Michael S. Cicchillo, MD
- vascular surgery
Location and Office HoursNorthside Medical Center
Youngstown, OH 44504
- Anthem BlueCross BlueShield
- BlueCross BlueShield
- BlueCross BlueShield of Illinois
- Coventry Health Care
- First Health
- Great-West Healthcare Cigna
- Medical Mutual of Ohio
- United Healthcare
- Forum Health Northside Hospital
- Forum Health Trumbull Memorial Hospital
What are the most serious injuries to the foot and ankle?
Fractures of the very small bones in the foot and ankle create very complex management problems, says Christopher Hodgkins, MD, an orthopedic surgeon at Baptist Health South Florida. Learn more in this video.
What is meniscal injury?
William N Levine, MD, Orthopedic Surgery, answered
The meniscus cartilage is like a shock absorber pad between the femur (thigh bone) and tibia (shin bone) in the knee. There are 2 menisci - 1 on the inside of the knee ("medial meniscus") and 1 on the outside of the knee ("lateral meniscus"). Actually many meniscal tears can and are successfully treated without surgery. Typically physical therapy (to strengthen the surrounding muscles) and anti-inflammatory medicines (i.e. Ibuprofen, to decrease inflammation and swelling) will be recommended initially for symptomatic meniscal tears.
One type of meniscal tear that will require surgery is a "bucket-handle" tear. This is a tear that usually occurs acutely and causes a "locked knee" where the knee gets stuck due to a large segment of the meniscus cartilage becoming lodged between the femur and the tibia. The 2nd type of meniscal tear that may require surgery is one in which the symptoms persist (pain and swelling and often prevention of performing activities and/or sports) despite appropriate non-operative treatment.
For those patients who require surgery, make sure you ask your doctor what the status of the surface cartilage is before the operation. The surface cartilage is also called articular cartilage and is like the white, glistening tissue on the end of a chicken bone. The loss of articular cartilage is what happens in arthritis and sometimes is damaged as well in patients with meniscal tears and can alter the treatment, rehabilitation, and ultimate outcome in patients having meniscal surgery.
Ultimately, arthroscopic treatment for isolated meniscal tears is highly successful in most patients.
What is a meniscus tear?
Symptoms of a meniscus tear depend on the size and location of the tear and whether other knee injuries occurred along with it. Pain can also be due to swelling and injury to surrounding tissues.
With small tears, you may have minimal pain at the time of the injury. Slight swelling often develops gradually over several days. Many times you can walk with only minimal pain, although pain increases with squatting, lifting or rising from a seated position. These symptoms usually go away in 2 to 3 weeks although pain may recur with bending or twisting.
In a typical moderate tear, you feel pain at the side or in the center of the knee, depending on where the tear is. Often, you are still able to walk. Swelling usually increases gradually over 2 to 3 days and may make the knee feel stiff and limit bending. There is often sharp pain when twisting or squatting. Symptoms may diminish in 1 to 2 weeks but recur with activities that involve twisting or from overuse. The pain may come and go over a period of years if left untreated.
Larger tears usually cause more pain and immediate swelling and stiffness. Swelling can develop over 2 to 3 days. Pieces of the torn meniscus can float into the joint space. This can make the knee catch, pop or lock. You may not be able to straighten your knee. The knee can also feel "wobbly" or unstable, or give way without warning. If other injuries occurred with the meniscus tear, especially torn ligaments, you may have increased pain, swelling, a feeling that the knee is unstable and difficulty walking.
Older people whose menisci are worn may not be able to identify a specific event that caused a tear, or they may recall symptoms developing after a minor incident such as rising from a squatting position. Pain and minimal swelling are often the only symptoms.
Pain at the inside of the knee can mean there is a tear to the medial meniscus. Pain at the outer side of the affected knee can mean there is a tear to the lateral meniscus.
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