Meniscus tears can also be treated without surgery

Prof. Dr. Alper Murat Ulaşlı, Medical Director of Romatem Ankara, answered the magazine’s questions on meniscus tears and their treatment.

Does every tear need surgery?

The menisci are crescent-shaped fibrous cartilage between the femur and the tibia. They stabilise the knee, reduce friction between the bones and act as suspension that protects the joint cartilage. Damage comes in two forms: acute injury from sport or trauma, and wear-related damage. Large acute tears may need surgery. Chronic tears can be treated for their symptoms: physical therapy, exercise, anti-inflammatory medication and injections into the joint such as PRP, exosomes and stem cells relieve many patients without surgery. If pain persists or progresses, or swelling restricts movement, surgical repair may be needed.

In the past the damaged part or the whole meniscus was removed; today, with a better understanding of its role in knee mechanics, the approach is to preserve as much as possible.

How common, and who is affected

The most common knee problem is osteoarthritis; meniscus damage occurs on its own or alongside it. Other knee conditions include anterior cruciate ligament tears, jumper’s knee, collateral ligament tears and kneecap injury or dislocation. In younger people tears follow trauma or overuse, and a large injury is not required: a sudden twist or repeated squatting can be enough, and bending and turning inward or outward raise the risk. In older people tears develop from wear, sometimes from a slight misstep or a squat, because the meniscus has thinned over the years.

Symptoms and when to see a specialist

The first sign is knee pain, typically when climbing stairs, using the toilet, in sport or during prayer and other knee-bending movements. Swelling from fluid, restricted movement, difficulty walking, catching and giving way follow. Repeated tears can lead to early wear and osteoarthritis. Knee pain lasting more than two weeks, or severe pain after trauma or a strenuous movement, warrants a visit to a physical medicine and rehabilitation specialist.

Physical therapy aims to reduce effusion, normalise walking, restore pain-free joint movement, prevent muscle weakening and preserve the knee’s proprioception and normal position.