Monday, November 19, 2012
ROCHESTER, Minn. — A meniscus tear — due to injury or wear and tear — is one of the most common knee injuries. The November issue of Mayo Clinic Health Letter provides an overview of this condition and treatment decisions, which can be more complex when osteoarthritis also is present in the affected knee.
Meniscus is the cartilage in the knee that is a cushion between the shinbone (tibia) and thighbone (femur). A meniscus tear can occur suddenly, for example, when an athlete abruptly stops running and changes directions. A tear may develop over time with joint wear that occurs naturally, or it can be related to degenerative arthritis.
Symptoms of a meniscus tear may include:
Knee pain or other symptoms should prompt a visit to the doctor. A history and physical exam may be enough to diagnose a tear. When osteoarthritis is suspected, X-rays or other imaging may be recommended. Patients and their doctors should be cautious about magnetic resonance imaging (MRI) results. These images are so sensitive that they detect abnormalities in the knees that don't cause pain and don't need treatment.
Nonoperative treatments — rest, ice and nonprescription pain relievers — are usually considered first. After the pain diminishes, physical therapy and exercise at home can help strengthen the muscles supporting the knee.
If the condition does not improve after several months, surgery may be an option to remove or repair torn menisci. However, if osteoarthritis also is present in the knee and the menisci tears are due to wear and tear related to aging, surgery may not provide the hoped-for pain relief. Several studies have shown that this surgery offers no advantages for people with advanced osteoarthritis. A large multicenter study is under way to compare the effectiveness of surgery to nonoperative treatment in patients with mild and moderate osteoarthritis and menisci tears.
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