Treating a Torn Meniscus in the Knee: From Home Care to Surgery

The meniscus is a C-shaped piece of cartilage that acts as a shock absorber between the shinbone and the thighbone. A torn meniscus is one of the most common knee injuries. This article provides an overview of how a torn meniscus is treated, from initial home care to physical therapy and surgical options if needed.

Introduction

The meniscus bears the load of the body’s weight across the knee joint and helps stabilize the knee during movement. A forceful twist or rotation of the knee can cause the meniscus to tear. Athletes are especially prone to meniscus tears. Without treatment, a torn meniscus can lead to persistent pain, locking of the knee, and an increased risk for arthritis. Fortunately, a variety of nonsurgical and surgical treatment options are available.

Initial Home Care

At the first signs of a torn meniscus, home treatment can provide pain relief and help improve knee function. The RICE protocol—rest, ice, compression, and elevation—is recommended.

• Rest avoids activities that aggravate knee pain and swelling. Crutches may be needed to prevent bearing weight on the knee.
• Ice application for 15 minutes several times per day decreases inflammation and pain.
• Compression with an elastic bandage helps limit swelling.
• Elevation of the knee above heart level also minimizes swelling.

Over-the-counter nonsteroidal anti-inflammatory medicines like ibuprofen help relieve pain and inflammation as well. strictly following RICE and avoiding strenuous activities during the initial recovery period gives the best chance for the torn meniscus to heal on its own.

Physical Therapy

If pain and swelling persist beyond a few weeks, a physician may recommend physical therapy. After evaluating the knee, a physical therapist will prescribe a customized rehabilitation program. The focus is on gradually strengthening muscles around the knee joint to improve stability.

Gentle exercises to improve knee flexion and extension are also included. Weight-bearing exercises like squats or leg presses using very light resistance can help rebuild strength. However, activities that cause sharp knee pain should be avoided. Physical therapy can continue for 6 to 8 weeks.

Corticosteroid Injections

If inflammation is contributing to knee pain and swelling, a doctor may inject a corticosteroid medication around the knee joint. Steroid injections can reduce inflammation and provide temporary pain relief. However, they do not help heal a torn meniscus. The effects of injections are temporary, lasting from several weeks to a few months.

Surgery

If home care, physical therapy, and injections do not relieve symptoms, arthroscopic surgery may be recommended. The type of surgery depends on the location and pattern of the meniscus tear. Partial meniscectomy, meniscus repair, and meniscus transplantation are the main surgical options.

Partial Meniscectomy

This is the most common surgery for a torn meniscus. The damaged portions of the meniscus are trimmed away, leaving as much intact meniscus as possible. It provides quick pain relief and allows most patients to return to normal activity within a few weeks. However, it can increase the risk of knee arthritis years later.

Meniscus Repair

When the torn edges of the meniscus are still vascularized, stitches can be used to sew the pieces back together. Repair surgery has high success rates, especially for younger patients. The repaired knee requires a long, gradual rehab period of restricted weight bearing.

Meniscus Transplantation

If the entire meniscus has been removed, a donated meniscus can be surgically implanted. This procedure is typically reserved for younger patients without arthritis. It can restore stability and prevent early joint degeneration.

Conclusion

With proper treatment, most torn meniscus injuries can heal successfully. Beginning home care immediately at the first signs of injury gives the best results. While physical therapy may be beneficial, patients not responding to conservative treatment after 6-8 weeks may require arthroscopic knee surgery. Surgical options range from trimming damaged meniscus tissue to suturing tears. Close adherence to rehabilitation protocols after surgery facilitates recovery. Prompt treatment helps minimize the risk of complications from a torn meniscus.

References

Mayo Clinic. Meniscus Tear.

KidsHealth. Meniscus Tears.

American Academy of Orthopaedic Surgeons. Meniscus Tears.

UC San Francisco Health. Meniscus Tear Treatments.