Meniscal Tears in Athletes

By Jeff Davick, MD, DMOS

A meniscal tear is a common knee injury in athletes. A torn meniscus typically results from a twisting injury to a flexed knee. There are actually two types of cartilage in the knee joint. The articular cartilage is the shiny cartilage at the end of the bone. The meniscus cartilage is a shock absorber piece of cartilage that sits between the femur (thigh bone) and the tibia (shin bone). There is a lateral meniscus on the outer aspect of the knee and a medial meniscus on the inner aspect of the knee. The meniscus cartilage provides cushion to the knee joint and also helps in knee stability.

Meniscal tears typically occur when the knee is twisted or flexed severely. Athletes may report feeling or hearing a “pop” in the knee. With a torn meniscus, the knee will slowly start to swell and develop a tight or stiff feeling. Once the meniscus is torn, it can also catch within the knee joint and can cause the knee to lock in a bent position.

A good physical examination will often detect a torn meniscus. The knee is typically tender along the joint line and certain physical tests and motions of the knee may cause a clicking sound and reproduction of the pain. Because the meniscus is cartilage, it cannot be detected on an X-ray. An MRI scan will show the meniscus and any associated tears.

The type, location, size and blood supply to the meniscus and its tear will determine the type of surgery needed. Meniscal surgery is done arthroscopically where a small camera is placed into the joint and then instruments can be utilized to either stitch up the torn meniscus or remove the torn portion of the meniscus. The peripheral or outer one-third of the meniscus does have a blood supply and tears in this region can be sutured and expected to heal. Tears on the inner two-thirds of the menisci do not have the potential to heal since there is no blood supply in this region. Tears that occur in the inner two-thirds of the meniscus are typically debrided or simply smoothed down to prevent any catching or further tearing. If the meniscus is sutured or repaired, the athlete typically needs to wear a brace and utilize crutches for six weeks, and avoid running or jumping activities for 3-4 months. If the meniscus is simply trimmed and not sutured, the athlete only needs to be on crutches for 2-4 days and can typically return to sports as early as four weeks.

Although meniscal tears are extremely common in athletes, they are typically easily recognized, diagnosed and treated arthroscopically. Surgery is almost always successful to the point where the athlete can eventually return to their desired sport and level of participation.

Dr. Davick’s practice emphasizes the care of sports injuries. Dr. Davick volunteers as a team physician for local schools. His practice also includes joint replacement surgery of the knee and shoulder. Dr. Davick is available at DMOS – West in West Des Moines. To reach Dr. Davick or to schedule an appointment please phone 515-224-5218.