The treatment of meniscus injuries depends on the type of tear, its size, its location and its zone; apart from age of the patient, activity level of the patient and the associated injuries. 

The meniscus is a ‘C’ shaped structure and only the outside one-third of the meniscus has a blood supply. This outer third of the ‘C’ is known as ‘red zone’. A tear in this ‘red zone’ may heal itself or may require a repair surgery. But a self healing or a repaired healing also depends on several other factors like type of tear, pattern of tear and age of the patient.

The inner one-third of the ‘C’ shaped meniscus has no blood supply. As there is no blood supply to this area, a tear in this area does not heal. This zone is known as ‘white’ zone. As the tear cannot heal, the best treatment is to trim the torn part. 

The middle one third of ‘C’ shaped structure has a precarious or doubtful blood supply. This area is known as ‘red-white’ zone. The tear in this area has a poor probability of healing and is ofter treated in the same way as tears of white zone.

Nonsurgical Treatment

During the First Week

The first line of treatment for any suspected meniscus tear is non-surgical. The first week should follow a protocol called RICE.

RICE stands for Rest, Ice, Compression, and Elevation.

• Rest: Take a rest from your usual activities and sporting activities. Avoid putting weight on the knees also helps sometimes. 
• Ice: It helps in cooling down the joint. The best way that we recommend is ‘Saumya Orthocare Way’. Click here to find out ‘Saumya Orthocare Way’ of doing ice application.
• Compression: Use a crepe bandage to control additional swelling that might develop. An elastic compression bandage may help but sometimes causes swelling in the foot.
• Elevation: Keep your limbs or knees elevated on a couch or on two pillows. 

Some supportive drugs are also advised in addition to RICE protocol.

After the First Week

A small tear in red zone or an incomplete tear (often reported as Grade I tear by MRI - Radiologists) has a high chance of healing itself. For such cases, if patient’s symptoms gradually disappears then no other treatment is offered. A rehab program like ‘Meniscus Rehab’ is all that is advised. 

Surgical Treatment

During the First Week 

A bucket handle meniscus tear or a locked knee joint is the only indication for surgical treatment during the first week.

After the first week

A persistent symptoms after one week of non-surgical treatment may demand surgical procedure.

The surgical procedure is known as ‘arthroscopy surgery’ or ‘key hole surgery’. There are two types of arthroscopy surgery that might be recommended. 

• Meniscectomy: The damaged part of the meniscus that is torn and is without blood supply is trimmed in this procedure.
• Meniscus repair: A tear in the ‘red zone’ that is simple in variety can be stitched back in some selective cases. The selection requires young age, fresh tear, simple variety of tear, and in red zone. As stitching back requires the torn tissues to heal; it requires a much longer and dedicated rehab and has a longer recovery time.

Rehabilitation

Meniscus Rehab is a very important and integral part of the treatment of the meniscus tears. It is important for all the patients treated either operatively or non-operatively. In non-operative patients, the ‘meniscus rehab’ is targeted in protecting the torn area and at the same time, improving the strength of the knee joint.  

In operated cases, the main target is to bring back the lost strength and improve the flexibility of the joint. A proprioceptive training is also important aspect of the ‘meniscus rehab’ of the knee joint.

Recovery

Meniscal tears are extremely common knee injuries. With proper diagnosis, treatment and rehabilitation; patients often return to their pre-injury abilities.