Meniscal Injury
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Basics
Description
- The menisci are fibrocartilaginous structures between the femoral condyles and tibial plateaus.
- The menisci help stabilize the knee and distribute forces across the joint.
- There are acute/traumatic and chronic/degenerative meniscal tears.
Pediatric Considerations
- Meniscal injuries are rare in children <10 years of age and are often due to a discoid meniscus.
- MRI is less sensitive and specific for diagnosing meniscal tears in children <12 years of age.
- Meniscal repair is an effective treatment option with good clinical outcomes in the pediatric/adolescent population (1,2).
Epidemiology
Bimodal age distribution—young athletes (traumatic) and older patients >40 years (degenerative)
Incidence
Medial meniscus more commonly injured
Prevalence
One of the most common musculoskeletal injuries
Etiology and Pathophysiology
- Acute/traumatic tears occur due to a twisting motion of the knee with foot planted.
- Chronic/degenerative tears occur with minimal trauma or overuse.
Genetics
Presence of a discoid meniscus increases the risk for a meniscal tear. No specific gene locus has been identified.
Risk Factors
- Acute/traumatic tear:
- High degree of physical activity (especially cutting sports)
- Younger patients
- Anterior cruciate ligament (ACL) insufficiency
- Chronic/degenerative tear:
- Increased age (>60 years)
- Obesity
- Work-related kneeling/squatting/climbing stairs
General Prevention
- Treatment and rehabilitation of previous knee injuries, particularly ACL injuries
- Strengthening and increased flexibility of quadriceps and hamstring muscles
Commonly Associated Conditions
- Acute/traumatic tear
- ACL is concomitantly torn in 1/3 of cases.
- Degenerative tear:
- Baker cyst—association with medial meniscal tears
- Osteoarthritis (OA)
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Basics
Description
- The menisci are fibrocartilaginous structures between the femoral condyles and tibial plateaus.
- The menisci help stabilize the knee and distribute forces across the joint.
- There are acute/traumatic and chronic/degenerative meniscal tears.
Pediatric Considerations
- Meniscal injuries are rare in children <10 years of age and are often due to a discoid meniscus.
- MRI is less sensitive and specific for diagnosing meniscal tears in children <12 years of age.
- Meniscal repair is an effective treatment option with good clinical outcomes in the pediatric/adolescent population (1,2).
Epidemiology
Bimodal age distribution—young athletes (traumatic) and older patients >40 years (degenerative)
Incidence
Medial meniscus more commonly injured
Prevalence
One of the most common musculoskeletal injuries
Etiology and Pathophysiology
- Acute/traumatic tears occur due to a twisting motion of the knee with foot planted.
- Chronic/degenerative tears occur with minimal trauma or overuse.
Genetics
Presence of a discoid meniscus increases the risk for a meniscal tear. No specific gene locus has been identified.
Risk Factors
- Acute/traumatic tear:
- High degree of physical activity (especially cutting sports)
- Younger patients
- Anterior cruciate ligament (ACL) insufficiency
- Chronic/degenerative tear:
- Increased age (>60 years)
- Obesity
- Work-related kneeling/squatting/climbing stairs
General Prevention
- Treatment and rehabilitation of previous knee injuries, particularly ACL injuries
- Strengthening and increased flexibility of quadriceps and hamstring muscles
Commonly Associated Conditions
- Acute/traumatic tear
- ACL is concomitantly torn in 1/3 of cases.
- Degenerative tear:
- Baker cyst—association with medial meniscal tears
- Osteoarthritis (OA)
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