by Matthew Harris MD, MBA
Meniscal Injuries are among the most common Orthopedic injuries that I treat. For all intents and purposes, they are best classified into two categories: 1. Acute and 2. Degenerative. We subdivide meniscal pathology into these groups because our treatments tend to correlate with which type of injury it is. The meniscus is a sophisticated shock absorber and stabilizer of the knee joint, and it is made of very durable cartilage. Meniscal injuries require attention, but not always surgery. Above all else, the underlying condition needs to be explained to the patient so that an informed decision can be made with regard to how to best manage the meniscal injury.
When discussing a meniscal injury, it is important to review the anatomy of the menisci with your physician, as well as, to discuss healing potential (or lack thereof) as it specifically related to the type of injury you have, as well as, the location and the mechanism.
Quite simply, there is significant variability between the immediate and long-term implications for treatment of a substantial meniscal tear that a 17 year old Junior Olympic Volleyball team member suffers in a game, versus the 64 year old recreational golfer with mild arthritis and some wear and tear who twisted his knee awkwardly while swinging the club. Just because your knee swells up and you have a lot of pain doesn't mean you need urgent surgery. For the first patient, performing a meniscal repair and offering that young athlete the best chance possible of healing the tear and going on to not just an athletic career, but a lifetime of maintaining adequate cushioning and stability in the knee is very important. For the middle-aged golfer, we are more likely to succeed with a conservative course of treatment, consisting of activity modification after a short period of rest and ice until the initial swelling and pain subsides.
No two meniscal injuries are the same. Age, activity level, and athletic demands are only several of the factors that go into making a customized decision for each patient. In order to learn more about some of the other factors that determine our recommended treatment, please feel free to visit two websites that I find particularly useful. The first link is a page developed by the AAOS (American Academy of Orthopedic Surgeons) on meniscal injuries. The second page can be found on the website of one of my teachers, and a highly regarded expert on meniscal injury, Dr. Howard Luks.
Dr. Harris is happy to answer any questions that you may still have after reviewing any of this information.