Meniscus injuries in the athlete
- Q: How does an athlete injure their meniscus?
- Adam Anz, M.D.: We most often see meniscus injuries associated with ACL injury. That's the most often meniscus repair that we perform and it is associated with an ACL injury. At the time of your ACL injury, there's a screw motion in your knee that typically causes injury to the posterior lateral or in the back outside portion of your knee. You also can have an injury to the inside portion of your meniscus at that time as well. Those are the most often meniscus injuries. We see sometimes we'll have twisting types of compression injuries and other athletes where they enter their medial meniscus and it can it can flop into the intercondylar notch area. We call those bucket handle types of meniscus injuries. Those are the two most often that we see with our athletic population. As we age, we typically see other types of meniscus injuries, and we usually call those horizontal in shape because those are the most often we see in that population. Those typically don't necessarily always need a surgery and a lot of times we can rehabilitate those types of meniscus injuries. So the older population, a lot of times we can recover just with rehabilitation, whereas the younger populations that occur with our sporting accidents, a lot of times we repair those surgically.
- Q: What are treatment options when it comes to meniscus injuries?
- Adam Anz, M.D.: With meniscus injuries, if they're older degenerative injuries, we always start with trying to treat the inflammation of the joint and strengthen the muscles around with physical therapy. If there's a piece that's flipping in and out of place and causing a mechanical clunk or catch, we do perform arthroscopic partial meniscectomy and trim the piece that is clicking out of place or moving out of place. We try to be very judicious with partial mastectomy. We want to leave as much meniscus as we can because that meniscus is increasing surface area, which is important for the health of the joint.
- Q: What can a patient expect postoperatively from a meniscus surgery?
- Adam Anz, M.D.: With meniscus surgery, they tend to fall into two categories. If we repair a meniscus, we have to go slow – giving it time to heal, so we limit your way and anywhere from three weeks out to six weeks depending upon the type of meniscus tear. If we have to trim a piece that's flapping and catching, we let you bear weight as tolerated with crutches and get your motion back in your quad back using the crutches and then let you go from there. There's another type of meniscus tear called the root tear. Meniscus are c-shaped and their shape and they anchor in the front and in the back or we call those the roots because they root down into the bone. If there's a root tear it's important because the whole piece of meniscus is then not functional and we repair those routinely – they're important ones to be cognizant of or to know about. You have to be on crutches for six weeks with a root tear though.
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