For the past 20 years, we’ve all watched sports reporters tell about a professional athlete who injured his or her knee and required a “knee scope” to fix the problem. Although orthopaedic surgeons use a “scope” to fix a variety of problems in the knee joint, by far the most common is a torn meniscus.
Each knee has two discs of cartilage, which serve to transmit force from the thighbone (femur) to the shinbone (tibia) and to stabilize the knee. These cartilages are known as menisci (each one is called a meniscus). A meniscus may become torn in a variety of ways. In an athletic setting a specific accident can usually be recalled when the knee became injured. This commonly involves a twisting injury with the foot planted. It is possible to get a degenerative meniscus nevertheless. People who have the latter may not recall a specific injury but may have a torn meniscus nevertheless.
Signs, symptoms and indications of a torn meniscus are a suspicious history like the one above: swelling, popping, catching, locking, giving out or giving way, and pain along the joint. A torn meniscus may be present with all of these symptoms or only a few.
Since a meniscus is made of cartilage, which is soft tissue, diagnosis cannot be made by x-ray. However, an orthopaedic surgeon will often obtain x-rays of the knee to rule out another pathology. MRI (Magnetic Resonance Imaging) is useful in diagnosing a torn meniscus in people with a confusing clinical picture. Depending on a variety of factors, MRI can be quite accurate in determining if a meniscus is torn. However, in many cases, a doctor can diagnose a torn meniscus by listening to the history of the injury and by performing an examination of the knee.
Once it has been determined that the meniscus is torn, the orthopaedic surgeon will make a determination on the best course of treatment. In the vast majority of cases, a “knee scope” is required. The term “knee scope” is short for knee arthroscopy. This means that the surgeon performs the procedure with the aid of a camera, which is placed into the knee joint through a tiny incision. The instruments are introduced into the knee similarly. Typically three tiny holes or portals are required.
A knee arthroscopy for a torn meniscus usually involves removing the torn portion of the cartilage. The remaining healthy meniscus is left behind and continues to function as a shock absorber and stabilizer.
Rehabilitation following arthroscopic meniscal removal usually progresses very well. Weight bearing begins very rapidly as do range of motion and strengthening exercises. If an additional procedure is performed, rehab time may need to be extended. Once adequate strength and range of motion are attained and pain and swelling are gone, the patient may typically return to full activity. This commonly takes about six weeks, give or take a week or two.
If you feel that you have signs and/or symptoms of a torn meniscus, it is important that you consult with an orthopaedic surgeon. An untreated torn meniscus can cause further damage to the knee by scraping the cartilage on the ends of the bones that make up the knee joint.