Where a meniscus tear occurs is one of the most important things that affects healing. Sports medicine definition and meaning collins english. The utilization of the mc in the evaluation and treatment of a 20yearold soccer player with an apparent acute meniscal injury is presented. Data sources medline 1966december 31, 2000 and healthstar 1975. Orthopaedic surgeons used to treat young people presenting after an injury with a locked knee by trimming the torn meniscus in open surgery. Medical disability advisor sample topics brought to you by reed. Recovery following a meniscal tear great lakes orthopedics. The inner area white zone lacks a good blood supply and therefore does not heal well.
In rare cases secondary signs can be seen, such as a soft tissue swelling next to the meniscus when a meniscal cyst is present 4. Pain and swelling are the most common signs of an injury to your meniscus. Complex meniscal tears extend in more than one plane, and can in turn create separate flaps of meniscus radiographic features mri knee. The mensical tear usually includes a combination of radial, horizontal, and longitudinal components any two or all three. You may do exercises 4 through 6 when the pain in your knee has decreased. Part of the diagnosis commons, rehabilitation and therapy commons, and the sports sciences commons recommended citation rhinehart, alex j. Older people are more likely to have degenerative meniscal tears.
Tears at the outer edge red zone tend to heal well because there is a good blood supply. Summit medical group is making it easier than ever for patients to seek care while limiting exposure to covid19. Epidemiological studies showed that all meniscal lesions, in. Journal of sports medicine and allied health sciences. There are two menisci in each knee, a medial one on the inside, and a lateral one on the outside. Burns school of medicine, university of hawaii jennifer r. Meniscus tear the meniscus is a c shaped pad of cartilage that sits between the heads of your femur thighbone, tibia shinbone, and patella kneecap. Osteoarthritis may result from an injury to the knee earlier in life. What makes knee arthritis more likely after meniscectomy. The presence of a displaced vertical longitudinal buckethandle tear was more commonly associated with a meniscal click.
Sports injury medicine department 9250 sw hall blvd. Acute traumatic tears occur most frequently in the athletic population as a result of a twisting injury to. This unusual presentation of a medial meniscal tear has never been reported. Meniscus tear orthopedic and sports medicine specialists. Osteoarthritis of the knee center for sports medicine. Soll presentations march 2007 minnesota sports medicine grand rounds.
Apr 26, 2010 meniscal tears nicola maffulli1, umile giuseppe longo2, stefano campi2, vincenzo denaro21centre for sports and exercise medicine, queen mary university of london, barts and the london school of medicine and dentistry, mile end hospital, london, england. The meniscus is cartilage, which acts as a shockabsorbing structure in the knee. Unfortunately, meniscal tears usually do not heal themselves once they have reached a substantial length 1 cm. There is also an normal variant of the lateral meniscus where the meniscus forms a circleor disc and is called a discoid meniscus. Knee effusion and joint line masses are nonspecific findings and, as such, their etiology is. Symptoms knee pain and tenderness along the joint stiffness or swelling. If the tear is not fixable, then the torn portion may be removed back to stable edges to prevent propagation of the tear and any further injury to the overlying cartilage. General wear and tear can also cause meniscal injuries and there is often little difference in the appearance between these and sudden trauma tears. A lateral meniscal tear involves a disruption in the lateral fibrocartilage of the knee. Its a piece of cartilage in your knee that cushions and stabilizes the joint. Meniscal injuries produce disability in a large portion of the population, and sports injuries are a common cause. One third of meniscal tears are associated with sports injuries. Players may squat and twist the knee, causing a tear. The new england journal of medicine n engl j med 1 original article surgery versus physical therapy for a meniscal tear and osteoarthritis jeffrey n.
Journal of knee surgery, sports traumatology, and arthroscopy 20. The sports medicine patient advisor patellofemoral pain. Improving detection of meniscal tears clinicians brief. Arthroscopic surgery for degenerative meniscal tears is a commonly performed procedure, yet the role of conservative treatment for these patients is unclear. Created by the american orthopaedic society for sports medicine aossm, in partnership with. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease. Meniscal cartilage tear exercises summit medical group. In fact wear and tear is actually many small traumas happening over a long period of time. Meniscus tears are common in contact sports like football as well as noncontact sports requiring jumping and cutting such as volleyball and soccer. Fractures involving the joint surfaces, instability from ligament tears, and meniscal injuries can. Orthopedics today a healthy 18yearold men sustained a left knee dislocation while snowboarding 4 days prior to presentation to our office. The type of tear often determines whether a tear can be repaired. Pdf functional rehabilitation after medial meniscus repair. He was seen immediately following the injury at an.
The content on this site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. Keep your pelvis level as you lift your hipspelvis and buttocks into the air. Across all tests, surgeon experience did not increase tear detection. Pullthetoesofyourinjuredlegtoward youasfarasyou cancomfortably whiletightening themusclesonthetopof your thigh. The specificity of the mtct was 77% and 73% for novice and experienced groups, respectively.
Information and opinions supplied by the staff at up and. Place a soccer or basketballsized ball behind your back. The effect of partial meniscectomy on future knee function. From that point, diagnostic tests will attempt to determine which meniscus is torn, how severely it is damaged, and what treatment is recommended.
Outcomes of fastfix meniscal repairs, manuscript in progress 19931995 student research assistant in biological science laboratory. They can happen when a person changes direction suddenly while running, and often occur at the same time as other knee injuries, like an anterior cruciate ligament acl injury. In years past, the meniscus was thought to be unnecessary and was completely removed in. Anterior cruciate ligament acl injury primary care sports. Functional rehabilitation after medial meniscus repair in a high school football quarterback. Pdf meniscal injuries in active patients researchgate. Nicholas emphasized the importance of epidemiologic studies in an effort to better define the risk of various sports. A sprain is a joint injury that causes a stretch or a tear. On plain radiographs, meniscal tears are not visible. Only when associated with more complex injuries plain film may suggest a meniscal tear, e. Other knee injuries, most commonly to the anterior cruciate ligament acl andor the medial collateral ligament, may occur at the same time as a meniscus tear. Pediatric sports medicine assistant clinical professor department of surgery, john a. There are different types of tears depending on the location and how they look.
But all it takes is a good twist of the knee to tear the meniscus. If a repair is performed, then physical therapy will be necessary for three months before returning to sports. The meniscus is a piece of cartilage in the middle of your knee. Lay on your back with your knees bent to prepare for the bridge exercise. Com meniscal cartilage tear top view femur thighbone tibia shinbone medical meniscus front view of knee lateral meniscus torn what are the symptoms. Cartilage is tough, smooth, rubbery tissue that lines and cushions the surface of the joints. In young individuals, meniscal tears are usually caused by trauma. Patient education compassion and care our goal at primary care sports medicine is to provide you with efficient and complete care that will allow you to return to the activities or sports. There are several types of meniscus tear and some of these are shown in the diagram below.
Diagnostic processes for meniscal tears aim to determine first and foremost whether a tear is present, or whether the knee symptoms are caused by something else. Meniscal tears can occur as a result of sports, dancing, or other activities that cause sudden twisting or movement within the legs and especially the knee. Meniscal cartilage tear rehabilitation exercises you may do exercises 1 through 3 right away. The outer portion of the meniscus, often referred to as the red zone, has a good blood supply and can sometimes heal on its own if. Shortterm sequelae of meniscal injury include knee pain as well as deficits in knee. Direct contact, like a tackle, is sometimes involved. Adhesive capsulitis april 2006 minnesota sports medicine grand rounds. Facing a wall put your hands against the wall at about eye level. Sitonthefloorwithyourinjured leg straight andtheotherlegbentsothefootisflatonthefloor. Key factors in determining progression of rehabilitation after meniscal repair anatomic site of tear suture fixation too vigorous rehabilitation can lead to failure location of tear anterior or posterior other pathology pcl, mcl, or acl injury. Context while most meniscal or ligamentous knee injuries heal with nonoperative treatments, a subset should be treated with arthroscopic or open surgery. A new england journal of medicine nejm study showing that physical therapy is just as effective as surgery in patients with meniscal tears and arthritis of the knee should encourage many health. You have a meniscus on the inner side of your knee the medial meniscus and a meniscus on the outer side of the knee the lateral meniscus. Aug 03, 2016 in addition, future studies should include factors not assessed or adequately evaluated by several of the included studies, such as meniscal tear pattern, age, mechanical alignment, sex of the patient, activity level, meniscal tears associated with other injuries such as the acl, smoking, and the effect of previous surgery.
If the tear can be repaired, then it should be fixed. Treatment for meniscal tears depends on the size and location of the tear. Objective to analyze the accuracy of the clinical examination for meniscal or ligamentous knee injuries. Other factors which influence treatment include age, activity level and related injuries. Doctors specializing in torn meniscus can be located through university medical schools, county medical societies, or state orthopedic societies. Mri versus clinical examination for the diagnosis of meniscal. As you write or produce stories about a professional athletes acl tear, or shed light. Sportsrelated injuries of the meniscus, an issue of clinics. Rehabilitation guidelines for meniscal repair uw health.
The tears occur when the knee is twisted while in a flexed, weightbearing position. The effect of partial meniscectomy on future knee function meniscal tears are the most common injury to the knee joint and meniscectomy is one of the most commonly performed orthopedic procedures in the united states. Sports related meniscal tears often occur along with other knee injuries, such as anterior cruciate ligament tears. Our telemedicine options include virtual video visits, telephone checkins, and patient portal communication. This creates a shear force on the meniscus, causing it to tear. Hold for 35 seconds, then return the leg to the ground and repeat with the opposite leg. Dec 30, 2016 if youve torn your meniscus it is very likely that you are in a fair amount of pain and may have sought immediate medical treatment for the tear. Meniscus rehab exercises the physical therapy advisor.
Meniscal damage is a common comorbidity associated with unstable stifles from ccl rupture in dogs. Palpation of a meniscal click strongly correlates with the presence of a meniscal tear, but the absence of a click does not reliably rule out meniscal pathology. Arthroscopic surgery for knee pain british journal of sports medicine. Passing this test allows us to progress into more functional strengthening, stability, and endurance.
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