Doctor: Do I have a meniscus tear ?

Every day I see several patients that ask this question. The most common story is that of a twisting motion of the knee that hurts and a sense that something strange happened inside the knee – some times it is a popping or tearing sensation, or a feeling that something has moved inside that is not normal. This is often followed by pain and a feeling that the knee will not fully extend or bend. Many people develop swelling within a few hours or days. You’ll get the feeling as if there is water inside your knee along with the pain. This swelling typically resolves after a day or two. You may start to have recurrent popping or clicking in the knee when you walk. This may happen when you bend, get out of a chair, twist in bed, or do almost any activity that involves moving your knee. A meniscus tear does not have to happen because of a Trumatic event. This may be a simple twisting injury in the kitchen as well as a more traumatic injury on the soccer field. Most of the pain from a meniscus tear will go away after a few days. People tears complain of intermittent sharp pain in the knee, popping and clicking, but then have a lot of time during the day where they don’t really have much pain at all. Many people can identify specific moves or maneuvers that cause pain.

What do you find on exam with a meniscus tear ?

It’s important to have an experienced orthopedic surgeon evaluate your knee. After hearing your story, a careful examination should identify several things. First, the location of pain. This is usually along the joint line either on the inside or outside of your knee. It is usually tender. Next, it is often difficult to fully bend and straighten your knee. Many people have pain as they come out in to full extension or straight. People also have pain when they try to bend too far. This usually pinches on the meniscus tear and causes pain. Finally, there are some specific moves, the most important called the McMurray’s test, that involve twisting at the knee while bending and straightening. This will often result in a click or pop and cause pain. Sometimes it’s just the click, and sometimes it’s just pain. Both of these are highly suggestive of a meniscus tear.

Do I need an MRI scan for a meniscus tear ?

Meniscus Tear on MRIAn MRI scan is extremely helpful to identify a meniscus tear. In most cases, the patient story and examination are enough, however, getting an MRI scan can be very helpful. The MRI can help determine what kind of tear you have, but it is not always conclusive for this. An MRI of the knee can help predict where the tear has occurred and if it might either heal on its own, or heal with surgery.
Meniscus Tears: Understand your MRI results
Meniscus Repair

Does an x-ray show a meniscus tear?

An x-ray will NOT show a meniscus tear. It will show a lot of very other important things including the relationships between the bones of the knee as well as any sign of arthritis. This is always an important step for a good examination. I get x-rays on all my patients.

Can my tear heal without surgery?

Sometimes meniscus tears are in a portion of the meniscus that has a great blood supply and therefore a lot of potential for healing. The vast majority of them, however, do not have this great blood supply and typically will not heal. Many tears need surgery however this is an important discussion for you to have with your orthopedic surgeon.

What kind of surgery do I need for a meniscus tear?

Surgery for a meniscus tear is performed arthroscopically. This type of surgery requires a few very small incisions on the knee through which a small camera can look inside the joint and repair the tear. The surgery takes about 15 to 20 minutes and is always done as an outpatient procedure. Treatment for a meniscus tear is always tailored specifically for you. No two patients are the same. I have a long discussion with my patients in the office about the next best step – which is not always surgery! Make careful, educated decisions about your knee. Send me your questions !