Case Manager's Corner

Mechanism of Injury:

Most commonly results from a twisting type injury with the foot planted. May also occur with sudden knee hyperflexion. Rarely results from a direct blow to the knee.

Subjective Symptoms:

Acutely, patients complain of joint line pain and delayed knee swelling. Symptoms may diminish over 1-2 weeks, but may recur with squatting, pivoting or cutting activities. Patient may also experience locking, catching or giving-away.

Objective Signs:

Effusion, palpable joint line tenderness, pain with squatting, positive McMurray's test. MRI may be helpful for confirmation.

Natural History:

Not all meniscal tears will require surgical intervention. Natural history depends on patient activity level, tear location, size and type. Large unstable tears tend to become symptomatic while small degenerative tears may be associated with minimal symptoms. Small degenerative tears are often found as incidental findings on MRI and must be correlated to clinical findings.

Nonsurgical:

Physical therapy may be appropriate for small tears that become asymptomatic through relative rest and protection.

Surgical:

Arthroscopic meniscectomy or meniscal repair.

Nonsurgical:

6-8 weeks

Avoid squatting, climbing

Surgical:

6-8 weeks (meniscectomy)
12-16 weeks (meniscal repair)

Avoid squatting, climbing