In the very near future my husband will undergo outpatient surgery to repair a torn meniscus in the inside of his right knee. This occured while he attempted to remove his very heavy brief case from the back of a rental car. The large and poorly designed side doors were not meant to open fully in a parking space. They open outward instead of sliding. Fortunately, this surgery and recovery should be simple.
Menisci are pads of cartilage which act as cushions between the two bones (the femur and the tibia) that help distribute body weight in the joint. Without the meniscus present, the weight of the body would be unevenly applied to the bones in the leg. This uneven weight distribution would cause excessive forces in specific areas of bone leading to early arthritis of the knee joint. Therefore, the function of the meniscus is critical to the health of a person’s knee.
There are two menisci in the knee; each rests between the tough cartilage and conform to the surfaces of the bones upon which they rest. One menisci is on the inside of the knee; this is the medial meniscus. The other menisci rests on the outside of the knee, the lateral meniscus.
A torn meniscus is damage to the cartilage that sites on top of the tibia and allows the femur to glide when the knee joint moves. Tears are usually described by where they are located and their appearance. The rather amusing terminology is often called “bucket handle” tear, longitudinal, parrot beak, and transverse. While physical examination can predict whether it is the medial or lateral menisus that is damaged, a diagnostic procedure, like an MRI or knee arthroscopy can locate the specific part of the cartilage that is torn and how it appears.
The meniscus is nourished by small blood vessels, but the meniscus also has a large area in the center that has no direct blood supply (avascular). This presents a problem when there is an injury to the meniscus as the avascular areas tend not to heal. Without the essential nutrients supplied by blood vessels, healing cannot take place.
Typically a forceful twist or sudden stop can cause the end of the femur to grind into the top of the tibia pinching and potentially tearing the cartilage of the meniscus. This injury can also occur with a deep squatting or kneeling position, especially when lifting a heavy weight (i.e. my husband’s brief case). Motions that require pivoting and sudden stops, such as tennis, basketball, baseball and other sports can also cause meniscus damage.