From the Guidelines
A meniscal knee injury typically presents with pain along the joint line, swelling, mechanical symptoms, and limited range of motion, with the most common symptom being pain localized to either the inner or outer side of the knee. The signs and symptoms of a meniscal knee injury can vary depending on the severity and location of the tear. According to the study by 1, meniscus tears in patients with knee osteoarthritis are a challenging clinical complication, and the majority of patients with knee osteoarthritis, particularly with more advanced osteoarthritis, are unlikely to get much improvement from surgical treatment of the meniscus tear. However, a small number of truly obstructing displaced meniscus tears are a primary cause of predominantly mechanical symptoms and warrant treatment.
Some common signs and symptoms of a meniscal knee injury include:
- Pain along the joint line of the knee, often localized to either the inner (medial) or outer (lateral) side of the knee
- Swelling that develops gradually over 24-48 hours after injury
- Mechanical symptoms such as catching, locking, or giving way of the knee during movement
- A clicking or popping sensation that may occur with certain movements
- Limited range of motion, with difficulty fully extending or flexing the knee
- Pain that worsens with activities that load the knee joint, particularly twisting movements, deep squatting, or pivoting
- Joint line tenderness when the area is pressed during examination
The injury often results from a twisting force applied to the knee while the foot is planted, common in sports or when changing direction suddenly, as mentioned in the study by 1. Meniscal tears occur because these C-shaped cartilage pads absorb shock between the thigh bone (femur) and shin bone (tibia), and when subjected to abnormal forces, they can tear, disrupting normal knee mechanics and causing these symptoms. The diagnosis and treatment of meniscal knee injuries should be guided by a thorough history, clinical examination, and appropriate imaging modalities, such as radiographs, to facilitate adequate management and prevent potential complications.
From the Research
Signs and Symptoms of Meniscal Knee Injury
The signs and symptoms of a meniscal knee injury can vary depending on the severity and location of the injury. Some common symptoms include:
- Pain, especially when twisting or rotating the knee 2, 3, 4, 5
- Swelling, which can be caused by a knee effusion 2
- Mechanical symptoms, such as locking or catching of the knee 5
- Joint line tenderness, which can be detected through physical examination 2
- Limited range of motion or stiffness in the knee 2, 4
Diagnosis of Meniscal Knee Injury
Diagnosis of a meniscal knee injury can be made through a combination of:
- Physical examination, including the McMurray, Apley, and "bounce home" maneuvers 2
- Magnetic Resonance Imaging (MRI), which can confirm the diagnosis and define the type, location, and severity of the injury 2, 5
- Plain radiographs, which can be used to rule out other causes of knee pain 5
Management of Meniscal Knee Injury
Management of a meniscal knee injury depends on the severity and location of the injury, as well as the patient's overall health and activity level. Treatment options may include:
- Conservative management, such as reduction of swelling and pain, and rehabilitation with tri-planar functional retraining 2
- Arthroscopic knee surgery, which may be necessary for bucket handle tears or non-vascularized meniscal injuries 2, 3
- Meniscal repair, which is currently preferred over partial menisectomy to avoid premature osteoarthritis 2, 4