen the muscles that stabilize the knee
Knee braces for support and stabilization

Surgical Treatment

Complete tears, mechanical locking of the knee, or persistent symptoms often require surgical intervention:

Meniscal repair (suture): In fresh tears with good blood supply, surgeons attempt to preserve the meniscus by suturing the torn edges together.
Partial meniscectomy: Portions of the meniscus that cannot heal are removed arthroscopically.
Meniscal transplantation: In rare cases, a donor meniscus can be transplanted if the entire meniscus had to be removed.

Recovery and Prognosis

The chances of recovery depend greatly on the type, location, and extent of the injury. Tears in the well-vascularized outer zone of the meniscus heal better than those in the poorly vascularized inner zone. After surgery, physiotherapy is essential for a full recovery. Return to sports is generally possible within several weeks to months.

References

Deutsche Gesellschaft für Orthopädie und Unfallchirurgie (DGOU) - Guideline on Meniscal Disorders, AWMF Register No. 033-006, 2021.
Englund M., Guermazi A., Lohmander S. L. - The role of the meniscus in knee osteoarthritis: a cause or consequence? Radiol Clin North Am. 2009; 47(4): 703-712. PubMed PMID: 19631935.
Petersen W., Tillmann B. - Collagenous fibrocartilage of the human knee joint menisci. Anatomy and Embryology. 1998; 197(4): 317-324.

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