Understanding Meniscus Tears: Symptoms and Causes

What Is a Meniscus Tear?

A meniscus tear is a common knee injury that can affect anyone from active Singaporeans playing sports to individuals performing everyday tasks like squatting or climbing stairs. As a critical cartilage cushion in the knee, the meniscus absorbs shock and stabilizes the joint, but it’s prone to tears from sudden twists or gradual wear. Whether you’re feeling a sharp pain, swelling, or a locking sensation in your knee, recognizing the symptoms and causes of a meniscus tear is essential for timely care.

Meniscus Tear Symptoms

A meniscus tear can manifest with the following symptoms:

• Knee pain and stiffness.
• Limited range of movement in the knee
• Difficulty bending the knee
• Pain in the outside or inside part of the knee
• Tenderness at the knee joint
• Swelling at the knee joint.
• A feeling of weakness in the knee as if it cannot support your weight
• A Feeling of knee locking or a popping sensation from the knee.

Causes of Meniscus Tear

Meniscus tears are caused by trauma or degeneration because of old age. It typically occurs in athletes when they plant their feet on the ground and then twist their upper leg, causing the knee joint to bend in an unnatural position.

To recommend a meniscus tear treatment, an orthopaedic doctor must first determine the cause and type of meniscus tears. In Singapore, treatment for a torn meniscus is available at various orthopaedic centres, including Ray of Health. A leading specialist like Dr. James Tan can provide both conservative and surgical torn meniscus treatment in Singapore based on individual needs.

Types of Meniscus Tears

A meniscus tear can be classified into the following types, according to its location.

• Posterior horn tears: These tears are on the back of the meniscus. These are the most common types of meniscus tears.
• Medial meniscus tear: These tears are on the inner side of the meniscus and since there is no blood flow in this region, this medial meniscus tear cannot be repaired.
• Lateral meniscus tear: A lateral meniscus tear or peripheral tear is on the outer side of the meniscus and can sometimes be repaired.
• Anterior horn tears: These tears are on the front of the meniscus and are less common.

Meniscus Tear- Image Credit: Mayo Clinic

Depending on the appearance, a meniscus tear can be classified as follows:

• Radial tear: A radial tear of the meniscus occurs at the most central part of its C-shape and extends towards its peripheral edges. This part of the meniscus lies in that region of the knee that has no blood supply. Therefore, the chance of a radial tear healing on its own is almost negligible and meniscus tear surgery may be the only option.
• Horizontal tear: A horizontal tear of the meniscus occurs in the central region, splitting the meniscus into upper and lower parts. This happens in the vascular region of the knee where there is some blood flow. Therefore, horizontal tears are often repaired during surgery by stitching the circumferential fibres together. The blood flow in the region ensures good healing.
• Bucket handle tear: A bucket handle meniscus tear is a vertical, longitudinal tear in the central part of the meniscus. This tear restricts the movement of the knee and the patient feels as if the knee is stuck. Such a tear usually requires surgery to regain the normal bending motion of the knee.
• Flap tear: A flap tear is the kind of tear in the meniscus that causes some part of the meniscus to be pushed into the joint space, causing pain and restriction of motion. Also called parrot beak tears, these tears can cause the meniscus to flap in and out of place. Depending on the severity of the tear, the surgeon may attempt to repair or reconstruct the meniscus.
• Intrasubstance/ Incomplete tear: Intrasubstance tears of the meniscus happen because of early degenerative changes and wear and tear. This tear is often diagnosed in people in their 20s and 30s. These tears are also called stable tears as usually they do not require surgery; they are managed through conservative means.
• Complex tear: A complex tear involves a combination of multiple tear patterns, for example, horizontal and radial tears together. Complex tears are not generally repaired during surgery because of their complexity. The surgeon may remove some parts of the torn meniscus and repair other parts during surgery.

How to Diagnose Knee Pain Associated With Meniscus Tears?

The doctor performs a thorough physical exam to determine if the knee pain and other symptoms may be caused by a meniscus tear. The doctor will take a detailed medical history of the patient and the circumstances that led to the injury. He may also perform physical tests, including the McMurray test, which can help identify pain and a clicking sound in the knee that may indicate a meniscal tear.

Furthermore, the orthopaedic specialist may order imaging tests to confirm his diagnosis further. These tests include X-rays (to rule out any bone problems or fractures) and magnetic resonance imaging MRI (a meniscus tear MRI can visualise soft tissues in the knee region and can identify a tear). Depending on the diagnosis, the knee specialist will be able to recommend a plan for knee pain treatment in Singapore.

Frequently-Asked Questions

Who is at risk of getting a meniscus tear?

Athletes and sportsmen are more at risk of getting a meniscus tear than the normal population. People who play contact sports that require sudden stopping and pivoting movements, such as football, basketball, and volleyball, are more prone to injuries. Some people may get this tear while lifting heavy objects or squatting. Another group of individuals who are at risk are older people with a degenerative condition. In such individuals, injuries can occur even with everyday movements like standing up from a chair. Generally speaking, the risk of meniscus tear injuries increases as one gets older.

How can I prevent meniscus-related injuries?

Meniscal tear injuries usually occur during sports and athletic activities such as jumping, hopping, and running. It is essential to strengthen your lower limbs, quadriceps, and hamstring muscles to ensure that the meniscus is not burdened beyond its strength. Moreover, improving your jumping and landing techniques if you are a sportsman can also help prevent meniscus tear injuries. For older individuals, meniscus-related injuries can be prevented by adopting a healthy lifestyle and doing strengthening exercises. Exercising caution and avoiding sudden, abrupt movements of the knee can also prevent meniscal injuries.

What is the difference between a meniscus sprain and a meniscus tear?

A meniscus sprain and tear may manifest with similar symptoms of pain, swelling, and stiffness. However, you may also experience a popping sound or sensation with a meniscal tear. A meniscus strain can heal by itself in much less time as compared to a tear that may require more aggressive treatment.

When is a torn meniscus an emergency?

In cases where severe pain and knee locking prevent walking, immediate medical consultation is advised. As a temporary measure, follow the RICE protocol—Rest, Ice, Compression, and Elevation—to alleviate pain and swelling. For urgent care, contact a healthcare provider to assess the need for emergency treatment.