Meniscal Tears

The knee is a hinge joint that is made up of three weight-bearing bones: femur, tibia, and fibula. The knee allows for flexion and extension mainly some very slight movements in the lateral direction. There are four ligaments that provide stabilization in the knee:

ACL – anterior cruciate ligament. It connects the femur to the tibia and prevents the tibia from sliding forward. 

PCL – posterior cruciate ligament. The PCL connects the femur to the tibia and prevents the tibia from sliding backward. 

LCL – lateral collateral ligament. The LCL connects the outside of the femur to the fibula and prevents outward motion at the knee. 

MCL – medial collateral ligament. The MCL connects the inside aspect of the femur to the tibia and prevents inward motion at the knee.

These are mostly what people think of when they think of a knee injury, however, they’re in another structure in the knee that is often injured: the meniscus. The meniscus is a C-shaped layer of cartilage that is between the aspects of the femur and tibia that are constantly touching each other. There are really two separate menisci: the lateral and medial.

The menisci have many different functions:

• Provide cushion and lubrication while the knee bends and extends.
• Provide shock absorption.
• Increase joint stability.
• Limit how far the knee can bend and extend.

Meniscus tears can happen either over time or in an instant. Typically, meniscus injuries that occur in an instant are caused by rotation and bending of the knee, impinging the meniscus between the tibia and femur. This can happen in many different ways in many different sports. It can also occur during contact with another person or even with no contact at all. This injury occurs to either the lateral or medial meniscus, but percentages show it’s most often with the former. When the ACL is torn, there is often an associated lateral meniscus tear as well.

Tears can also happen over time with repetitive motion. This is especially common in the lateral meniscus because it has greater mobility. This can also happen in most sports because all sports involve a lot of repetitive motion, such as running, jumping, and kicking.

When it comes to symptoms, there are some "classic" ones that will be there no matter how the tear occurred. These include pain that is right at the line where the femur and tibia meet; a complaint of "locking" or "clicking" in the knee; and pain while going up stairs and knee giving way during activity. The injuries that are instantaneous will also have redness, swelling, and pain, and the injury site will be hot. The best way to manage these symptoms is to rest, ice for pain, and elevate the limb so that the fluid can easily be taken back to the trunk of the body.

There are tests that doctors and athletic trainers will use to attempt to diagnose this injury. However, the best way to truly diagnose a meniscus tear is to have an MRI done. From there, the doctor will decide if surgery is the best option.

To learn more about or make an appointment with a member of the MUSC Health sports medicine team, call 843-876-0111 or visit MUSC Health Sports Medicine.