Treatment or management protocols for posterior horn menial meniscus tears are quite challenging. It has been reported that the force experienced by the medial meniscus in the ACL-deficient knee increased by 52% in full extension and by 197% at 60 of flexion under a 134-N load. Collateral and cruciate ligaments are intact. Peripheral Meniscal Tears: How to Diagnose and Repair - ResearchGate However, coronal sections may reveal the presence of meniscal extrusion or vertical defects, and sagittal sections may reveal the ghost sign (absence of an identifiable meniscus or increased signal replacing the normal hypointense signal of meniscal tissue). My husband has complex tear of the body and posterior horn of the medial meniscus with flap components, horizontal oblique tear of the body and posterior horn lateral meniscus. Evaluation of meniscal injury accounts for most requests for MR imaging of the knee at most institutions. How is Oblique Fracture Treated? If the test is positive (suggesting a meniscal tear), the patient will feel pain and the clinician will feel and/or hear meniscal movement when the meniscus is compressed between the tibia and femur 32, Figure 2. Sometimes, its possible to repair a torn meniscus, especially if you are a young adult. Oblique tear of the posterior horn of the medial meniscus Am J Sports Med 2008;36:12839. You might feel a pop when you tear the meniscus. There is no resting pain. If the knee is still painful, or if it locks, your doctor may recommend surgery. Because there is no supply, there is little capacity for these tears to heal on their own. The RICE protocol is effective for most sports-related injuries. From January 2018, it was superseded by AJGP: Australian Journal of General Practice, The Royal Australian College of General Practitioners 2021. Rehabilitation time for a meniscus repair is about 3 to 6 months. Should I have meniscus surgery? Reviews of Surgical and Nonsurgical Ask if your condition can be treated in other ways. Because the pieces cannot grow back together, symptomatic tears in this zone that do not respond to conservative treatment are usually trimmed surgically. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. https://orthop.washington.edu/patient-care/articles/sports/torn-meniscus.html, Phone If your symptoms persist with nonsurgical treatment, your doctor may suggest arthroscopic surgery. Athletes, particularly those who play contact sports, are at risk for meniscus tears. Additional pain may be felt when flexing or twisting the knee. Rosemont, Ill. American Academy of Orthopaedic Surgeons. More often, the patient will complain of joint line pain with a minor traumatic event, such as squatting. Meniscal root tears are a form of radial tear that involves the central attachment of the meniscus (12a). However, meniscus tears do not always appear on MRIs. The medial meniscus is the cushion that is located on the inside part of the knee. I read on a medical site that it is difficult to get to the posterior horn of the meniscus and sometimes there is a need to make an incision or the knee becomes dislocated. Torn meniscus - Symptoms and causes - Mayo Clinic a feeling that your knee is catching or locking, usually when it's bent - you may notice it clicking. True locking is less common, and suggests a bucket-handle tear, with the torn fragment preventing full extension. These meniscus tears are displaced into the tibia or femoral recesses and can be often difficult to diagnose intraoperatively. Cole BJ, Dennis MG, Lee SJ, et al. A 501(c)(3) non-profit organization. The difference in tear type between these populations is explained by the three-dimensional fibrous structure of the meniscus: horizontal delamination occurs in degenerative injuries, while the fibrous structure is ruptured in a vertical fashion in younger patients. Arthroscopy. One or two other small incisions are made for inserting instruments. what is the treatment? Metcalf MH, Barrett GR. The treatment of these type of tears can be either arthroscopy (surgery through a tiny hole in knee) or conservative. Sensitivity and Specificity of MRI in Diagnosing Concomitant Meniscal However, these patients are rare. There are numerous types of meniscus tears, including: This type of tear is often a sign of degenerative changes in the meniscus tissue. The vertical flap tear is a displaced type of radial tear that often occurs in the posterior medial meniscus. Inferiorly displaced flap tears of the medial meniscus: MR appearance and clinical significance. The Thessaly test is the most sensitive and specific clinical test to diagnose meniscal injury. The Thessaly test for detection of meniscal tears: validation of a new physical examination technique for primary care medicine. Biologics injections, such as platelet-rich plasma (PRP), are currently being studied and may show promise in the future for the treatment of meniscus tears. A high level of suspicion is required to detect these injuries, and repair is recommended to preserve joint function. 3 Thornton DD, Rubin DA. These can occur through either a contact or non-contact injury for example, a pivoting or cutting injury. The tear results in a vertical signal abnormality on sagittal MR images. In some cases, your doctor may suggest an arthroscopyto examine and possibly treat your knee. Although an X-ray will not show a meniscus tear, your doctor may order one to look for other causes of knee pain, such as osteoarthritis. bucket-handle tear: displaced vertical tear parrot beak tear: oblique radial tear Radiographic features Plain radiograph On plain radiographs, meniscal tears are not visible. Missouri: Mosby, 1998. The posterior horn it the back portion of the menisci at the end of the curve, where it tapers . controlling the movements of the knee joint. In cases where surgery is required, this time frame increases to somewhere around three to four months. As stated above, the most common cause of Posterior Horn Medial Meniscus Tear can be trauma to the knee which can be sustained due to a sporting injury, a slip and fall, a blunt trauma to the knee, and in majority of the cases natural degeneration of the meniscus due to the work load of the knee. The degenerative aetiology and reduced vascularisation secondary to ageing also means that meniscal tears in the elderly population are less likely to be amenable to surgical management;7 only about 6% of patients over 40 years of age have operable lesions.24 To prevent re-injury of the meniscus, activity modification is important for example, ceasing sports such as soccer or netball. Other established anatomical variants include the transverse meniscal ligaments and the meniscofemoral ligaments, which mimic meniscal tears at their meniscal attachment sites. Other nonsurgical treatment. Medial meniscal root tears are more frequently diagnosed in patients who are older than 40 years, are overweight and cannot recall an inciting event. A longitudinal tear is an example of this kind of tear. The goal of meniscal root repair is to restore the joint to a near native function of the meniscus and prevent cartilage degradation associated with nonsurgical treatment or meniscectomy. for a 22 year old severe pain. How to treat an oblique tear of the posterior horn of the medial This type of tear is particularly devastating to meniscal function. You will start with exercises to improve your range of motion. Medial meniscal root tears: Fix it or leave it alone - Healio Performing activities that involve aggressive pivoting and twisting of the knee puts you at a significantly higher risk of tearing your meniscus. apalia R, Del Buono A, Osti L, Denaro V, Maffulli N. Meniscectomy as a risk factor for knee osteoarthritis: a systematic review. Even better would be to describe a peripheral longitudinal tear extending to the tibial surface within the posterior horn of the medial meniscus! 16 OShea JJ, Shelbourne KD. What is the posterior horn of the medial meniscus? I have an oblique horizontal tear posterior horn medial meniscus, what does that mean? The accuracy of physical diagnostic tests for assessing meniscal lesions of the knee: a meta-analysis. SPHE425_Quiz_5.docx - Quiz 5 Attempt 1 Written: Aug 6, 2022 In younger patients, this is typically a twisting force on a weightloaded flexed knee. Meniscus Tears - OrthoInfo - AAOS - American Academy of Orthopaedic Following root repair, patients are required to remain non-weight-bearing for 6 weeks. Description of Medial Meniscus Tear The medial meniscus is an important shock absorber on the inside (medial) aspect of the knee joint. Know why a test or procedure is recommended and what the results could mean. A meniscus tear can lead to knee instability, an inability to move the knee normally, and chronic knee pain. Of course, if a displaced meniscal fragment is identified, the tear is by definition unstable. In this case, a portion may break off, leaving frayed edges. A case also can be made for medial meniscal root repairs for a symptomatic acute and possibly a chronic medial meniscal root tear in a non-obese patient older than 40 years with a MRI that does not have early arthritic changes. Chahla and Geeslin report no relevant financial disclosures. The meniscus comma sign has been described for displaced flap tears of the meniscus. Oblique tear of the posterior horn and body of the medial meniscus involving inferior articular surface and peripheral meniscal margin. One of the main tests for meniscus tears is the McMurray test. A recent study demonstrated 46% of patients with degenerative meniscal tears elected not to have surgery after 4 weeks of nonoperative treatment, and their functional improvement matched patients in the operative group.21 Another study of degenerative tears demonstrated that supervised exercise caused the same reduction in knee pain and the same increase in function and satisfaction as partial meniscectomy plus exercise.23 As degenerative tears are more common in elderly patients, this group is more likely to respond to conservative treatment. Depending on your duration of symptoms you can at least start off with physical therapy, a knee sleeve, and if there is arthritis present consider a c Dr. Christopher Ferguson and another doctor agree. RICE. Many tears are repaired with dartlike devices that are inserted and placed across the tear to hold it together. Your doctor will bend your knee, then straighten and rotate it. A horizontal meniscus tear runs along the circumference of the fibers of the meniscus. Inferiorly Displaced Flap Tears of the Medial Meniscus Radial tears, because they are oriented perpendicular to the c-shaped fibers of the meniscus, have a devastating effect upon meniscal function. Vincken PW, ter Braak AP, van Erkel AR, et al. Explains two kinds of surgery.