The knee is made up of three main components: the femur, tibia, and patella, which meet at the joint and are connected by a system of tendons, ligaments, and muscles. Located at the center of the joint are the menisci, two crescent-shaped cartilage components that act as shock abosorbers throughout the range of knee movements. Dispersing body weight and reducing friction, damage to either or both of the structures can cause pain, discomfort, and in some cases, disability.
A damaged meniscus may stem from a single traumatic injury; however, ongoing wear-and-tear may also be to blame. In addition, tears are categorized by both appearance and specific location. Common forms include: bucket, flap, handle, longitudinal, parrot-beak, and mixed/complex.
Through an in-depth examination process, Dr. Haar will assess the form and severity of each unique case, and recommend the best approach for corrective treatment.
Immediately following a meniscal tear, many individuals will continue to walk and participate in their usual activities with only slight discomfort. However, often within 2-3 days, the knee will become inflamed, and be accompanied by any or all of the following symptoms:
In the cases of some tears, a small piece of the meniscus will enter the joint construct and impede successful knee movement.
After taking note of medical and symptom histories, Dr. Haar will examine the knee for tenderness and visible inflammation. In addition, the McMurray test will likely be administered, during which the knee will be moved through a range of motions for observation of ‘clicking’ or other unusual behaviors. Imaging tests, such as an x-ray or MRI (magnetic resonance imaging), may also be employed.
As the outside of the meniscus possesses a rich blood supply, tears to that zone may be able to heal without surgical intervention. In such a case, Dr. Haar may prescribe the use of pain killers and anti-inflammatory medication for immediate relief. The use of the RICE approach (rest, ice, compression, and elevation) may also provide the conditions necessary for successful meniscal recovery.
If these approaches prove ineffective, or the injury is to the interior of the meniscus, surgical intervention may be recommended.
During an arthroscopic operation, Dr. Haar will examine the knee interior and menisci through use of a fiber-optic camera inserted by way of one or two small incisions. The camera will broadcast a live feed of the joint structure and injury to a monitor in the operating room.
While under an anesthetic (likely local or regional), Dr. Haar will apply the necessary incisions and insert the camera for examination. Small tools, such as razors or scissors, will also be inserted in order to correct any meniscal damage. In most cases, the arthroscopic procedure will last no longer than an hour, followed by an in-hospital recovery period of 1-2 hours.
After correcting the meniscal tear, Dr. Haar will likely recommend a combination of pain medication, at-home exercises, and physical therapy. To guarantee ongoing recovery success, it will be important to adhere to the suggested regimen, reporting any unusual post-op symptoms or pain to the orthopaedic team.
Dr. Haar is nationally recognized for his expertise in the treatment of knee injuries and use of minimally invasive techniques. To schedule an appointment, contact his New York City office at (212) 876-7000.