Meniscus tears are a common cause of knee pain and many people go to knee surgery for their condition. But is surgery always necessary? Are all meniscus tears treated the same?
In practice, various factors are used to determine the ideal treatment of a meniscus tear
Some of these factors include the age of the patient, results of non -surgical treatment, and whether there is another injury other than just a torn meniscus.
In addition, the specific type of meniscus tear can determine the most appropriate treatment. Six common types of meniscus tears are described here.
Intrasubstance / Incomplete Tear
An intrasubstance tear is a common finding on an MRI report.
An intrasubstance tear is usually normal at the time of surgery. Often it is a sign of early degeneration changes of meniscus tissue, but they are rarely the sign of a problem. Incomplete and intrasubstance tears of the meniscus are solid injuries, and generally do not require any surgical treatment.
By the time people are in their 20s or 30s, changes in the intrasubstance of meniscus tissue are usually seen on an MRI. Radial Tear.
The radial tear of the meniscus, reflected in the middle of the top row is the most common type of meniscus tear. These tears are within the avascular zone of the meniscus, where there is no blood supply, and therefore there is little capacity for these tears to heal.
Therefore, when these tears require surgical treatment, usually the only option is to amputate the damaged part of the meniscus.
A horizontal tear is a tear that is commonly used to repair the meniscus. Seen in the upper right corner of the image, a horizontal tear runs along the circular fibers of the meniscus. Instead of removing the damaged part of the meniscus, a horizontal tear can be sewn together.
The key to determining the treatment of these tears is their location. If located within the vascular part of the meniscus then there is curative potential, and thus fix. When located more in the middle, these tears will not heal, even fix.
A flap tear of the meniscus is an unusual tear pattern. In cases where the flap causes symptoms of knee arrest. Usually, the meniscus flap can only be removed without removing much of the tissue.
A complex tear means there is a combination of tear patterns. A complex tear often involves both radial and horizontal tear patterns.
Usually, complex tears are not treated by meniscus repair due to the complex nature of the tear. In some unusual circumstances, some of the torn menisci may be removed, while other parts may be repaired.
A bucket-handle tear is a large type of horizontal meniscus tear. These tears are often caused by the knee joint by causing a torn portion of the meniscus to block normal knee movement. Tears that touch the bucket often require more urgent surgical treatment to allow the knee to start bending again.