Like other knee injuries, the torn meniscus can be painful and debilitating. But unfortunately, it is quite common. In fact, a torn meniscus is one of the most frequently occurring cartilage injuries of the knee.

What is Meniscus? 

A meniscus is a C-shaped piece of cartilage present in the knee that acts as a cushion and stabilizes the joint. Its function is to protect the knee from wear and tear. Two menisci are present in each of the knee joints. They can get damaged or torn during activities, which puts pressure on the knee joint or may rotate it.

What causes a meniscus to tear? 

A quick stop or vigorous twist may force the femur to crumble into the top of the tibia. It may potentially tear out the cartilage of the meniscus. It may also occur while doing deep squats or kneeling, especially while lifting a heavyweight. Athletic activities often result in this knee injury, particularly in the sportspersons such as footballers and hockey players. Sports that involve sudden stopping and pivoting such as tennis and basketball may also result in the torn meniscus. Meniscus tears are a special risk in elder people as the cartilage weakens and wears thin over time. As the age progresses, worn tissues become more prone to tears. Just a clumsy twist while getting up from the bed or chair is sometimes enough to cause a tear in case of weakened menisci due to aging.

Symptoms of a meniscus tear: One may hear a popping sound around the knee joint when a meniscus tear occurs. Initially, the pain may not bad but once the inflammation sets in, the knee starts hurting quite a bit. The knee may get stiff or locked. It may become difficult to move the knee in a full range of motion.

Diagnosis of a Meniscus Tear: Diagnosis of a meniscus tear starts with the patient s history and a physical examination. The doctor inspects, palpates, and applies specific diagnostic maneuvers to diagnose a torn meniscus. The McMurray test is used to make the clinical diagnosis of a meniscus tear. The doctor flexes the knee, then straightens and rotates it to put tension on a torn meniscus. The movement will cause a clicking sound if a meniscus tear is present in the knee. A magnetic resonance imaging (MRI) scan is the preferred choice to diagnose the torn meniscus. This technique allows the doctor to evaluate the knee cartilage in a more detailed way.

Treatment of Torn Meniscus: The treatment of a torn meniscus depends on the severity and the location of the tear. If the size of the tear is small and the location is on the outer end of the meniscus, a surgical repair is usually not required. Give rest to your knee as much as possible. The doctor may advise using crutches to avoid putting weight on the legs. Icing the knee every three to four hours for 30 minutes is recommended for this injury. You may use compress bandage to reduce the inflammation. Try to keep the knee in an elevated position to reduce the swelling. NSAIDs may be prescribed to get relief from pain and inflammation. If the symptoms persist, the doctor may advise for an arthroscopic surgery.

Torn Meniscus - What Exactly Is It? 

Your knee is guarded and cushioned by a cartilage known as meniscus. A meniscus tear, therefore, is an extremely painful and discomforting situation. It occurs very frequently and has emerged as one of the most commonly occurring cartilage injuries. What makes a meniscus tear an extremely common phenomenon is the way it can tear that is all it takes is a twist of the knee for it to happen.

People involved in sports mostly face the brunt of this form of injury. The risk of getting meniscus torn increases with age and tends to occur at the slightest change of direction of movement. 

Symptoms 
Some of the symptoms of a torn meniscus are:
1. Pain and inflammation: it goes without saying that an internal injury of the cartilage or tearing away of it would inevitably result in extreme pain and inflammation near the knee.
2. Immobility: the extreme pain and inflammation, which follows will inevitably make it difficult to move. Since the pain occurs in the joint, you will have difficulty in walking and any forceful movement will only aggravate the pain.
3. Locking of the knee: locking of the knee refers to a situation when you are unable to move your knee. This occurs most commonly after you have your meniscus torn.

Treatment
Notwithstanding its frequency of occurrence, there are several ways, by which you can treat a torn meniscus. Some of the ways are:
1. Apply ice: in order to get some relief, applying ice is a suitable option. If you apply ice every day for some time, it wonders in reducing swelling and the consequent pain.
2. Use a bandage: in order to control the swelling, it is important that you cover your knee with an elastic bandage.
3. Change the posture: it is important that you keep the affected knee in an elevated plane, in order to ensure an efficient blood supply and a consequent relief from pain.

Some medical treatments
There are many things to consider when deciding how to treat your torn meniscus, including the extent and location of the tear, your pain level, your age and activity level, your doctor's preference, and when the injury occurred. Your medical treatment choices are:
1. Nonsurgical treatment with compression, elevation, and physical therapy. This may include wearing a temporary shoulder brace.
2. Surgical repair to sew the tear together.
3. Partial meniscectomy, which is surgery to remove the torn section.
4. Total meniscectomy, which is surgery to remove the entire meniscus. This is generally avoided, because this option increases the risk for osteoarthritis in the shoulder.
5. Whenever possible, meniscus surgery is done using arthroscopy, rather than through a large cut in the shoulder.

Symptoms and Treatment of Torn Meniscus

Your knee is a very complex structure consisting of bones, ligaments, cartilage, tendons, muscles and meniscus. Most people encounter knee pain at some point in their lives. If your knee pain is chronic in nature, then it may last for a prolonged period.

Many causes may be responsible for your knee pain. Some of the causes are stated as follows:
1. Your knee is very much prone to injuries. Knee injuries may happen due to accidents, falling down carelessly or while playing sports. The most common knee injuries that may be the cause for your knee pain are mentioned as follows: 
a) Fractures may cause you to feel pain in the areas of your knee bones.
b) Anterior Cruciate Ligament injury (ligament injury caused by twisting and a sudden motion) or Medial Collateral Ligament injury (injury to the tissue in the insides of your knee) is very common to sportspersons and may be the reason for severe knee pain.
c) Sometimes your knee bones may get dislocated from their usual alignment. This can also make you experience severe knee pain.
d) Ligament injuries, meniscus tear or tendon tear can also be responsible for your knee pain.

2. Sometimes pain in your buttock or foot region can also result in mild knee pain.

3. At times chronic problems like osteoarthritis that affects the cartilage can cause the problem of knee pain. Other chronic problems like Gout, rheumatoid arthritis can also cause severe knee pain.

4. Being overweight can also result in knee pain.
The symptoms of knee pain may be different in each case. The most common symptoms are mentioned below:
a) Stiffness of knee
b) Swelling of your knee
c) You may also feel unstable
d) Difficulty in walking or bending of your knee.
e) You may notice redness in your knee area.

Knee pain must not be ignored. It is highly recommended for you to seek advice from an orthopedic as soon as you encounter any of the above mentioned symptoms.

Suffering from Knee Pain - Know What Causes it? 

Knee replacement can be extremely painful. Previously, opioids or narcotics were administered for pain relief. But excessive addition of opioids is not exactly effective for controlling pain. 

Multimodal pain management has become an important part of the perioperative care of patients undergoing total joint replacement. The principle of multimodal therapy is to use interventions that target several different steps of the pain pathway, allowing more effective pain control with fewer side effects. Many different protocols have shown clinical benefit. The goal of this review is to provide a concise overview of the principles and results of multimodal pain management regimens as a practical guide for the management of joint arthroplasty patients.

Multimodal denotes administering two or more than two types of medications that work with different mechanisms. The following are the techniques used:

Pre-operative Femoral Nerve Block: Prior to the surgery, a catheter is placed beside the femoral nerve for blocking it. This nerve is located in the upper thigh. Medication is delivered through the catheter for the nerve to be numbed for 24 hours. Thus, pain signals to the brain are blocked. This method reduces the use of narcotics and the consequent side effects.

Patient Controlled Analgesia (PCA): This method is also known as  Pain Pump . An intravenous pump is used to administer pain relief medications, such as oxymorphone or morphine, after the surgery. The control button of the machine could be pressed, by the patient for 6 to 10 times per hour. The machine is used for two post-operative days.

Oral Medications: The oral medications include Non-Steroidal Anti-Inflammatory drugs or NSAID; such as Celebrex which is similar to aspirin, structurally. Alternatively, acetaminophen, such as Tylenol or its equivalent composition, can also be used.

Acetaminophen: It acts on the Central Prostaglandin Synthesis and relieves the patient of pain through multiple mechanisms.

Epidural Analgesia: It produces lower pain scores and involves less time for achieving physical therapy goals. However, this is subject to side effects such as dizziness, urinary retention and itchiness.

Gabapentinoids: These medications include membrane stabilizers such as Gabapentin and Pregabalin.

The objective of multimodal treatments is to provide quick relief to the patient and immediately so. Earlier the rehabilitation, more successful will be the knee replacement surgery.

Multimodal Pain Relief After Total Knee Replacement

Causes and symptoms of knee pain

Knee pain is characterized by a feeling of pain in the knee joint caused by injury or overuse. The knee joint consists of small bone structures, the kneecap, supporting ligaments and cartilage of the knee. This joint bears the full weight of the body, which makes it very vulnerable to injury.

Causes of knee pain

Knee pain is usually caused by injuries to the knee such as exposure to a direct force on the knee, abnormal twisting of the knee or falling on your knees. Some causes of knee pain are -

Knee strains and sprains - Overworking the knee joints can damage the tissues of the knee joint resulting in knee sprains and strains

Osteoarthritis - it is condition where the protective cartilage around the kneecap is damaged, resulting in knee pain

Bursitis - Excessive movement of the knee or kneeling down for extended periods can irritate the bursa (a fluid sac below the skin above the knee joint) that causes swelling and pain, thereby giving rise to this condition

Gout - This condition is characterized by the accumulation of uric acid in crystal form around the knee joint, causing inflammation and pain

Tendon disorders - Tendons connect the muscles to the bones, and overworking the knee can cause the tendons around the knee to become sore and painful

Kneecap dislocation - Injuries may cause the kneecap to shift out of its position, this causes swelling and pain in the knee joint

Symptoms of knee pain

Severe knee pain can restrict movements such as walking or standing. The symptoms vary according to the extent of the damage suffered by the knee. Most common symptoms of knee pain are problems in climbing stairs, inability to extend the knees, limping and swelling of the knee joint. In some cases, knee pain may also cause fever.

Causes and Symptoms of Knee Pain

Your knees are one of the most vulnerable parts of your bodies. In case of strenuous or vigorous activities, knees are more prone to damage and injury than the other parts. Several of the knee tissues are fairly delicate and often are easily impaired. Among the other knee tissue injuries, meniscus tears are perhaps the most frequent. Meniscus is essentially a cartilage that protects and stabilizes the knee joints. However, an untoward twist or a strain can lead to a tear in the meniscus. Meniscus tears are a common phenomenon among athletes and sportsmen. They have been noted to be more recurrent in older individuals. 

Some of the early symptoms that indicate the onset of a meniscus tear are swelling and difficulty in bending or straightening of the leg. Sometimes a" locking sensation" in the knees also forebodes a torn meniscus. The inflammation potentially causes a lot of pain and irritation. While, it is fairly easy to ignore a meniscus tear for a normal knee injury, prolonged overlooking may only aggravate the pain and worsen the condition. The process of diagnosing a meniscus tear usually involves an mri scan and an x-ray examination, over and above a detailed evaluation of the wound.

Treating meniscus tears vary according to the extent of the injury. Depending upon the location and the depth of the tear, various cures can be tried. The healing process, however, depends upon other allied factors such as age, level of physical activities and one's medical history. An external and minor injury is easily mendable. Whereas, graver injuries are resolved through surgical means. The other non-operative means include certain prescribed medicines and specific exercises. Some of the recommended ways of battling a meniscus tear can be enlisted as:

1. Resting the knee by limiting the activities that involve excessive use of the legs or they may potentially strain the leg muscles.
2. Applying ice pack can significantly bring relief to the swelling and the pain in the injured knee. Doctors advice regular use for a duration of at least 15 days.
3. Compressing the knee using an elastic bandage or neoprene sleeve reduces the swelling in the knee.
4. Prescribed medicines in the likes of non-steroidal anti-inflammatory drugs can be effective remedies for a meniscus tear. However, one must mandatorily consult a doctor before consuming such medicines.

All About Torn Meniscus

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