LATERAL MENISCAL INJURY

LATERAL MENISCAL INJURY

The lateral meniscus is less prone to injury than the medial meniscus due to having less adhesive attachments to other structures in the area.

Nevertheless injuries may be sustained during twisting movements, direct impact to the knee joint or due to degeneration of the cartilage in the older population.

SIGNS AND SYMPTOMS

• Tenderness or pain around the lateral surface of the knee joint

• Swelling- usually witin 24-48 hours of injury

• Pain, particularly when bending the knee

• Pain when rotating and pressing down on the knee in prone position.

• Audible popping, cracking or clicking sounds

• Positive 'McMurrays' test

WHAT CAN THE ATHLETE DO

• If there is swelling you should apply RICE (Rest, Ice, Compression, Elevation) to the injured knee.

• Gentle exercises to maintain quadriceps strength, although care should be taken not to aggravate the symptoms.

• Wear a heat retainer or support.

• Take a glucosamine / joint healing supplement.

• See a sports injury specialist or doctor

TYPES OF MENISCAL INJURIES

v DEGENERATIVE CHANGES: This may lead to edges of the menisci becoming frayed and jagged

v LONGITUDICAL TEARS: This is a tear that occurs along the length of the meniscus

v BUCKET- HANDLE TEARS: This is an exaggerated form of a longitudical tear where a portion of the meniscus becomes detached from the tibia forming a flap that looks like a bucket handle

TREATMENT 

The first aim of the sports injury specialist will be to correctly diagnose the injury. He/she may do this by utilizing specific tests for meniscal tears such as a 'McMurrays' test.

Once diagnosed the practitioner may consider two different modes of treatment depending on the extent of the injury.

CONSERVATIVE TREATMENT

This may be indicated in the case of a small tear or a degenerative meniscus and may involve:

• Ice, compression and recommendation of NSAIDs e.g. Ibuprofen.

• Try wearing a knee support or brace if the knee feels unstable.

• Electrotherapy i.e ultrasound, laser therapy and TENS.

• Manual therapy

• Once pain has subsided, exercises to increase range of movement, balance and maintain quadriceps strength may be prescribed.                                         These may include: squating, single calf raises and later, wobble-board techniques.

SURGICAL INTERVENTION

In the event of more severe meniscal tears such as a bucket handle tear, arthroscopic surgical procedures may be necessary to repair the lesion.

The aim of surgery is to preserve as much of the meniscus cartilage as possible. The procedure itself will normally invlove stitching of the torn cartilage.

The success of the surgery depends not only on the severity of the tear but also on the age and physical condition of the patient. Younger and fitter patients are known to have better outcomes.

Following surgery a rehabilitive exercise program will be outlined for the patient which may include strenghtening and balance training.