The meniscus has a very difficult time healing its own injuries because of a lack of vascularization to the entire meniscus. Once its damaged, it doesnt always heal, which can cause a person to experience chronic knee pain. Follow my progress during weeks 3336 post op after acl and medial and lateral meniscus surgery. In the image here, the medial meniscus is highlighted red and the lateral meniscus is highlighted yellow. It is nearly circular and covers a larger portion of the articular surface than the medial. Feb 15, 2016 the menisci play a key role in the knee. Our meniscus transplant center is dedicated to replacing the meniscus and has been successful at getting athletes back to high levels of activity, even if they had developed arthritis meniscus anatomy the meniscus is a soft and fibrous cartilage resting between the femur and the tibia in the knee. Note the bleeding from the peripheral part of the lateral meniscus after partial meniscectomy. At knee joint the menisci plays a major role in congurency of the joint. The medial meniscus is c shaped whereas the lateral is a shorter incomplete circle with closer spaced horns. Consider the following icd10 codes with a higher level of specificity. When a discoid meniscus causes symptoms, arthroscopic surgery is often necessary. This technique achieves lateral meniscus root fixation, reducing the risk of. A complete discoid meniscus almost completely covers the lateral half of the articulating surface of the tibia, while an incomplete type covers a smaller surface.
It is one of two menisci of the knee, the other being the medial meniscus. Here are two of the most common causes of knee pain from golfing, how theyre caused and what to do about them. The er informed me i had sprained my mcl and lcl ligaments and at that time had no idea that i tore my lateral meniscus and my acl as well. As far as im aware, the meniscus repair and the misalignment of the patella are not connected as far as this particular pain is concerned.
The meniscus is cartilage between the shin and thigh bones. Acute acl injuries are more common in lateral meniscus, and chronic acl injuries are more common in medial. A meniscus can be split in half, ripped around its circumference in the shape of a c or left hanging by a thread to the knee joint. In addition, if a person with these symptoms attempts to move the knee or walk around, they will feel a locking or catching sensation towards the side or back of the knee, said shybut. There are two cshaped cartilage semilunar moonshaped discs within the knee that act as shock absorbers between the end of the thigh bone femur and the upper part of the shin bone tibia. Lateral meniscus tear meniscal tears physioadvisor. Discoid lateral menisci were first described in the late 1800s. Posterior lateral meniscal root tears and meniscal repair. This can lead to osteoarthritis, where the joint cartilage and the bone underneath wear down, which means your knee can feel painful, warm and swollen. These two structures are known as the medial and lateral meniscus. A good musculoskeletal examination and proper imaging will help determine if surgical intervention is necessary for you. Lateral meniscal cyst presenting as medial compartment knee. The mri of his knee confirmed the presence of a tear in the lateral meniscus associated with a meniscal cyst. During arthroscopy, the surgeon inserts a small camera in the knee and uses these images to guide miniature surgical instruments.
The role of the meniscus in the knee joint knee specialist approach to arthroscopic menisc repair viewmedica. For most tears, some simple exercises can help maintain muscle strength in the front of the thigh quadriceps, back of the thigh hamstr. Apr 06, 2015 the lateral meniscus is attached to the shin and is located on the outer side of the knee. Menisci are fibrocartilaginous, rubberlike structures situated between the femur thigh bone and the tibia shin bone. The lateral meniscus is situated at the outer aspect of the knee joint and when damaged typically causes pain or discomfort in this area. This procedure involves removing the torn part of the meniscus and leaving the remaining parts of the meniscus alone. Menisci forms the concavity in which the femoral condyles sits. Lateral meniscus synonyms, lateral meniscus pronunciation, lateral meniscus translation, english dictionary definition of lateral meniscus. Lateral meniscus tear injuries and rehab forums t nation. The word menisci are derived from the greek work meniskos, which means crescent. The lateral meniscus is toward the outer side of the knee joint. If a discoid meniscus is not causing pain, popping, or other symptoms, then treatment may not be necessary. The lateral meniscus is on the outside of the knee.
The meniscus transplant center meniscus replacement for. The meniscus is a critical component of a healthy, functional knee and plays a role in load bearing, load distribution, shock absorption, and joint stabilization. The increase in difficulty lies not in the diagnosis, but the care of these tears. Left knee posterior lateral meniscus root tear involving more than 50% of the root. I have clips of some of the exercises i did throughout the month, as well as a description of my.
This allows the knee to be moved freely through its full range of motion fig 1. Hi, ive commented before on the acl forum but briefly, i injured both my meniscus and my acl back on 729 while playing volleyball. A lateral meniscus tear is a relatively common injury involving tearing of shock absorbing tissue, known as cartilage, within the knee joint. Meniscus tears can vary widely in size and severity. The inner meniscus can be easier to repair because tendons and other soft tissues make the outer meniscus more difficult for a surgeon to access. I went to rehab very good, hardworking rehab for about 3 months total after surgery. Also, menisci come in pairs, and each knee has a lateral outer and medial inner meniscus. If the knee twists and there is a popping sound followed by swelling overnight, the meniscus may be torn. Aug 22, 2019 discoid lateral menisci were first described in the late 1800s. Arthroscopic view illustrating meniscal vascularity. The meniscus transplant center is one of the few places in the world dedicated to this procedure.
Menisci rests between the thigh bone femur and the tibia and there are two knee joint ligaments. Mar 09, 2015 the meniscus is cartilage between the shin and thigh bones. Jun, 2017 michael stuart, md, and aaron krych, md, rochester, mn demonstrate the arthrex tibial guide with marking hook for use in lateral meniscus root repair. The meniscus cartilage in the knee includes a medial inside meniscus and a lateral outside meniscus. When i had my meniscus repaired, i was on crutches about 68 weeks and could bear weight after about 2. Pdf arthroscopic direct repair for a complete radial tear.
The shape of the tear can play a role in surgical considerations. When doctors and patients refer to torn cartilage in the knee, they actually may be referring to an injury to a meniscus at the top of one of the tibiae. Incomplete lateral discoid meniscus middle, in right side diagram b. How to avoid the painful knee pain from golfing rolflex. A thickened crescentshaped cartilage pad in the outer portion of the joint formed by the femur thigh bone and the tibia shin bone. Meniscal transplantation surgery knee surgeons in st. This cshaped, rubbery, cartilage plays a key role in maintaining stability of the knee. Sep 29, 2009 as far as im aware, the meniscus repair and the misalignment of the patella are not connected as far as this particular pain is concerned. They contribute to load transmission and distribution, joint lubrication, proprioception, and cartilage nutrition and act as secondary stabilizing structures. If the meniscus is torn in the middle 23, where there is no blood supply to the meniscus and therefore little capacity for the meniscus to heal again, a partial meniscectomy is performed instead. A tear of a meniscus is a rupturing of one or more of the fibrocartilage strips in the knee called menisci. In the past, if a meniscus was damaged beyond repair, it was simply removed. I have a tear of the lateral meniscus in my right knee, today i saw an ortho surgeon to discuss the treatment. The normal configuration of a meniscus is that of a matured crescent moon, whereas that of a discoid meniscus generally is a thickened, very early crescent moon.
Furthermore, it also showed an illdefined medially located multilocular lesion which was associated with tortuous vessels fig. The meniscus is a disc of cartilage situated in the knee, between the tibia aka the shin bone and the thigh bone. A torn meniscus can be repaired, regenerated or replaced at the stone clinic. Discoid meniscus johns hopkins all childrens hospital.
The lateral meniscus acts as a smooth surface for the joint to move on. So now my surgeon is advising me to try to repair it again as i am 25 years old and my meniscus is already quite tiny, he would like to avoid to cut it by adding more stitches this time 3 instead of 1, and extending the rehab from 3 weeks last time to 6 weeks without any weight pressure first time i was encouraged to put some weigh after. Sep 19, 2012 if the knee twists and there is a popping sound followed by swelling overnight, the meniscus may be torn. Left untreated, a meniscus tear can limit regular movement and your ability to exercise or play sports. Discoid lateral menisci frequently asked questions. The difference between medial and lateral meniscus tears simply comes down to location. The code is not valid for the year 2020 for the submission of hipaacovered transactions. Based on our data, stable left in situ lateral meniscus tears appear to show a better prognosis than medial tears. Located in the space between the distal femur and the tibial plateau, the elastic crescentshaped menisci the medial meniscus and the lateral meniscus play a number of important roles in the proper functioning of the knee. Schematic of the knee joint depicting the medial and lateral. The lateral meniscus external semilunar fibrocartilage is a fibrocartilaginous band that spans the lateral side of the interior of the knee joint. Posterior lateral meniscus root reattachment with suture anchors. The menisci are wedge shaped, being thinner toward the center of the knee and thicker toward the outside of the knee joint figures. The lateral meniscus is attached to the shin and is located on the outer side of the knee.
Biomechanical analysis of the pullout strength of rotator cuff and glenoid anchors. The meniscus can have a 90% tear and it will still figure out how to function. This procedure involves removing the torn part of the meniscus. That is the blood which carries healing elements do not reach all of the meniscus. It is grooved laterally for the tendon of the popliteus, which separates it from the fibular collateral ligament.
Due to its high diagnostic accuracy and efficacy mri is the modality of choice for the diagnosis of meniscal pathology. The medial meniscus is located on the inner side of joint, while the lateral meniscus is on the outer side. Both structures mix in the acl ligament in the knee, which is why its common to see a medial meniscus injury go along with an acl injury. He did however, say that it would lead to premature arthritis in my 40s or 50s im 19 which i kind of knew already. Specifically, these types of movements can lead to a torn meniscus. Schematic of the knee joint depicting the medial and lateral menisci. Meniscal tear presentation, diagnosis and management racgp.
I asked him about how much damage there was, if there was any chance of repair, as i brought the mri images and he. They allow the rounded end of the femur to closely fit with the relatively flat top of the tibia. The outer border of the medial meniscus is firmly attached to the joint capsule and deep fibers of the medial collateral ligament. Oct 31, 2018 here are two of the most common causes of knee pain from golfing, how theyre caused and what to do about them. Complex posterior horn tears of the medial meniscus are common.
Complete lateral discoid meniscus last, in right side diagram c. Total knee replacement if you are suffering from a knee injury or chronic knee pain, it is a good idea to be evaluated by an orthopedic su rgeon. Apr 08, 20 this feature is not available right now. Theres another part on the outside lateral that also attaches in the middle. Division of sports medicine, department of orthopaedic surgery, north shore university hospital, and orthopaedic associates of manhasset, manhasset, new york abstract increasing emphasis on the comprehensive reconstruction of the knee and on restoration of knee function after. The medial meniscus is on the inner side of the knee joint. Table 4 exclusion criteria in medial meniscal tear randomized. Lateral meniscus definition of lateral meniscus by the free. Meniscus transplant is a highly skilled procedure involving accurate diagnosis, acquisition of the perfect donor tissue, complex surgery, and specialized rehabilitation. Rehabilitation following meniscus repair memorial hermann. Other meniscus derangements, anterior horn of lateral meniscus, left knee oth meniscus derang, anterior horn of lat mensc, left knee icd10cm diagnosis code m23. Tear of lateral cartilage or meniscus of knee, current. Isolated complex tears of the lateral meniscus that extend to the periphery in a radial fashion at the popliteal hiatus represent a true treatment decision enigma for orthopedic sports medicine.