Materiały źródłowe

• #1 Knee Meniscal Tears – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431067/

  The lateral and medial menisci are crescent-shaped fibrocartilaginous structures that collectively cover approximately 70% of the articular surface of the tibial plateau and primarily function in load transmission and shock absorption through the tibiofemoral joint. […] Isolated meniscal tears occur due to rotational or shearing forces placed across the tibiofemoral joint, especially when an increased axial load is placed through the menisci. Such scenarios include positions with increased degrees of closed kinetic chain flexion (kneeling, squatting), lifting/carrying heavyweights, and activities requiring rapid acceleration/deceleration, change of direction, and jumping. […] Meniscal tears are categorized by both their shape and location when visualized on magnetic resonance imaging (MRI), in which high-intensity intrameniscal signals communicate with at least one articular surface on an otherwise black-appearing meniscal tissue. Horizontal (cleavage) tears run parallel to the tibial plateau through the mid-substance of the meniscus. […] Meniscal repair is preferred over meniscectomy if possible since the risk of accelerated osteoarthritis increases with the removal of meniscal tissue due to decreased cushioning and increased force transmission across articular cartilage surfaces.

• #2 Meniscal Tears and Other Knee Cartilage Injuries | Doctor

  https://patient.info/doctor/meniscal-tears-and-other-knee-cartilage-injuries-pro

  The two menisci in each knee are crescent-shaped pads of cartilage tissue. The main functions of the menisci are tibiofemoral load transmission, shock absorption, lubrication of the knee joint and to improve the stability of the knee joint. […] Meniscal root tears are radial tears located within 1 cm from the meniscal attachment or a bony root avulsion. This injury is biomechanically comparable to a total meniscectomy, resulting in decreased tibiofemoral contact area and increased contact pressures in the involved compartment. […] The mechanism of injury is typically twisting or pivoting. Acute meniscal tears occur in young, active people. No or minimal force can be sufficient to cause a degenerative meniscal tear in middle-aged and older people. […] Surgical management is the mainstay of treatment for meniscal tears.

• #3 Torn meniscus – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/torn-meniscus/symptoms-causes/syc-20354818

  A torn meniscus is one of the most common knee injuries. Any activity that causes you to forcefully twist or rotate your knee, especially when putting your full weight on it, can lead to a torn meniscus. […] The meniscus is a C-shaped piece of tough, rubbery cartilage that acts as a shock absorber between the shinbone and the thighbone. It can be torn if you suddenly twist your knee while bearing weight on it. […] A torn meniscus can result from any activity that causes you to forcefully twist or rotate your knee, such as aggressive pivoting or sudden stops and turns. Even kneeling, deep squatting or lifting something heavy can sometimes lead to a torn meniscus. […] In older adults, degenerative changes of the knee can contribute to a torn meniscus with little or no trauma. […] Performing activities that involve aggressive twisting and pivoting of the knee puts you at risk of a torn meniscus. The risk is particularly high for athletes especially those who participate in contact sports, such as football, or activities that involve pivoting, such as tennis or basketball. […] A torn meniscus can lead to a feeling of your knee giving way, inability to move your knee as you usually do or persistent knee pain. You might be more likely to develop osteoarthritis in the injured knee.

• #4 Meniscus tear – Wikipedia

  https://en.wikipedia.org/wiki/Meniscus_tear

  A tear of a meniscus is a rupturing of one or more of the fibrocartilage strips in the knee called menisci. […] The traumatic action is most often a twisting movement at the knee while the leg is bent. […] Damage to the meniscus due to rotational forces directed to a flexed knee (as may occur with twisting sports) is the usual underlying mechanism of injury. […] A valgus force applied to a flexed knee with the foot planted and the femur rotated internally can result in a medial meniscus tear. A varus force applied to the flexed knee when the foot is planted and the femur rotated externally result in a tear of the lateral meniscus. […] Tears produce rough surfaces inside the knee, which cause catching, locking, buckling, pain, or a combination of these symptoms. Abnormal loading patterns and rough surfaces inside the knee, especially when coupled with return to sports, significantly increase the risk of developing arthritis if not already present.

• #5 The knee meniscus: structure-function, pathophysiology, current repair techniques, and prospects for regeneration

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3161498/

  The healing capacity of each area is directly related to blood circulation, leaving the white region susceptible to permanent post-traumatic and degenerative lesions. […] In the United States, meniscal lesions represent the most common intra-articular knee injury, and are the most frequent cause of surgical procedures performed by orthopedic surgeons. […] In young patients, sports-related injuries are the most common cause of meniscal lesions, accounting for more than 1/3 of all cases. […] Meniscal tears resulting from vehicle accidents are also associated with increased incidences of meniscus lesions in this particular age group. […] A substantial amount of research has focused on the efficacy and reliability of these repair techniques for achieving anatomical and functional restoration of the meniscus.

• #6 Meniscus Tears – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/meniscus-tears/

  Meniscus tears are among the most common knee injuries. Athletes, particularly those who play contact sports, are at risk for meniscus tears. However, anyone at any age can tear the meniscus. When people talk about torn cartilage in the knee, they are usually referring to a torn meniscus. […] The meniscus can tear from acute trauma or as the result of degenerative changes that happen over time. Tears are noted by how they look, as well as where the tear occurs in the meniscus. Common types of meniscus tears include bucket handle, flap, and radial. […] Acute meniscus tears often happen during sports. These can occur through either a contact or non-contact injury for example, a pivoting or cutting injury. […] As people age, they are more likely to have degenerative meniscus tears. Aged, worn tissue is more prone to tears. An awkward twist when getting up from a chair may be enough to cause a tear in an aging meniscus.

• #6 Meniscus Tears – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/meniscus-tears/

  The outer one-third of the meniscus has a rich blood supply. A tear in this „red” zone may heal on its own or can often be repaired with surgery. A longitudinal tear is an example of this kind of tear. In contrast, the inner two-thirds of the meniscus lacks a significant blood supply. Without nutrients from blood, tears in this „white” zone with limited blood flow cannot heal. Because the pieces cannot grow back together, symptomatic tears in this zone that do not respond to conservative treatment are usually trimmed surgically. […] If your symptoms persist with nonsurgical treatment, your doctor may suggest arthroscopic surgery. […] Some meniscus tears can be repaired by suturing (stitching) the torn pieces together. Whether a tear can be successfully repaired depends upon the type of tear, as well as the overall condition of the injured meniscus.

• #7 Torn Meniscus: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/17219-torn-meniscus

  A torn meniscus is a tear in the tough cartilage inside your knee. […] This cartilage is the meniscus. The rubbery wedges of cartilage act like shock absorbers for your knee, providing cushioning for your bones and knee joint. It can tear after a hard twist or rotation of your knee. […] Arthritis (a breakdown of cartilage in the joints) can also lead to a meniscus tear. […] Acute meniscus tears occur during a sudden motion in which your knee twists while your foot stays planted on the ground. The tear frequently occurs while playing sports. […] Sometimes, degeneration from arthritis causes a tear, even without a knee injury. […] If your meniscus tear doesn’t heal properly, you may have continued pain and discomfort in your knee. Meniscus injury can also speed up the wear and tear on your knee joint, increasing your risk for osteoarthritis.

• #8 Meniscus Tear in Knee: Symptoms, Causes, and Treatments

  https://www.webmd.com/pain-management/knee-pain/meniscus-tear-injury

  Tears are more common in the medial rather than in the lateral meniscus, perhaps because of this lack of mobility. […] These tears run perpendicular to both the tibia and the long axis of fibers in the meniscus. This means they can put increased pressure on the joint by disrupting the structure that helps distribute weight in the knee. […] This is a tear due to aging (rather than because of a specific injury) and is often linked to knee osteoarthritis. Most people with this condition have no symptoms. Those who do may have knee pain and feel the knee locking up. Treatment starts off with exercise, pain relievers, and topical treatments. The doctor may also advise you to lose weight. […] If a tear is large, unstable, or causing locking symptoms, your doctor will perform what’s known as arthroscopic surgery. They’ll insert a tiny camera through a small cut in the knee. This allows them to see inside the knee. Then they’ll insert some surgical instruments through two or three other tiny cuts to trim or repair the tear.

• #8 Meniscus Tear in Knee: Symptoms, Causes, and Treatments

  https://www.webmd.com/pain-management/knee-pain/meniscus-tear-injury

  Like a lot of knee injuries, a meniscus tear can be painful and debilitating. Unfortunately, it’s quite common. In fact, a meniscal tear is one of the most frequently occurring cartilage injuries of the knee. Cartilage is connective tissue that protects your joints and bones. […] A tear can happen when you change direction suddenly while running, or twist your upper leg while your foot is still and your knee is bent. These tears often occur alongside other knee injuries, like an anterior cruciate ligament (ACL) injury. In some cases, a piece of the shredded cartilage breaks loose and catches in the knee joint, causing it to lock up. […] But the menisci also weaken with age, so as you grow older, you might get a tear just from making an awkward turn when you get out of a chair. More than 40% of people 70 or older have had a torn meniscus.

• #8 Meniscus Tear in Knee: Symptoms, Causes, and Treatments

  https://www.webmd.com/pain-management/knee-pain/meniscus-tear-injury

  The outer portion of the meniscus, often referred to as the red zone, has a good blood supply and can sometimes heal on its own if the tear is small. In contrast, the inner two-thirds of the meniscus, known as the white zone, does not have a good blood supply. Tears in this region will not heal on their own, as this area lacks blood vessels to bring in healing nutrients.

• #9 Meniscal tear Presentation, diagnosis and management

  https://www.racgp.org.au/afp/2012/april/meniscal-tear

  Meniscal tears occur due to a shear force between the femur and tibia. In younger patients, this is typically a twisting force on a weightloaded flexed knee. These are often 'bucket-handle tears’, in which there is a vertical or oblique tear in the posterior horn running toward the anterior horn, forming a loose section which remains attached anteriorly and posteriorly. In older patients, tears are generally due to degeneration associated with ageing and tend to be horizontal tears. The difference in tear type between these populations is explained by the three-dimensional fibrous structure of the meniscus: horizontal delamination occurs in degenerative injuries, while the fibrous structure is ruptured in a vertical fashion in younger patients. […] Surgical treatment is usually reserved for younger patients with a vertical longitudinal tear within the vascularised outer third of the meniscus. This is termed the 'red-red zone’ (denoting area of vascularity). Repair of the 'red-white zone’ (watershed area between vascular and avascular meniscus) is controversial with many different surgical techniques. Tears in the 'white-white zone’ (avascular zone) are rarely repaired rather the damaged segment is resected (meniscectomy). Damaged avascular meniscus must be removed. However, meniscectomy causes long term osteoarthritis, so is only performed when the patient suffers joint locking or meniscal pain that is refractory to conservative management.

• #9 Meniscal tear Presentation, diagnosis and management

  https://www.racgp.org.au/afp/2012/april/meniscal-tear

  Research is currently investigating the possibility of implantation of collagen, allogenic and xenogenic cells, embryonic and adult stem cells, or scaffolds derived from polymers, hydrogels, tissues and extracellular matrix, and action of biological stimuli (eg. growth factors) on meniscus tissue is being investigated.

• #10 Bucket Handle Meniscus Tear: What It Is, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/23906-bucket-handle-meniscus-tear

  A bucket handle meniscus tear is an injury to the meniscus, a type of cartilage in your knee. […] This kind of injury often happens when you accidentally twist your knee during sports. […] A bucket handle meniscus tear can happen to anyone, but it’s more likely to occur if you play sports or exercise frequently. […] Most bucket handle tears happen when you suddenly twist or turn your knee during sports or exercise. […] Without treatment, a bucket handle tear can lead to arthritis in your knee and long-term knee pain. […] A meniscus tear also decreases your knees stability. […] Bucket handle meniscus tears often respond well to meniscus surgery because they usually have good blood supply. […] A meniscus transplant can help prevent osteoarthritis and future knee pain. […] If you have symptoms of a bucket handle tear or heard a pop in your knee, see your provider. […] Even meniscus tears that arent very painful can result in osteoarthritis and other knee problems later if you dont receive treatment.

• #11 Meniscal Tears and Other Knee Cartilage Injuries | Doctor

  https://patient.info/doctor/meniscal-tears-and-other-knee-cartilage-injuries-pro

  The two menisci in each knee are crescent-shaped pads of cartilage tissue. The main functions of the menisci are tibiofemoral load transmission, shock absorption, lubrication of the knee joint and to improve the stability of the knee joint. […] Meniscal root tears are radial tears located within 1 cm from the meniscal attachment or a bony root avulsion. This injury is biomechanically comparable to a total meniscectomy, resulting in decreased tibiofemoral contact area and increased contact pressures in the involved compartment. […] The mechanism of injury is typically twisting or pivoting. Acute meniscal tears occur in young, active people. No or minimal force can be sufficient to cause a degenerative meniscal tear in middle-aged and older people. […] Surgical management is the mainstay of treatment for meniscal tears.

• #11 Meniscal Tears and Other Knee Cartilage Injuries | Doctor

  https://patient.info/doctor/meniscal-tears-and-other-knee-cartilage-injuries-pro

  For meniscal root tears, one systematic review found: In patients who experience meniscal root tears, meniscal repair may provide the greatest improvement in function and lowest risk of conversion to total knee arthroplasty when compared with partial meniscectomy or conservative methods. […] Partial meniscectomy appeared to provide no benefit over conservative treatment, placing patients at a high risk of requiring total knee arthroplasty in the near future. […] Knees with known meniscal injury have accelerated cartilage wear, leading to early onset osteoarthritis. One study found that more than 75% of patients with symptomatic osteoarthritis have a meniscal injury.

• #12 Meniscus Tear: Causes, Symptoms, and Treatment Options

  https://regenexx.com/condition/knee/meniscus-tear/

  Meniscus tears fall into two main groups: acute and degenerative tears. Acute tears often result from an injury involving a sudden force or twist to the knee. Degenerative tears develop over time. They are usually due to the aging process, which weakens the meniscus and makes it more prone to tearing. […] Aging can hurt several components of the joint, including the meniscus. When the body’s ability to regenerate tissues decreases with age, the meniscus can become thinner, worn down, brittle, and more likely to tear. […] Meniscus tears often occur alongside other knee injuries. The most common ones are anterior cruciate ligament (ACL) tears. One study also found that experiencing an ACL tear can increase the risk of subsequent meniscus tear by 22% to 86%. […] Research shows that surgery for a torn meniscus is often overprescribed and, in some cases, no more effective than physical therapy. Unfortunately, patients are not always informed of the low success rate of these procedures. […] Whether patients undergo a partial meniscus “clean-up” (a piece is surgically removed) or a complete meniscectomy, these procedures may alter knee biomechanics and increase the risk of developing knee arthritis over time.

• #13 Torn Meniscus: Symptoms and Nonsurgical Treatment | HSS

  https://www.hss.edu/condition-list_torn-meniscus.asp

  A tear in the meniscus causes pain and locking. Injuries to the meniscus are common, particularly among athletes. The meniscus tears due to an acute injury (traumatic meniscal tear) or from being worn down over time (degenerative meniscal tear). Traumatic tears usually result from a forceful twisting of the knee. Degenerative tears usually occur in older people, as years of use can lead the meniscus to deteriorate. Degenerative or atraumatic tears, usually seen in older people, are caused by biological degeneration and breakdown of the meniscal structure. People with degenerative tears may accelerate tears by twisting their knees. However, the tear pattern in a degenerative tear is different from that of a traumatic tear. This is important because the treatment for a degenerative tear is different from that of a traumatic tear. Untreated tears can progress and become worse over time. Progressive meniscus loss can increase the risk that a person will develop degenerative knee arthritis.

• #14 Degenerative meniscus: Pathogenesis, diagnosis, and treatment options

  https://www.wjgnet.com/2218-5836/full/v5/i5/597.htm

  The symptomatic degenerative meniscus continues to be a source of discomfort for a significant number of patients. […] With vascular penetration of less than one-third of the adult meniscus, healing potential in the setting of chronic degeneration remains low. […] Continued hoop and shear stresses upon the degenerative meniscus results in gross failure, often in the form of complex tears in the posterior horn and midbody. […] Degenerative meniscal tears were associated with the presence of Outerbridge II chondral degeneration more than 85% of the time, compared to 12% for flap tears and 0% for longitudinal tears. […] Osteoarthritis and degenerative meniscal tears share many of the same risk factors and biological processes. […] The healing potential of chronic degenerative menisci remains poor.

• #15 How A Meniscus Tear Can Affect The Long-term Health Of Your Knee: Joe Cooper, MD: Orthopedics

  https://www.joecoopermd.com/blog/how-a-meniscus-tear-can-affect-the-long-term-health-of-your-knee

  Studies show that these tears are common in the elderly especially in people who have symptoms of knee arthritis. […] As early as 2009 studies reported that meniscus damage plays an important role in the development of knee OA. […] Knees with known meniscal injury have accelerated cartilage wear, leading to early onset of osteoarthritis. Studies report that meniscus tears can lead to osteoarthritis of the knee, and conversely, OA of the knee can cause degenerative meniscus tears. […] However, as evidence continues to grow on the essential role of the meniscus, my practice and shifted more and more to repairing meniscus tears to protect the cartilage of the knee and improve the long-term health of the knee.

• #16 Meniscus Injuries of the Knee | PM&R KnowledgeNow

  https://now.aapmr.org/meniscus-injuries-of-the-knee/

  There is greater healing potential in the vascular region (outer one third or red-red zone), which carries an excellent prognosis if the location of a tear is here. […] Tear location based on imaging/arthroscopy is an important decision-making tool because healing potential is vascular-dependent. Peripheral tears with inherently high healing potential should be repaired whereas nonvascular tears, where healing is unlikely to occur, should be excised. […] The goal of repair is to preserve as much meniscal tissue as possible with the inside-out technique the gold standard. […] Meniscal root tears can be managed both non-operatively and operatively. Operative options include either partial meniscectomy or meniscal root repair. […] The prognosis depends on the age of the patient, type of tear, and underlying condition of the knee, with overall good outcomes in tears amenable to nonsurgical treatment.

• #17 The knee meniscus: structure-function, pathophysiology, current repair techniques, and prospects for regeneration

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3161498/

  The first trials in this direction have been largely based on the positive healing outcomes of allogeneic articular, auricular, and costal chondrocytes in lesions in the avascular zone of the meniscus. […] The limited ability of cell isolation for large-scale constructs is a notable example. […] The mechanical properties of the matrix can be enhanced through three general mechanisms: deposition, alignment, or compaction. […] The mechanical properties of the knee meniscus are appropriately tuned to withstand the forces exerted on the tissue. […] The contact forces on the meniscus within the human knee joint have been mapped. […] The intact menisci occupy approximately 60% of the contact area between the articular cartilage of the femoral condyles and the tibial plateau, while they transmit 50% of the total axial load applied in the joint.

• #18 The knee meniscus: structure-function, pathophysiology, current repair techniques, and prospects for regeneration

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3161498/

  The biomechanical effects of total removal of the lateral meniscus in 10 cadaveric knees and reported a 50% decrease in total contact area, resulting in a 235-335% increase in peak local contact load. […] The problems accompanying meniscus tissue engineering research are considerable, we are undoubtedly in the dawn of a new era, whereby recent advances in biology, engineering, and medicine are leading to the successful treatment of meniscal lesions.

• #19

  https://link.springer.com/article/10.1007/s00167-011-1818-0

  Any substantial loss of meniscal tissue from injury or iatrogenic meniscectomy permanently alters the biomechanical and biological environment of the knee joint. […] Subtotal or total meniscectomy increases the risk of secondary osteoarthritic changes by a factor 14 when compared to matched controls, eventually resulting in radiographic changes in 30-70% of patients. […] The role of concomitant cartilage damage related to the trauma that resulted in meniscal injury in the first place, or of iatrogenic damage related to the meniscectomy procedures, has not been determined, but is likely to play a role as well. […] Joint laxity and instability have long been considered to be a strong contributor to the development of post-traumatic osteoarthritis. […] Nonetheless, the definition of instability remains nebulous.

• #19

  https://link.springer.com/article/10.1007/s00167-011-1818-0

  Joint laxity and instability shift the centrally located primary load bearing area to a more peripheral location, resulting in overloading of part of the articular cartilage. […] The anterior cruciate ligament (ACL) is the knee ligament most common disrupted. […] Even after adequate ACL reconstruction, 50 to 80% of injured knees show radiographic osteoarthritic changes at 9 years or more follow-up. […] In conclusion, malalignment, loss of meniscal tissue, cartilage defects and joint instability all seem to be strongly correlated to osteoarthritis in one way or the other.

• #20 Can a Meniscus Tear Cause Arthritis?

  https://www.aasthajoints.com/blog/can-a-meniscus-tear-cause-arthritis-what-you-need-to-know/

  Research suggests that patients who undergo meniscus removal (meniscectomy) have a higher risk of developing arthritis than those who receive meniscus repair. […] A torn meniscus can lead to ongoing inflammation within the knee joint. When the body senses damage, it releases inflammatory enzymes that attempt to repair the tissue. However, prolonged inflammation can: […] A meniscus tear changes how the knee functions. Many patients with untreated meniscal injuries compensate by adjusting their gait (walking pattern). This unnatural movement leads to: […] Many patients ignore meniscus tear symptoms, assuming the pain will go away with time. However, delaying treatment can: […] If you suspect a meniscus tear, seeking treatment from an experienced meniscus tear surgeon or orthopedic doctor can help you manage the condition effectively and reduce arthritis risk.

• #20 Can a Meniscus Tear Cause Arthritis?

  https://www.aasthajoints.com/blog/can-a-meniscus-tear-cause-arthritis-what-you-need-to-know/

  A torn meniscus is often thought to be a short-term injury, but it can cause long-term joint problems, like arthritis, if it is not treated or controlled properly. Wear and tear on the knee joint over time leads to arthritis. A torn meniscus can speed up this process in a number of ways, including: […] The meniscus plays a crucial role in stabilizing the knee joint by distributing body weight evenly across the joint surface. When the meniscus is torn, it disrupts this balance, leading to: […] Over time, this instability causes cartilage breakdown, leading to osteoarthritis, a degenerative joint disease. […] When the meniscus is damaged, the knee loses an essential protective layer that prevents bone-on-bone contact. Without proper cushioning, the remaining cartilage in the knee joint experiences:

• #21 The mediating role of synovitis in meniscus pathology and knee osteoarthritis radiographic progression | Scientific Reports

  https://www.nature.com/articles/s41598-024-63291-6

  The association between meniscus extrusion and KOA radiographic progression has been reported in the previous literature. Our study adds to this evidence to prove the longitudinal association between medial meniscus extrusion and KOA progression. […] Our results suggest that the progression of KOA caused by medial meniscus extrusion (but not meniscal damage) is partly mediated by synovitis. […] The change in knee joint load caused by meniscus extrusion may be the initial driving factor of the disease. […] Medial meniscus extrusion may increase the mechanical stress of articular cartilage and subchondral bone, thereby expediting the progression of synovitis. Conversely, synovitis may facilitate the deterioration of articular cartilage and subchondral bone by generating pro-inflammatory cytokines and matrix metalloproteinases, ultimately contributing to the radiological advancement of knee osteoarthritis.

• #22 3 Types of Meniscus Tear Treatment | Knee Specialist | Baton Rouge, LA

  https://www.jeremyburnhammd.com/meniscus-tear-arthroscopic-meniscus-surgery/

  The meniscus aids other structures in providing knee stability and is known as a secondary stabilizer in the context of ACL, or anterior cruciate ligament, injury. […] The meniscus has limited blood supply, and some areas can’t heal on their own. […] Recent studies showed that a tear with sufficient blood supply can recover after being sewed together. […] In the case of degenerative meniscal tears, the symptoms will usually improve. However, some types of meniscal tears lead to rapid arthritis or cause knee instability, lack of motion, stiffness, or weakness.

• #22 3 Types of Meniscus Tear Treatment | Knee Specialist | Baton Rouge, LA

  https://www.jeremyburnhammd.com/meniscus-tear-arthroscopic-meniscus-surgery/

  The meniscus can be torn during a twisting or impact injury to your knee, or it can develop a tear over time from overuse. […] Many meniscus tears can be treated successfully without surgery. […] Some types of meniscus tears, such as a meniscal root tear or a bucket-handle tear often need surgery. […] Although the meniscus has traditionally been considered a difficult structure to heal, newer techniques and biologic augmentation such as PRP, stem cells, fibrin clots, and cartilage scaffolds have led to an improved rate of healing. […] Current literature suggests that meniscal repair is successful between 75-95% of the time, depending on the type and location of the tear. […] Degenerative meniscus tears, sometimes referred to as complex tears, are tears that usually cant be repaired and can be trimmed arthroscopically if non-surgical treatment is not effective.

• #23 Meniscal Cartilage Tears & Injuries: Symptoms, Diagnosis & Treatments

  https://yorkshirekneeclinic.com/knee-conditions/meniscal-cartilage-injuries/

  A torn meniscus does not function properly and it can lead to early wear in the joint. […] The commonest meniscus-related problem is a tear – a “torn cartilage”. […] A cartilage tear may also result in swelling or even a sensation of the knee giving way (though this is usually a sign of ligament damage). […] A tear of the meniscal cartilage in a young adult usually occurs with a greater force than in a middle aged or elderly person. The reason for this is that the strength of the cartilage reduces as you grow older. With the natural aging process, the meniscus cartilage goes from being tough and resilient to quite fragile and brittle. Therefore the cartilage tears or splits more easily. […] In middle aged or elderly patients a cartilage tear may occur with a relatively minor injury.

• #24

  https://www.orthobullets.com/knee-and-sports/3005/meniscal-tears

  Complete radial tears that extend to the meniscocapsular junction are biomechanically equivalent to posterior root tears. […] Functionally equivalent to a total meniscectomy. […] Medial root tears associated with chondral injuries are more common in women with increased age, obesity, varus knee alignment, and a sedentary lifestyle. […] Indications for meniscal repair include peripheral in the red-red zone (vascularized region) and vertical and longitudinal tear. […] Current literature shows no difference in healing for 2nd generation all-inside repairs with/without concomitant ACL reconstruction. […] 70-95% successful outcomes for meniscal repair, with the highest success when done with concomitant ACL reconstruction (90%).

• #24

  https://www.orthobullets.com/knee-and-sports/3005/meniscal-tears

  Meniscal tears are common sports-related injuries in young athletes and can also present as a degenerative condition in older patients. […] Degenerative tears in older patients usually occur in the posterior horn medial meniscus. […] Medial tears are more common than lateral tears; the exception is in the setting of an acute ACL tear where lateral tears are more common. […] MRI is most sensitive diagnostic test, but also has a high false positive rate. […] MRI grade III signal is indicative of a tear; linear high signal that extends to either superior or inferior surface of the meniscus. […] Parameniscal cyst indicates the presence of a meniscal tear. […] Bucket handle meniscal tears indicated by „double PCL” sign. […] „Double anterior horn” sign may indicate meniscal root tear.

• #25 Meniscus and Articular Cartilage Injuries How are they Treated?

  https://www.myorthodoc.com/meniscus-and-articular-cartilage-injuries/

  When the articular cartilage and the meniscus are damaged severely, over the course of many years, and, when the space between the femur tibia or patella decreases (joint space narrowing), it is called arthritis. […] Both types of cartilage tears can lead to a decrease in performance. […] The bigger the meniscus tear or chondral defect, the more severe the symptoms. […] If you have meniscus repair or microfracture of a chondral lesion there is a small chance it does not heal so you will need another surgery in about 6-9 months. […] The patients whom I find experience difficulty with recovery are those with a meniscus tear and arthritis. After the meniscus tear is fixed the arthritis continues to be a problem even in those patients who were fine before the tear. […] The general rule for chondral injuries is that the smaller the defect the more likely things will turn out well.

• #25 Meniscus and Articular Cartilage Injuries How are they Treated?

  https://www.myorthodoc.com/meniscus-and-articular-cartilage-injuries/

  Knee meniscus and articular cartilage / chondral tears are among the most common injuries I see in my Orange County Orthopedic surgery practice. […] Often times meniscus or articular cartilage tears occur in conjunction with other injuries especially anterior cruciate ligament (ACL) tears and medial collateral ligament tears (MCL). […] Articular cartilage tears, aka chondral defects are injuries to the joint surface or lining. […] The younger the patient the more likely the lesion is isolated and discrete. The older the patient, the more likely the lesion is degenerative and diffuse (degenerative joint disease). […] Most of the time chondral lesions are associated with ACL tears. […] Patients who have arthritis will have damage to both the meniscus and the chondral surface. […] Arthritis is a pathology that has a spectrum, that is, it probably started with an isolated meniscus or chondral lesion, which led to a situation of progressive breakdown of the joint causing worsening cartilage/chondral damage which eventually lead to complete wear down of the joint.

• #26 The Knee Meniscus: Torn between Rehab or Surgery? – Newcastle Sports Medicine

  https://newcastlesportsmedicine.com.au/knee/meniscus-injuries/

  The only meniscal tears that need surgery are those that can be repaired, or tears that give persistent pain despite good quality non-operative care. […] In general, if you are over 30 years old the meniscus has reduced healing potential and is less likely to be repaired as the blood supply to your meniscus starts to diminish. […] A specific type of meniscal tear called a ‘bucket handle tear’ can occur and cause your knee to be locked (cannot fully straighten your knee). […] If you have a tear of the meniscus in or near the blood supply, the meniscus may heal if surgical stitches hold it together whilst it heals. […] Partial meniscectomy affects function of the knee and will speed up the onset of degenerative osteoarthritis. […] Although surgery may help pain it will affect knee function and speed up osteoarthritis. […] The only tears that can be repaired are those in the outer edge of the meniscus, usually in people less than 30 years old.

• #27 Meniscus tear in children and teens (knee injuries) | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/meniscus-tear-children-and-teens-knee-injuries

  Meniscus tears usually occur after a sudden forceful twisting of the knee, which causes the meniscus the semicircular, wedge-shaped collection of soft cartilage in the knee to stretch and tear. The cartilage absorbs the stress on the knee and acts as a cushion between the three bones that meet at the knee the femur (thigh bone), tibia (shin bone) and patella (knee cap). […] Because a meniscus tear is caused by a sudden, forceful twisting of the knee, athletes and active people (particularly those who participate in contact sports) are at an increased risk of meniscus tears, but anyone can injure a meniscus. […] A unique type of meniscus problem occasionally encountered in children is an abnormally shaped meniscus called a discoid meniscus. The disk shape of these menisci makes them more susceptible to tearing.

• #28 Degenerative meniscus: Pathogenesis, diagnosis, and treatment options

  https://www.wjgnet.com/2218-5836/full/v5/i5/597.htm

  Persistent hoop and shear stresses create complex tears in the posterior horn and midbody. […] For patients refractory to conservative therapy, arthroscopic partial meniscectomy can provide short-term pain relief when combined with a physiotherapy program. […] Surgery, however, is not a guaranteed success, especially in the presence of articular pathology. […] Ultimately, the long-term outcomes of surgical or non-surgical treatment have been shown to be similar for most patient subsets.

• #29 Torn Meniscus: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/17219-torn-meniscus

  More serious meniscus tears may not heal on their own. […] Surgery is a very effective way to repair a torn meniscus. If the tear is too big to repair, your surgeon may remove all or part of the meniscus. […] If you have surgery to remove all or part of your meniscus, you may be at a higher risk of developing arthritis down the road. That’s because you now have less shock absorption in your joint. Over time, the joint can break down.

• #30 What Happens When You Ignore a Torn Meniscus? – Weiss Memorial Hospital

  https://www.weisshospital.com/news/what-happens-when-you-ignore-a-torn-meniscus/

  One of the most common knee problems is a torn meniscus. Although this can be a painful, sidelining injury, many people put off a visit to the doctor. […] The menisci are two pieces of tough, rubbery C-shaped cartilage that absorb shock in the knee joint. […] A torn meniscus can happen during regular daily activities, but they commonly happen during sports, during motions that involve squatting or twisting, or as a result of direct impact. […] Because the knee is a complex joint of many different parts, any untreated knee injury can lead to further problems. […] If you don’t seek treatment for a meniscus tear, it’s possible for the injury to cause further knee problems down the line. […] An untreated torn meniscus can also lead to other long-term problems, including early development of osteoarthritis in the knee.

• #31 Torn Meniscus: Causes, Symptoms & Treatment | UW MedicineStethascopeHeart

  https://www.uwmedicine.org/conditions-symptoms/bone-joint-muscle/torn-meniscus

  A torn meniscus is often caused by a twisting movement of the knee while bearing weight. […] Meniscus tears can happen during a rotating movement while bearing weight, such as when twisting the upper leg while the foot stays in one place during sports and other activities. […] An untreated torn meniscus can result in instability of the knee and lasting pain. It can also increase your risk of osteoarthritis.

• #32 ACL Vs MCL Vs Meniscus Tear | Dr. Pamela Mehta, San Jose

  https://www.resilienceorthopedics.com/knee/acl-mcl-meniscus-tear/

  The menisci are two c-shaped pieces of cartilage that act as a cushion between the thigh bone (femur) and the shin bone (tibia). It helps absorb shock and provides stability to the knee joint. […] Meniscus tears frequently occur during activities that involve twisting or rotating the knee. The likelihood is increased if you are bearing weight. […] Accurate diagnosis of the type of knee tear is crucial for proper treatment. Medical professionals use various diagnostic tools, including: […] These methods help determine the injury severity and tell us what part of the knee is involved in the tear. […] For example, during a high-impact injury, it is not uncommon to sustain both an ACL tear and a meniscus tear. Multiple tears can complicate the diagnosis and treatment plan. […] Patients who suffer an ACL tear can also have a meniscus tear occur, with this being seen in up to 17% of ACL patients.

• #32 ACL Vs MCL Vs Meniscus Tear | Dr. Pamela Mehta, San Jose

  https://www.resilienceorthopedics.com/knee/acl-mcl-meniscus-tear/

  This type of injury can also occur due to high-impact collision during sports. […] The symptoms of a combined ACL and meniscus tear can be like the symptoms of an ACL tear or meniscus tear on its own. The type of treatment that you will need will depend on the severity of your injury. […] In most cases, knee surgery is recommended for a combined ACL and meniscus tear. […] This makes the decision to operate on both at the same time or not more complex. […] Your surgeon will advise whether the best option is separate procedures or combined. […] A combined ACL, MCL, and Meniscus tear is known as the unhappy triad or knee blowout. This is a complex knee injury that can result from high-force contact to the lateral (outside) part of the knee. […] This type of injury will almost always require surgery usually of the ACL and often the meniscus.

• #33 Diagnosing Knee Cartilage Injuries | NYU Langone Health

  https://nyulangone.org/conditions/knee-cartilage-injuries/diagnosis

  Meniscus is another form of cartilage found in the knee. Two crescent-shaped discs, the menisci, provide cushioning between the bottom of the femur and the top of the tibia. […] Damage to the articular knee cartilage can cause pain, inflammation, a clicking noise and catching sensation, and reduced range of motion of the joint. Cartilage injuries that are wider than a centimeter have the potential to get bigger over time, which may lead to osteoarthritis, a degenerative condition of the joint. […] Sometimes damage to articular cartilage occurs alongside other injuries of the knee, including meniscus tears and anterior cruciate ligament tears. […] An MRI, which creates images of soft tissues, helps your doctor determine whether you have an acute injury to the knee cartilage. This sensitive imaging test allows the doctor to evaluate the size and depth of the cartilage injury, whether or not loose pieces of cartilage are floating in the joint, and the status of other important structures, including the meniscus and knee ligaments.

• #34 The knee meniscus: structure-function, pathophysiology, current repair techniques, and prospects for regeneration

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3161498/

  Improving the healing process in this type of injury is an ongoing challenge for clinicians and researchers. […] Despite these results, none of the above techniques has been a recipient of general acceptance and application. Therefore, the main strategy for treating such tears is partial meniscectomy, with its related long-term degenerative implications for articular cartilage. […] The main reason behind such unfavorable results is the degenerative etiology surrounding meniscal tears in such patient groups, as well as the declining vascularization of the aging meniscus. […] The transplantation of expanded or modified autologous MSCs is another approach in MSC-based tissue engineering. […] The realization of the fact that the isolation of a sufficient number of healthy, undifferentiated meniscal cells extracted from an injured meniscus ranges from difficult to impossible, and the need for alternative cell sources, has led many researchers to use allogeneic cells for meniscus tissue engineering.

• #35 Meniscus Tears | Knee Specialist | Sugar Land, Pearland, Houston, TX

  https://houstonsportsortho.com/meniscus-tears-knee-specialist-sugar-land-pearland-houston-tx/

  Meniscus Tear […] What is a meniscus tear? Within the knee joint are two crescent-shaped discs of cartilage known as the meniscus. This tough and rubbery connective tissue is different from the articular cartilage that covers the ends of the femur (thigh bone) and tibia (shin bone) because it acts as a shock absorber during joint movement. The medial meniscus absorbs up to 50% of the stress load exerted on the inside compartment of the knee, and the lateral meniscus absorbs up to 80% of the stress load exerted on the outside compartment of the knee. Evenly distributing the weight between the femur and tibia provides protection for the soft-tissue structures as well as stability to the knee joint. A meniscus tear often occurs from the forceful rotation of the knee while bearing full body weight onto the knee. Athletes are commonly affected by this meniscus injury, but non-athletic individuals can also sustain a meniscus tear with activities of daily living. […] A complete medical history will be gathered by Dr. Patel and include the mechanism of injury. This is followed by a thorough physical examination evaluating knee range of motion and assessing for areas of pain, tenderness, and specialized meniscus tests (McMurray’s and Thessaly). Diagnostic imaging, such as x-rays and magnetic resonance imaging (MRI) may be warranted if a meniscus tear is suspected. These diagnostic tools can confirm a meniscus tear diagnosis, assess the extent of the injury, and identify any other damage to the soft-tissue structures surrounding the meniscus. […] The meniscus cartilage can be separated into two components. The outer third portion of the meniscus, the “red zone”, contains a healthy blood supply that allows small meniscus tears to heal without surgery. A “white zone” that lacks a blood supply comprises the inner two-thirds of the meniscus. This lack of nutrients creates an unfavorable environment for meniscus tears to spontaneously resolve. When formulating an appropriate treatment plan, Dr. Patel will consider the patient’s age, activity level, extent and location of the injury, and the desired recovery outcomes. […] In the event of failed conservative or non-surgical therapy, or a meniscus tear affecting the inner two-thirds of the meniscus, a minimally invasive surgical procedure may be necessary. This arthroscopic meniscus repair uses a small camera (arthroscope) and specialized surgical instruments to accomplish the necessary revisions. One or more of the following surgical techniques may be performed based on Dr. Patel’s intra-operative findings: Meniscectomy: This procedure removes the meniscus portions that are irreparably damaged. Patients with larger meniscus tears or who have exhausted all other treatment options are ideal candidates for this procedure. Meniscal Repair: This technique re-attaches the severed cartilage portions with special surgical anchors that are secured within the bone. This procedure is ideal for tears affecting the outer third portion of the meniscus that did not respond well to non-surgical therapies. Biologic Augmentation: The patient’s own bone marrow, known as Bone Marrow Aspirate Concentrate (BMAC), or a solution of platelet-rich plasma (PRP) can be introduced to generate new tissue at the injury site. These alternative therapies are often performed in conjunction with a meniscal repair.

• #36 Knee Cartilage Injury | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/knee-cartilage-injury

  UCSF offers the following cartilage repair and regeneration procedures: […] Microfracture: The surface layer of the bone, called the subchondral bone, is hard and has limited blood flow, so this technique creates small holes in the bone to allow for greater flow. […] Cell-based cartilage resurfacing: Matrix-induced autologous chondrocyte implantation, or MACI, is a cell-based cartilage resurfacing procedure. […] Osteochondral autograft transplantation (mosaicplasty): This technique involves transferring healthy cartilage tissue, called a graft, from one part of the knee to the damaged area. […] Osteochondral allograft: If a cartilage defect is too large to be treated by an autograft, an osteochondral allograft may be required. […] Meniscus transplant: This procedure is recommended for patients who have lost most of their meniscus or had it removed. […] After most cartilage repair surgeries, patients are on crutches for six to eight weeks. […] A full recovery takes several months.

• #37 Articular Cartilage Damage – Specialist Knee Surgeon in Manchester | Professor Sanjiv Jari

  https://www.thekneedoc.co.uk/injuries-and-conditions/articular-cartilage-damage/

  The moving surface of the knee is lined by articular cartilage. […] Traumatic damage to the lining surface of the joint is quite common. […] The more common mechanism for traumatic osteochondral defects is usually a rotational injury to the knee. The mechanism to cause an osteochondral lesion is usually a shearing force across the articular cartilage. […] Osteochondral/chondral injuries are commonly associated with major ligament injuries to the knee and also with meniscal injuries. […] The diagnostic investigation for articular cartilage injuries to the knee is MRI scanning. MRI scans will commonly reveal a loose fragment or may reveal the area of damage to the articular cartilage, with the overlying cartilage still being intact. […] It is not uncommon for articular cartilage injuries to be missed on a routine scan, to then be picked up on a high-resolution MRI scan.

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