Meniscus Tear- Causes, Symptoms, and Treatment

A tear in the meniscus is one of the most common knee injuries. It can be extremely painful and weakening. The largest joint in the body is the knee. It consists of three bones – the kneecap, the thighbone (femur), and the shinbone (tibia). The piece of cartilage that acts as a cushion between the shinbone and the thighbone is known as the meniscus. In each of our knee joints, there are two menisci.

Our knees enable us to bend where the thighbone and shinbone are attached. The knee joint is how we can perform different activities such as walking, running, squatting, and climbing. Athletes such as basketball players make these effortless turns and twists, but one wrong move can lead to a torn meniscus.

It happens most commonly while engaging in contact sports that require a lot of twisting or squatting. If you hear a pop sound, that is an indication of a tear in the meniscus. You might experience swelling and pain that comes and goes. It might also feel as if your knee is locking or giving away when you bend it.

Causes of Meniscus Tear

Engaging in any activity that requires one to rotate or twist the knee suddenly or forcefully can cause a tear in the meniscus. Sometimes, activities such as squatting, lifting something heavy, or kneeling can also lead to a torn meniscus. Older adults may suffer from a torn meniscus due to degenerative changes of the knee. As we grow old, the cartilage weakens and becomes thin, making it more prone to tearing.

Symptoms of Meniscus Tear

The most common symptoms of a meniscus tear are as follows –

• Swelling
• Pain in the knee
• Feeling like knee being stuck or locked up
• Popping sound while the occurrence of injury
• Difficulty while straightening or bending the leg

Athletes tend to play through the pain. It may seem like a minor injury but if left untreated, a torn meniscus could develop into a long-term knee problem such as arthritis or even require surgery.

Diagnosis

At Germanten Hospital, we have a dedicated team of physicians, orthopedic surgeons, and physiotherapists, led by Dr Mir Jawad Zar Khan, who is an expert in the diagnosis and surgical as well as non-surgical treatment of the knee. He has over two decades of experience in the field. To celebrate his achievements and efforts, he has been felicitated with the title of Best Doctor by the ex-CM of Joint Andhra Pradesh & Former Governor Tamilnadu, Shri Roshaiah Garu in 2018. In 2019, he was honored with the Vaida Ratna Award by the Honourable Health Minister of Telangana, Shree Etala Rajendra.

Your doctor at Germanten Hospital would discuss your medical history and symptoms with you. After that, he or she will examine your knee for tenderness where the meniscus is located, thoroughly. To check for a torn meniscus, your doctor will perform the McMurray test, wherein they will bend your knee, straighten it and rotate it, thus putting tension on the meniscus. If it is torn, then a clicking sound will be heard every time the doctor performs this test.

To rule out other knee problems with similar symptoms, your doctor might also perform X-rays and an MRI. X-rays can identify other causes of knee pain such as osteoarthritis and an MRI offers better visualization of the knee joint, especially the meniscus.

Treatment

After your diagnosis, the orthopedic surgeon will devise a treatment plan depending on the type, size, and location of your injury. Your age, level of activity, and previous injuries are also factored in while deciding on a treatment plan.

A meniscus tear can occur either in the outside one-third part or the inside two-third part of it. A tear in the outside one-third of the meniscus might heal on its own or it can be repaired with surgery, as this area has a rich blood supply. If the tear is in the inside two-thirds of the meniscus, then surgery is required to repair it since this area does not have a blood supply and cannot heal on its own.

Non-surgical Treatment

For a tear in the outside area of the meniscus, non-surgical treatment might be adequate. The RICE protocol is the best method for such treatments.

R – This stands for Rest. The first step is to rest after the injury and avoid indulging in the activity that has caused this injury.

I – This stands for Ice. Applying ice packs on the injured area for 20 minutes at a time, several times a day is essential for the injury to heal quickly.

C – This stands for Compression. Applying a bandage on the injured area helps prevent swelling and loss of blood.

E – This stands for elevation. Keep your leg a few levels above your heart to reduce the swelling in the injured area.

Your doctor might also prescribe you some medication to reduce pain and swelling. If your symptoms are not relieved after non-surgical treatment, your doctor might recommend performing surgery. Some commonly performed procedures to repair meniscus tears are –

• Arthroscopy – In this procedure, the surgeon creates a small incision through which a miniature camera is inserted. This offers a clear view of the knee to the surgeon. After this, the surgeon inserts miniature instruments through other incisions to trim or repair the meniscus tear.
• Meniscus repair – In this procedure, the surgeon repairs the meniscus tear by stitching the torn pieces together.
• Partial Meniscectomy – In this procedure, the surgeon trims away the part of the meniscus that has been damaged.

After treatment, your doctor will recommend to you some rehabilitation exercises to restore your knee’s strength and mobility. You can perform these exercises at home or go for physical therapy.

At Germanten Hospital, each operation theatre has a high-advanced laminar airflow for total infection control. With over 200 beds, Germanten Hospital is NABH accredited and has earned the title of Best Emerging Orthopaedic Hospital in India, awarded by the Times of India in 2019. It has also been named the Best Orthopedic Hospital in South India by the Economic Times 2021.

Platelet-Rich Plasma (PRP) Injection in orthopaedia: How It Works

The liquid component of blood is called plasma. Composed of nutrients, antibodies, proteins, and glucose, plasma is the medium through which the red and white blood cells, along with other material, travel through the bloodstream. Platelets are also a component of blood. The job of platelets is to secrete proteins and other growth factors that help maintain cell division, promote healing and tissue regeneration. Apart from this, platelets also assist the blood in clotting.

What is Platelet-rich Plasma (PRP)?

Platelet-rich plasma is plasma with more platelets than the concentration normally found in the blood. To prepare platelet-rich plasma, blood is drawn from the patient. From this blood sample, the platelets are separated from other blood cells. After this, a process called centrifugation is performed to increase the concentration of growth factors.

What is PRP therapy?

Platelet-rich plasma therapy is a form of regenerative medicine, wherein the blood’s natural healing properties are utilized. The healing solution is made by the above-mentioned procedure and is injected into the body at the point of injury. When the injected growth factors interact with local cells, these cells get triggered to begin healing the injury. Inflammation is reduced and tissue formation is also promoted, with this therapy.

Where can PRP therapy be used?

Platelet-rich plasma therapy can be applied for various purposes, such as:

• Acute injuries – PRP injections can be used to treat acute sports injuries such as knee sprains or pulled hamstring muscles.
• Tendon injuries – Tendon injuries such as tennis elbow, Achilles tendonitis, and jumper’s knee can heal very slowly, but PRP injections have been used to treat the same.
• Osteoarthritis – Traditionally, hyaluronic acid injections are used for treating osteoarthritis but studies have shown that PRP injections were more effective as compared to them. However, for definitive conclusions, more studies need to be conducted.
• Hair loss – PRP injections have been effective in treating male pattern baldness. PRP is injected into the scalp to prevent hair loss and promote hair growth.

How is PRP therapy used in Orthopaedics?

According to research, PRP therapy has been an effective form of treatment when conventional methods such as physical therapy, surgery, cortisone injections, or anti-inflammatories have failed to work. Many orthopedic conditions such as rotator cuff tears, tendonitis, arthritis, golfer’s elbow, tennis elbow, Achilles tendon ruptures, and soft-tissue injuries can be treated using PRP therapy.

PRP injection process

PRP therapy is a fairly simple procedure. First, the healthcare professional draws a sample of your blood. The amount of blood to be drawn depends upon the area of PRP injection. After this, the blood is placed into a machine called a centrifuge. The machine spins at a high speed such that the components of blood get separated. This process takes around 15 minutes. After this, a technologist will take the separated plasma and prepare it for injection. To pinpoint the exact area where PRP is to be injected, the doctor might perform imaging tests such as an ultrasound. After this, the PRP is injected into the affected area. The complete process takes around one hour.

Side effects of PRP therapy

Since PRP is injected directly into the skin, there may be a few side effects such as:

• Nerve injuries
• Tissue damage
• Infection
• Pain at the injection site

The risk of an allergic reaction is low since the body’s own substances are being injected directly.

Recovery time for PRP injections

It is recommended by doctors that after PRP injections, one should rest the area in question. Most people can continue their daily activities after PRP injections. The instructions given to you will be more related to your injury rather than the injection.
You may not notice an immediate difference, post taking the injection. It might take several weeks or months for the area to heal.

At Germanten Hospital, PRP therapy is used as an alternative for surgery to treat knee pain. Our team of doctors, led by Dr. Mir Jawad Zar Khan, aims to personalize PRP therapy according to each different patient and their injury, to provide the best possible results. Germanten Hospital is NABH accredited and each operation theatre is of class100 level, offering high-advanced laminar airflow for total infection control, with more than 200 beds. In 2019, Times of India graded Germanten Hospital as the Best Emerging Orthopaedic Hospital. It was also named the Best Orthopaedic Hospital in South India, by the Economic Times in 2021. At Germanten Hospital, the most recent, modern, and advanced medical procedures such as PRP are performed, to take orthopedic medicine to the next level.

At the forefront of Germanten Hospital is the renowned orthopedic surgeon, Dr Mir Jawad Zar Khan. A veteran of more than 20 years in the field of orthopedics, he is a gold medalist of Osmania University and has received advanced training from Germany and the USA. To celebrate his achievements and effort, he was awarded the title of Best Doctor by the ex-CM of Joint Andhra Pradesh & Former Governor Tamilnadu, Shri Roshaiah Garu in 2018. In 2019, he was honored with the Vaida Ratna Award by the Honourable Health Minister of Telangana, Shree Etala Rajendra.

Partial Knee Replacement: Procedure and Recovery

Partial knee replacement, also known as unicompartmental knee arthroplasty, is a surgical procedure wherein the damaged part of the knee cartilage, due to osteoarthritis, is replaced with a prosthesis.

What is osteoarthritis?

When the articular cartilage within the knee joint wears away, this condition is called osteoarthritis. The role of the articular cartilage is to prevent one bone from scraping against the other. It allows for smooth and stable movement of the knee and acts as a shock absorber, to protect against any unusual movement or injury. Due to osteoarthritis, the cartilage becomes thinner over time and due to this, the joint becomes inflamed. You might experience stiffness and pain in the joint and your range of motion might become limited.

Who is a candidate for partial knee replacement?

People who are suffering from lateral or medial knee osteoarthritis can be candidates for partial knee replacement surgery. Generally, medial knee joint degeneration is the most common deformity of arthritis. A few other factors that might be considered are:

• Persistent knee pain despite taking anti-inflammatory drugs and maintain your ideal weight
• Damage to only one compartment in the knee joint
• Sufficient range of knee motion
• Intact anterior cruciate ligament
• Stable knee
• Angulation of deformity

Partial knee replacement vs Total knee replacement

Whenever possible, partial knee replacement is preferred over total knee replacement procedure due to various reasons:

• • Better range of motion and knee function is preserved because healthy tissue and bone in the knee are preserved
  • Loss of blood is less, as compared to total knee replacement surgery
  • Faster recovery of knee motion

Diagnosis

Germanten Hospital in Hyderabad is the number one center in India for knee replacement surgeries. At first, your doctor will discuss your medical history and ask questions regarding your symptoms and general health. Then, he or she will perform a physical exam to determine the location of your pain. If it is entirely located either on the outside portion of the inside portion of the knee, you may be a good candidate for a partial knee replacement procedure. However, if the pain is spread throughout the entire knee or if it is situated in front of your knee, under the kneecap, you might require total knee replacement surgery.

Apart from this, your doctor will also check your knee’s range of motion and the quality of the ligament. If the ligament feels weak or torn or if the knee feels too stiff, then your doctor might not recommend unicompartmental knee surgery. To better visualize the extent of the damage in the knee, X-rays and MRI scans may also be performed.

Surgery

Once it is determined that you are a good candidate for partial knee surgery, you will be admitted to the hospital on the day of surgery. Your doctor will first discuss with you anesthesia options and verify the surgical site. Then, your surgeon will make an incision at the front of the knee to examine all three compartments of the knee. This is done to verify that the ligaments are intact and the damage to the cartilage is confined to one compartment only. After verifying, your surgeon will remove the damaged cartilage from the targeted compartment of the knee. This cartilage and bone are replaced with metal implants that recreate the surface of the joint. To create a gliding surface between the two metal components, a plastic spacer is inserted.

At Germanten Hospital, partial knee replacement surgery is performed using a robotic arm. It is one of the most advanced and precise medical technologies. The team of expert doctors at Germanten Hospital is led by Dr Mir Jawad Zar Khan. He has performed more than 10000 surgeries and has advanced training in the field of orthopedics from the USA and Germany. To celebrate his achievements and efforts, he was awarded the title of Best Doctor by the ex-CM of Joint Andhra Pradesh & Former Governor Tamilnadu, Shri Roshaiah Garu in 2018. In 2019, he was honored with the Vaida Ratna Award by the Honourable Health Minister of Telangana, Shree Etala Rajendra.

The infrastructure at NABH accredited Germanten Hospital is world-class. With state-of-the-art facilities, the hospital has more than 200 beds and a highly advanced laminar airflow in each operation theatre for total infection control. We aim to provide our patients with the best treatment and patient care. In 2019, Times of India graded it as the Best Emerging Orthopedic Hospital. It was also named the Best Orthopedic Hospital in South India by Economic Times in 2021.

Recovery

Usually, patients are discharged after one to three days of the surgery. You might feel some pain, for which your doctor might prescribe some pain-relief medication. You will be allowed to put weight on your leg immediately after the surgery. It might be a few weeks or months after the surgery for you to walk without any assistance. Patients can resume their daily activities after six weeks of surgery.

After your surgery, you will need physical therapy to regain your mobility and strength in the knee. A team of physiotherapists at Germanten Hospital will work with you to perform rehabilitation exercises for this purpose.