Common Knee Injuries

With the increasing popularity of youth sports such as football, soccer, and basketball where sports-specific footwork requires athletes to forcefully change direction, cut, slash, and pivot, it’s no surprise injuries to the knee are on the rise. One of those knee injuries is a meniscus tear.
 
What Is The Meniscus?
The meniscus is a C-shaped piece of cartilage situated between the thighbone (femur), and the large bone of the lower leg (tibia). It serves as a shock absorber when you’re walking, running, or jumping, and also provides stability and lubrication to the knee joint.

Predominantly a non-contact injury, meniscus tears commonly occur when the knee is flexed and an athlete attempts to pivot or change direction while the weight-bearing foot is firmly planted on the ground. This causes the upper and lower parts of the leg to twist in opposite directions, a motion that can capture the meniscus and ultimately cause it to tear.

When the injury occurs, you can sometimes hear or feel something pop. There’s localized pain, swelling, and the knee may have a tendency to lock, limiting range of motion. There may also be a clicking sound when the knee is bent or extended. While it may be a bit uncomfortable, most people can walk after tearing their meniscus.
 
What To Do?
To alleviate some of the immediate pain and discomfort, use the R.I.C.E. (Rest, Ice, Compression, Elevation) for the first 48 hours after injury. To control the pain, give your child an anti-inflammatory like ibuprofen.

If your young athlete is experiencing symptoms of a meniscus tear, a visit to an orthopaedic surgeon or sports medicine specialist is in order. The doctor will conduct a variety of pain-free tests on the joint that will help diagnose the injury. If after the examination the doctor suspects a meniscus tear, your child will be sent for an MRI to confirm the diagnosis.
Once a meniscus tear is confirmed, your doctor will discuss treatment options with you and your young athlete. Small meniscus tears can sometimes heal on their own with a little rest and physical therapy, but oftentimes surgery is required.

Surgical repairs of the meniscus are completed by arthroscopy, a less invasive procedure that uses a tiny camera inserted into the knee through a small incision. A second incision about the same size is made for the tools the surgeon uses during the procedure. On a video monitor, the surgeon can see the injury and use the tiny tools to repair the tear.

If the torn tissue is too damaged or in an area where healing cannot occur, the surgeon may choose to remove the damaged area and clean up any rough edges. The good news for young athletes is their growing bodies promote healing, which means many of their meniscal tears can be repaired, rather than removing the damaged area.

For repairs, the surgeon uses sutures (stitches) to fix the tear. These patients can expect to be on crutches for about four weeks after surgery. After the crutches, most patients require another four to six weeks of recovery and physical therapy before returning to sports.
If the tear is removed, most patients usually only require crutches for up to a week. In six to eight weeks, these athletes can return to their sport.

A meniscal tear, if repaired, has not been shown to increase your chance of future tears; however, failure to repair a torn meniscus or the removal of large parts of the meniscus can lead to an increased risk of arthritis later in life.

The vast majority of young athletes who suffer meniscus tears fully recover and can return to their sport after a short recovery period. Be sure to follow your physician’s post-operative instructions and return to activity only after your doctor has given you clearance.  K&S

Jeffrey M. Vaughn, D.O. is a sports medicine trained pediatric orthopaedic surgeon with Phoenix Children's expanding Center for Pediatric Orthopaedics. For more information contact Phoenix Children's Hospital' Center for Pediatric Orthopaedics or visit the PCH's Web site at www.phoenixchildrens.com.