About Meniscus Tears
The meniscus is the soft, fibrous shock absorber that rests in the knee between the femur and the tibia. When it is removed, pain and arthritis can develop. The tearing of the strong, fibrous tissue (meniscus cartilage) that forms the pads between the thigh bone (the femur) and the shin bone (the tibia), destroys the perfect fit that the knee joint requires to be both stable and smooth. Since the end of the femur is curved and the top of the tibia is somewhat flat, the empty space must be filled by a tissue that can absorb the tremendous forces seen by the joint surface and yet be durable enough to tolerate over two million steps in a year. When the tissue is torn, some bleeding occurs into the joint, and usually, but not always, causes swelling and pain. If the injury is ignored, the blood is slowly absorbed.
Meniscus Tear and Repair Slideshow Presentation
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Meniscus Tear and Repair Slideshow Presentation
(Swipe to view if using a mobile device.)
Once thought of as a needless remnant of tissue in the knee joint, the torn meniscus was frequently removed by surgery. Over the past several years, it has become clear that the meniscus plays a crucial role in joint stability, lubrication, and force transmission. Under a weightbearing load, the meniscus maintains the balanced position of the femur on the tibia and distributes the compressive forces by increasing the surface contact area thereby decreasing the average stress two to three times. The surface stress becomes smaller, the load bearing area wider, the compliance higher, and the stiffness of the joint lower with the menisci in place. Additionally, the menisci interact with the joint fluid to produce a coefficient of friction that is five times as slick as ice-on-ice.
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Loss of the protective, stabilizing meniscus leads to increased joint laxity or abnormal motions that lead to joint instability. The excessive motion and narrowed contact area promotes early arthritic changes. The changes noted by x-ray include ridge formation, narrowing of the joint space, and flattening of the curved femoral condyle. At the cellular level, there is initially a loss of cells from the superficial layer of the articular cartilage followed by cartilage splitting, subsequent thinning, erosion occuring, and finally protrusion of the underlying raw bone. The earliest arthritic changes have been noted three weeks after loss of the entire meniscus.
Since loss of the meniscus leads to early arthritic changes, great efforts are now undertaken to save as much of a torn meniscus as possible, and when possible, repair of the torn menisci with sutures.
Loss of the protective, stabilizing meniscus leads to increased joint laxity or abnormal motions that lead to joint instability. The excessive motion and narrowed contact area promotes early arthritic changes. The changes noted by x-ray include ridge formation, narrowing of the joint space, and flattening of the curved femoral condyle. At the cellular level, there is initially a loss of cells from the superficial layer of the articular cartilage followed by cartilage splitting, subsequent thinning, erosion occuring, and finally protrusion of the underlying raw bone. The earliest arthritic changes have been noted three weeks after loss of the entire meniscus.
Since loss of the meniscus leads to early arthritic changes, great efforts are now undertaken to save as much of a torn meniscus as possible, and when possible, repair of the torn menisci with sutures.
Meniscus Repair
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Meniscus Transplant or Replacement
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