Pathophysiology

The meniscus is a C-shaped disc which cushions the knee and distributes weight evenly. Each knee has two menisci, one which sits at the outer edge of the knee and one at the inner edge.

There are two types of tear, degenerative or traumatic. A traumatic tear generally occurs from a twisting motion whilst the foot is planted and the knee is bent and is quite common in sports such as football. Degenerative tears are relatively common and can be found in 60% of the population aged over 65. Generally speaking degenerative tears are horizontal and traumatic tears are vertical.

Symptoms

• Pain on the inside or outside of the knee along the tibiofemoral joint line
• Clicking of the knee
• Locking of the knee (inability to move the knee without use of hands)
• Pain at end of range bending or straightening

Management

• Activity modification
• Ice or heat
• Pain relief
• Physiotherapy including range of movement exercises and a graded strengthening programme
• Orthopaedic options- If traumatic with true locking may need further investigations. Generally conservative treatment for 3-6 months before considering onward referral.

Investigations

MRI if true locking with trauma

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