“If I don’t think it’s a tear, I’ll start with physical therapy. If you get better and can return to your sport, great. But if you don’t improve, still have pain or even get worse, I’ll order an MRI to see if the meniscus is torn. Then I’ll set you up for surgery – and in three to six weeks after the surgery, you will be doing fine and ready to return to sports.” – Dr. Romano
Flat on the bottom, concave on the top, the meniscus is the cartilage within the knee that acts as a cushion between the thigh bone (femur) and the lower leg bone (tibia). It helps to provide structural integrity to the knee joint as it moves and flexes – whether through normal, everyday activities or in sporting activities.
There are two main types of meniscus injuries (sometimes referred to as “torn cartilage”):
• Acute Tears which can occur as a result of injuries experienced in sports – football, soccer, rugby and others. These can take many sizes and forms such as vertical, radial, horizontal, oblique, and complex. These kinds of meniscus tears generally do NOT heal on their own and for that reason require surgical repair.
• Chronic Tears typically progress over the course of time due to wear and tear on the knee. These kinds of meniscus tears can sometimes be treated based on the symptoms experienced – to include physical therapy, and possibly injections of anti-inflammatory medications. Surgery, however, may still be necessary at some point.
As with all injuries, we take a very cautious approach with diagnosis and treatment. When someone comes in with pain in the knee, we don’t immediately jump to surgery. Our process is to first evaluate whether a tear is likely and try therapy if that seems appropriate. Surgery is recommended only in cases where therapy hasn’t or won’t work and surgery offers the best solution.
One thing that makes our approach different is that we can perform meniscus surgery using local anesthesia – you remain fully conscious throughout the entire procedure. Our skilled anesthesiologists will make sure you are totally relaxed and comfortable.
For this procedure, we make a small incision in your knee, insert a miniature camera, and remove or repair the torn meniscus with you awake the entire time – in fact, the majority of our patients watch on the monitors. In this way, you walk away with a better understanding of your knee, how it works, and what you need to do to preserve optimal function for as long as possible.
Afterwards, we move immediately on to therapy to get you on your feet and “back in the game” as quickly and safely as possible.