Meniscus Injury/Knee Pain

Knee Pain
Many conditions cause knee pain Non Mechanical Causes
Anterior Knee pain Patellofemoral pain

Mechanical Causes
Meniscus Tear ACL tear Loose bodies
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Disclaimer
Patients should discuss specific injuries with their primary care doctor or surgeon. This site is meant to give general information to patients about specific patient problems. It is impossible to individualize this discussion to specific patient issues.

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Non Mechanical
Anterior Knee pain
Most common cause of knee pain in my practice Often both knees involved Pain with stairs and extended knee flexion movie sign Affects both the young and old as well as athletes and non atheletes

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Treatment
Physical Therapy mainstay of treament
Strengthen quadriceps muscle Strengthen hip abductors Robust stretching program Avoid knee extension machine at Gym!

Neoprene sleeves Injections (steroid)

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Anterior Knee Pain Treatment

Surgery
Arthroscopy Lateral Release Realignment Osteotomies Articular transplants for defects on patella

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Results of Treatment
Most patients get better with physical therapy and modifications to activity in 6 months Surgery has variable results with success ranging from 40% to 90%

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Mechanical Causes
ACL (please see the other talk) Loose Bodies
Fragments of bone in the knee These cause giving way Usually seen on Xrays of knee Treatment is arthroscopy and removal

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Mechanical Causes
Meniscus Symptoms
Cause giving way Locking and catching symptoms Can be stable and unstable
Arthroscopic View of Normal Meniscus

Stable injuries can be treated electively

Primarily pain on one side of knee No locking and catching Usually seen on MRI

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Mechanical Causes
Meniscus Unstable Injuries
Locking and catching symptoms
Must be differentiated from popping and clicking

Sometimes cannot extend knee Surgery is indicated sooner because possible damage to knee from unstable meniscus

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Mechanical Causes Treatment

Physical therapy for stable mensicus tears Surgery for loose bodies, unstable meniscus tears Meniscus Repair
Works better in younger patients Must be right kind of tear (peripheral tears better) Slower rehabilitation to protect repair May need a second surgery if repair fails
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Expectations
Best expectations are with true mechanical symptoms Unstable mensical tears and loose bodies immediate improvement Stable meniscal tears less predictable. Hard to know whether mensical tear is the actual cause of pain

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Rehabilitation
Meniscal Repair: crutches for 4-6 weeks
No running until 3 months after surgery

Loose Bodies and Meniscal Resections

Start range of motion early Strengthening after 2 weeks Return to sports 6-8 weeks as tolerated
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