What is it ?
Menisci are knee shock-absorbers, they get damaged with ageing and time, and sometimes get torn even without an accident. This kind of degenerative tears often happen in patients after 50 years-old.
Meniscus Pathology
Degenerative meniscal tear
Clinical presentation
Knee soreness and inflammatory pain (night pain) are usual, and sometimes associated to knee sweeling.
When to consult a specialist?
In case of persisting pain and functional limitation (limping, reduced walking distance).
Non surgical treatment
Conservative treatment is always appropriate initially. The goal is to lower the pain and inflammation by per-os pain killers, cold-packs, gentle physiotherapy, and eventually intra-articular injections (anti-inflamamtory drug as cortisone and/or joint lubricant as hyaluronic acid).
Surgical treatment
The surgical treatment (arthroscopy) is indicated if pain and symptoms persist after 3 months of appropriate conservative treatment. An arthroscopy to clean the torn meniscus (a minima meniscectomy) and the joint; meniscal repair is rarely possible because of the poor quality of the degenerative meniscus. The only emergency to proceed to a surgery is the meniscal root avulsion or the complete radial tear because these kinds of tear will lead to a rapid joint wear/arthritis if not repaired.
Postoperative follow-up
In case of a minima meniscectomy, walking is allowed the same day after surgery, with cruches to help for the first week. Usual daily activities will be resumed after 10 days.
Risks and complications
Cartilage wear (arthritis) is the main risk after meniscectomy and is proportional to the quantity of meniscal removed. That’s why the surgical treatment of degenerative meniscal tear should be the last option.