Factors Impacting Meniscal Tear Treatment Approaches
When treating a torn meniscus the exact management approach taken depends heavily on several factors, including:
- The size, type and location of the tear suffered
- The age of the individual
- The individuals desired/required level of activity
- Any co-existing and related injuries
As noted in a previous blog regarding the anatomy of the knee meniscus, blood supply to the meniscus is typically poor, with the meniscus receiving nutrition from the joint capsule and synovial fluid. The outer part of the meniscus is sometimes referred to as the “red zone,” and this peripheral area of the meniscus has potential to heal on its own due to having some but limited direct blood supply. The “white zone,” which is the area deeper inside the knee joint lacks any significant blood supply and subsequently any torn meniscus situated in this inner two thirds of the meniscus will not heal on their own. Understandably more often than not it is “white zone” tears being the ones that require surgical intervention to achieve satisfactory results and less likely to self settle.
Worth Noting Is That Not Every Torn Meniscus Requires Surgery
Just because you have been diagnosed with a meniscal injury it does not mean that you will absolutely require surgery. Non-surgical treatment may suffice when the knee is stable and symptoms resolve. Small meniscal tears, or issues situated in the so called “red zone” may well respond both relatively quickly and successfully to conservative approaches such as physiotherapy treatment. At Sydney Physio Clinic physiotherapy treatment may focus on:
- Improving biomechanics and sporting or activity technique in an attempt to off load / alter the knee strain with said activities
- Addressing postural balance at the from the foot up or trunk down can help to reduce rotational stress at the knee and unload the knee.
- Increasing strength around the knee including the trunk, gluteal muscles, quadriceps as well as the hamstring and calf muscles can help improve the support and function of the knee.
The muscles of your legs act as shock absorbers around the knee. Henceforth strengthening the muscles in your legs can help reduce joint stresses and create a dynamically more stable knee. This can help off load the meniscus and aid in recovery following a torn meniscus. Manual therapy and electrotherapeutic options are sometimes relevant to help stimulate a healing response and desensitise painful structures and are also used when appropriate by our physio team when treating a torn meniscus.
A Torn Meniscus And Surgery
If physiotherapy and/or other conservative treatment approaches fail to achieve a desirable outcome due to meniscal tear size, type, or location then surgery may be recommended. Surgery may look to either repair, or remove any unstable edges, for which there are numerous techniques available that orthopaedic surgeons employ. Generally, the approach with surgery is to repair when appropriate and to save as much of the torn meniscus as possible. This will typically reduce any likely risks of developing issues such as joint pain and arthritic changes later in life due to the removal of your knees built in shock absorber. Following any surgical procedure for a torn meniscus physiotherapy is often recommended to help with the rehabilitation process, working on many of the things listed above to achieve a successful outcome.
Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance regarding Treating A Torn Meniscus should consult his or her orthopaedic surgeon, general practitioner, sports medicine specialist or physiotherapist.