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James M. Roswold is licensed in Missouri Only. Heather A. Lottmann is licensed in Kansas and Missouri. Victor B. Finkelstein is licensed in Kansas and Missouri.
Within the knee there are two wedge-shaped pieces of cartilage that act as the shock absorbers between the femur (thighbone) and the tibia (shinbone) bones. These shock absorbers are called the medial meniscus and the lateral meniscus. The medial meniscus carries up to 50% of the load applied to the inside compartment of the knee. The lateral meniscus absorbs up to 80% of the load on the outside compartment of the knee. As a person walks, the forces shift from one meniscus to the other and the forces on the knee can increase to 2-4 times the person’s body weight. As a person runs, the forces on the knee increase up to 6-8 times the body weight and these forces increase even higher when landing from a jump.
There are two types of injuries to the meniscus that can occur:
acute tears and
degenerative tears
An acute tear normally occurs when the leg is in a weight bearing position and the knee is bent and severely twisted. A degenerative tear, which is more common in older people, occurs due to age as the meniscus weakens and becomes less elastic. An asymptomatic degenerative tear can become symptomatic due to an injury, thereupon requiring treatment.
Risk Factors Acute meniscus tears are frequently associated with sports injuries, but can also occur because of direct contact such as that which can occur during a motor vehicle accident. Degenerative tears are typically a factor of aging. It is estimated that 60% of the population over the age of 65 has some type of degenerative tear. Again, such tearing is often asymptomatic but can be become painful and otherwise symptomatic and require medical treatment as a result of a traumatic injury.
Symptoms When the meniscus is injured, the person may hear a sudden “pop”. Occasionally, the injured person may continue with activity and be unaware of the injury. Over the following 2-3 days, however, the knee may become progressively stiff and swollen. Other symptoms include:
Pain
Stiffness and swelling
Catching or locking of the knee
The knee feeling like it is going to buckle
Loss of range of motion of the knee
Diagnosis & Treatment In checking for a meniscus injury a physician will conduct a physical medical examination of the injured knee. Tenderness along the joint line where the meniscus sits may indicate a tear. One of the main tests for meniscal tears is the McMurray test. The doctor will put tension on the meniscus by bending the patient’s knee, then straightening and rotating it. If there is an injury to the meniscus there will be a clicking sound that happens whenever the knee is put through this range of motion. Other tests may also be required, such as an x-ray to rule out osteoarthritis or an MRI scan to study better images of the soft tissues within the knee joint.
Treatment depends on four factors associated with a meniscus injury:
Location – tears may be located in the anterior horn, body or posterior horn, with posterior horn tears being the most common. The meniscus is broken down by outer, middle and inner thirds. The third in which the tear occurs is important because of the tear’s ability to heal due to blood supply in that area. Tears in the outer third have the best chance of healing.
Pattern – meniscal tears come in many shapes and are categorized into patterns. The patterns determine the course of treatment prescribed by a doctor. A complex tear includes meniscus injuries that have more than one tear pattern. Common tear patterns are as follows:
Longitudinal
Bucket-handle
Displaced bucket handle
Parrot beak
Radial
Displaced flap
Horizontal
Degenerative
Completeness – tears are classified as either being complete or incomplete. Complete tears go all the way through the meniscus and a piece of tissue is separated from the rest of the meniscus. Incomplete tears are those where a portion of the meniscus is still partially attached to the other part of the meniscus.
Stability – te
ars are classified as stable or unstable, depending on whether the meniscus is able to move abnormally. An unstable tear will likely require surgery.
Non-surgical treatments of meniscus tears normally follow the RICE protocol. RICE stands for rest, ice, compression and elevation. In addition, a physician may prescribe aspirin or ibuprofen in an effort to reduce pain and swelling.
Surgical treatments involve a procedure called knee arthroscopy. Knee arthroscopy is one of the most commonly performed surgical procedures and involves inserting a miniature camera through a small incision. The camera provides the surgeon with a view of the inside of the knee allowing surgical instruments to be inserted through another small incision for repairing the tear.
Following surgery, the patient may be required to wear a temporary knee brace to limit movement and the patient will also likely need to do physical therapy exercises in an effort to improve the range of motion.
If you or a loved one is suffering from a knee injury due to the negligence of another, you can find answers to many of your questions on this website. You can also use our “just ask” section to send us your question or our live chat for immediate response. For more information, download our FREE book, 10 Essential Steps You Must Take to Protect Your Personal Injury Claim.
For more information on these topics please contact Kansas City Accident Injury Attorneys by calling (816) 471-5111. Kansas City Accident Injury Attorneys has over 15 years of experience handling serious injury claims, including many knee injury cases, and any questions will gladly be answered.
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Kansas City Accident Injury Attorneys
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Kansas City Accident Injury Attorneys*
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Overland Park, KS 66210 *By Appointment Only: Heather A. Lottmann & Victor B. Finkelstein