Knee meniscus injuries are a very common cause of knee pain, locking and a catching sensation. They most often result from a knee sprain, but can also develop through accumulated microtrauma, osteoarthritis or instability caused by knee ligament injuries.

Meniscus injuries usually require surgery.

The menisci stabilise the knee and protect the articular cartilage by reducing pressure.

Suturing the meniscus can preserve it and prevent secondary joint damage.

Symptoms

  • pain
  • swelling
  • knee locking: inability to move the knee, usually to straighten it fully, following a knee injury
  • a feeling of instability in the affected knee

Diagnostics

  • diagnosis is based on a proper orthopaedic examination, including meniscal tests that allow an experienced doctor to identify the location and type of injury with a high degree of probability
  • ultrasound is a very useful additional examination and often confirms the initial diagnosis
  • in uncertain cases or if injury to other joint structures such as ligaments, articular cartilage or the joint capsule is suspected, MRI may be necessary; it identifies the injury location and allows precise surgical planning

Treatment

  • most meniscus injuries require surgery
  • arthroscopic treatment is the worldwide standard for meniscus injuries. Several small incisions, usually two, approximately 5–7 mm long are made around the knee. An arthroscope, a high-resolution miniature camera, and miniaturised instruments are introduced into the joint to perform the necessary operation with minimal invasiveness.
  • depending on the injury type and location, the meniscus can be sutured in its outer part adjacent to the joint capsule, where a rich blood supply supports healing, or damaged fragments can be removed sparingly
  • an injury can sometimes produce a meniscal cyst. Depending on its size and location, it may be closed using suitable arthroscopic techniques or removed with arthroscopic assistance.

Postoperative management

  • in most cases, patients can leave hospital the day after arthroscopic treatment of meniscus injuries
  • patients usually use forearm crutches for two weeks to protect the operated knee
  • in special cases, the limb may need immobilisation for several weeks in a brace that protects the knee
  • several days of thrombosis prevention are usually required after surgery
  • Patients discharged home learn the basic ways to manage postoperative swelling.