Meniscal Injury
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.
- Meniscal tears can lead to knee pain and disability and, ultimately, are a risk factor for the development of knee osteoarthritis (OA).
Pediatric Considerations
- Meniscal injuries are rare in children <10. In this population, they are often due to a discoid meniscus and not trauma (1).
- MRI is still the study of choice but is less sensitive and specific for diagnosing meniscal tears in children <12.
- Meniscal repair is an effective treatment option with good clinical outcomes in the pediatric/adolescent population.
Epidemiology
Bimodal age distribution—young athletes (traumatic) and older patients (degenerative)
Incidence
Medial meniscus more commonly injured
Prevalence
One of the most common musculoskeletal injuries, affecting 0.6 to 8 per 1000 patients each year (2)
Etiology and Pathophysiology
- Traumatic tears are acute. They generally occur due to a twisting motion of the knee with foot planted.
- Degenerative tears are chronic. They generally occur with overuse and minimal trauma.
Genetics
No specific gene locus has been identified.
Risk Factors
- Traumatic tear:
- High degree of physical activity (especially cutting sports)
- Younger patients
- Anterior cruciate ligament (ACL) insufficiency
- Underlying meniscal degeneration—can still increase risk of meniscal tear even in traumatic event (2)
- 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
- Weight management
Commonly Associated Conditions
- Traumatic tear:
- ACL concomitantly torn in 1/3 of cases
- Degenerative tear:
- Baker cyst—greater association with medial meniscal tears
- Osteoarthritis (OA)
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Citation
Domino, Frank J., et al., editors. "Meniscal Injury." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116901/all/Meniscal_Injury.
Meniscal Injury. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116901/all/Meniscal_Injury. Accessed June 3, 2023.
Meniscal Injury. (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116901/all/Meniscal_Injury
Meniscal Injury [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 June 03]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116901/all/Meniscal_Injury.
* Article titles in AMA citation format should be in sentence-case
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