Meniscus Tears

Menisci are "C"-shaped cartilage structures on the medial and lateral sides of the knee joint. They have critical functions: weight bearing, shock absorption, joint stability, and protection of joint surfaces. In athletes, they can tear during twisting and quick direction changes; in older age, degenerative tears occur. Treatment approach varies by tear type, location, size, and patient age.

Symptoms

Typical complaints:

• "Click" or "snap" sound heard at the moment of tearing
• Localized pain on medial or lateral knee
• Knee swelling (usually evident within 24-48 hours)
• Mechanical findings: catching, locking, sudden buckling
• Pain during squatting, descending stairs, twisting
• Inability to fully extend knee (locked knee)

Diagnostic Methods

On detailed clinical examination, McMurray test and Apley test suggest meniscal tears. The gold standard for diagnosis is MRI; tear type (radial, longitudinal, bucket handle, horizontal, etc.), location (anterior horn, body, posterior horn), and size are clearly shown.

Treatment Approach

Non-Surgical Treatments

Conservative treatment is sufficient in some cases: small stable degenerative tears, patients with preserved joint range, older patients with low activity. Treatment: RICE protocol, NSAIDs, physical therapy (quadriceps strengthening), in some cases hyaluronic acid or PRP injections. If knee is locked or mechanical complaints persist, surgery is inevitable.

Surgical Treatment

Performed via knee arthroscopy. Two approaches based on tear type:
1) Meniscal repair (suture) — Preferred for tears in peripheral vascular zone (red zone), young patients, and acute tears. Healing rate 80-90%.
2) Partial meniscectomy (resection) — For tears in the avascular inner zone and degenerative tears; torn tissue is trimmed to stable.

Surgical Process

Performed under regional (spinal) or general anesthesia. 2-3 small portals are used for camera and micro instruments. Repair cases take 45-90 minutes; simple resection 30-45 minutes.

Hospital Stay

Same-day discharge is possible. 1 overnight observation may be recommended for complex repairs.

Recovery Process

• Weeks 0-2: Crutches, partial weight bearing, ice, swelling control
• Weeks 2-6: Range exercises, start of physical therapy (slower if repaired)
• Weeks 6-12: Strengthening, proprioception
• Months 3-6: Sport-specific exercises (later if repaired)
• Return to sports 4-6 months after repair; 4-8 weeks after simple resection

Return to Work

Desk work in 3-7 days, standing work in 2-4 weeks, heavy work in 6-12 weeks. Slightly longer after repair.

Potential Complications

Complication rate around 1-3%. Problems: deep vein thrombosis (especially with prolonged immobilization), infection (very rare), intra-articular adhesion, motion restriction, nerve injury (especially near posterolateral portal), meniscal repair failure (10-20%).