The articular cartilage lines and cushions the thigh and shin bones at the knee joint. The meniscal cartilage lies in between the two bones. Unlike articular cartilage, which tends to wear, meniscal cartilage tends to tear with injury.
Older people can tear their meniscus in their routine daily activities, as they tend to have thin, easily torn menisci from years of use. Athletes, on the other hand, often present with a torn anterior cruciate ligament or other knee injury in conjunction with a torn meniscus, as a result of contact in sports
If you think you may have torn your meniscus, you may have heard a “pop,” have swelling, tenderness and stiffness in your knee, and a collection of fluid. See your doctor to be evaluated. If you have a meniscal tear and you do not treat it, a piece of cartilage may slip into your joint space, which may cause your knee to lock or slip.
To diagnose the problem, your doctor may order X-rays, a magnetic resonance imaging (MRI) scan, and/or use an arthroscope to look inside your knee joint (and potentially treat the tear at the same time).
By way of treatment, your doctor may suggest the conservative, surgical, or the new transplant approach, depending on your particular tear. The conservative approach is rest, ice, compression, and elevation (RICE). The surgical approach often entails the use of an arthroscope to visualize, clean up, and repair the torn cartilage. The transplant approach entails arthroscopic surgery as well, and donor cartilage, matched for your size, is fixed to your shin bone. For small tears at the edge of the cartilage, which has a good blood supply, the conservative treatment approach will often allow the cartilage to heal on its own. For deeper and larger tears, however, which do not have as good a blood supply, the surgical approach may be necessary. For severe tears in younger patients (usually under the age of 55) who do not have arthritis, meniscal transplant surgery may be an option.
This latter approach, transplant surgery, carries minimal risk and appears to have good outcomes. Complications occur at less than 1%, with the most common complications being infection and tissue rejection. The donated tissue is screened for infections such as hepatitis and HIV preoperatively, which nearly eliminates the risk of infection. In short-term studies, transplantation has shown to improve activity-related pain and swelling in 80-90% of patients. Long-term studies are needed to determine whether or not this procedure affects arthritis progression or development.