Meniscus Tear Injury Treatment Perth
Conservative Non-surgical torn meniscus treatment Perth Information
What is the function of the Meniscus?
The meniscus are C-shaped cartilages within the knee joint that are important for knee stability and acting as shock absorbers within the knee. Tearing of the meniscus is very common, particularly as we age. Certain types of meniscal tearing are best treated with a Physiotherapy exercise program.
What type of Meniscal tear is suitable for a Physiotherapy program?
In general, patients who are aged over 50 and have a degenerative meniscal tear are best to start an exercise program before considering surgery. Physiotherapy has been shown to be effective at reducing pain and restoring function for these type of tears. These tears do not usually heal, but pain can be reduced and function restored through an exercise program. Placebo ‘pretend surgery’ trials have shown that surgery does not give additional benefit for these tears beyond a Physiotherapy program. A link to the trial can be found here.
Which Meniscal tears are better treated with surgery?
Young patients, with large tears are better treated with surgery. Surgical repair of the meniscus can be performed in this patient group and has been shown to reduce the long term risk of arthritis compared to meniscus removal. Meniscal tears that should be considered for menicus tear surgery in Perth include:
Bucket handle meniscus tear (complete and displaced tear)
Combined meniscus and ACL tear
Peripheral tears in young patients
Tears that have failed a conservative Physiotherapy program
Tears that have mechanical symptoms (i.e. knee locking)
Meniscal root lesions – The meniscal root is at the end of the ‘c shape’ of the meniscus. Meniscal root repair has been shown to be superior to Physiotherapy for restoring function and lowering the long term risk of arthritis.
Can knee arthroscopy and meniscal removal damage the knee?
Yes, an arthroscopic ‘clean up’ can accelerate damage within the knee and result in early osteoarthritis. This is why patients aged over 50 who have degenerative tears should try and avoid this procedure and attempt an exercise program first. This is different to meniscal repair in young patients, which will decrease the long term risk of osteoarthritis.
What type of Physiotherapy is effective for meniscal tears?
An exercise based muscle strengthening program should form the foundation of your Physiotherapy program. This will focus on restoring range of motion and improving quadriceps strength.
Web page author: Dr Daniel Meyerkort, leading Perth orthopaedic surgeon specialising in Perth knee surgery.
KNEE MENISCUS FAQS
Can the meniscus heal?
Yes, small peripheral tears can heal on their own. Degenerative tears rarely heal but may become pain free through a suitable muscle strengthening program with your Physiotherapist. Large displaced tears usually require surgery.
How do I know if my meniscus tear has healed?
If your knee motion becomes normal and pain settles, this is a good sign that you do not require surgery. The meniscus may heal or may become pain free. If you have a small or degenerative pain-free tear, this does not require surgery.
How do you know if you have a torn meniscus?
Pain, localised to the inside or outside part of the joint can indicate meniscal tearing. Additionally, the knee can catch or lock with motion. Large tears may result in restricted knee motion or swelling of the knee. MRI scanning is the best imaging to determine if you have meniscal tearing.
Can you walk / exercise with a torn meniscus?
Absolutely! This is a good treatment to strengthen your muscles and can help improve your overall knee strength and function. If you are aged over 50 with a degenerative tear, an exercise program should be your first line of treatment. Initially, you may need a short period of rest and simple pain medications (Paracetamol / anti-inflammatory) to let the pain settle. As the pain settles your Physiotherapist will focus on knee motion and muscle strengthening. Good long term exercises include walking, cycling, swimming and gym based strength and conditioning.
Can you make a meniscus tear worse?
If you have suffered an acute knee injury, with sudden onset of pain, swelling and loss of knee motion it is advisable to image your knee with an MRI and be reviewed by your Physiotherapist / Surgeon or GP. Some acute meniscal injury is better treated with meniscal repair and if you start an exercise program, the meniscus can be damaged further.
If you are aged over 50 and have slow onset knee pain, there is no risk of damaging your meniscus further and best practice is to start an exercise program with your Physiotherapist. MRI is only necessary if your pain does not improve with a Physiotherapy program.
Is a meniscus tear seen on x-ray or ultrasound?
X-ray does not show a meniscus tear but can show underlying arthritis in the knee. Ultrasound is not useful to assess the meniscus. The best test to assess the meniscus is an MRI scan.
Is bike riding good for meniscal tear?
In general, if you are aged over 50 and have slow onset knee pain, bike riding is one of the most useful exercises that you can undertake for your knee.
Is a knee brace useful for meniscal tearing?
If you find that a small knee brace is useful for your knee pain it is worthwhile using. Long term a muscle strengthening exercise program should form the foundation of your treatment.