How Are Meniscus Tears Diagnosed?
A thorough listening and physical examination largely confirm the diagnosis of a meniscus tear. X-rays are ordered to assess the extent of wear and tear in the knee and to determine whether there are other bone problems or accompanying conditions. An MRI is performed to confirm the diagnosis of a meniscus tear, determine the nature of the tear, identify any accompanying conditions, and develop a treatment plan. The accuracy of an MRI in detecting meniscus tears depends on proper imaging and evaluation by experienced hands. However, MRI is not the sole determinant in determining diagnosis and treatment. In some cases, a tear may appear to be present even when it is not present (a false-positive result), or conversely, a tear may be present but not detected on MRI (a false-negative result). Therefore, proper imaging is extremely important. Especially if the meniscus has been previously surgically treated, the margin of error increases, and more advanced diagnostic methods may be required. In determining diagnosis and treatment, the patient's complaint, examination findings, and MRI scans should be consistent. In some cases, all of these diagnostic methods may be insufficient. In such cases, arthroscopy (looking inside the joint) is used to confirm the diagnosis.
How Are Meniscus Tears Treated?
Treatment of meniscus tears in young people is usually surgical. Except for very rare, small, non-full-thickness tears, the meniscus does not heal on its own. In patients with significant symptoms, if the tear is suitable for repair, surgical intervention is performed. If the tear is not suitable for repair, the torn portion is removed, and the remaining meniscus tissue is reconstructed. In older patients, meniscus tears are often accompanied by wear and tear (arthrosis) of the joint cartilage in the knee. Treating the meniscus tear alone may not completely resolve the problem. In such cases, other methods such as medication, intra-articular injections, physical therapy, arthroscopy, and bone-smoothing surgeries are also included in the treatment. Repair is the first option for meniscus tears to ensure the long-term health of the knee and its ability to perform its important functions. Due to the meniscus's vascularity, its healing capacity is not very high. Roughly one-fifth of meniscus tears are suitable for repair. Meniscus repair and removal of the torn portion using arthroscopic (inspecting the inside of the joint) techniques allows for an early return to daily life and athletic activities.
What is Meniscectomy?
The torn portion of the meniscus that is not suitable for repair is removed. This procedure is called Meniscectomy. During this procedure, only the torn portion is removed, preserving the remaining healthy portion of the meniscus. This is called Partial Meniscectomy. The more meniscus tissue that can be preserved, the better the long-term health of the knee. This is because the preserved meniscus tissue continues to bear weight, even if only partially. Partial Meniscectomy offers excellent early results. A rigorous postoperative rehabilitation program is not required. It's possible to return to normal life and sports within a few days or weeks, often following home exercises.
What is Meniscus Transplantation?
For patients with severely damaged menisci who require complete meniscus removal, frozen meniscus tissue taken from cadavers can be transplanted after testing to prevent disease transmission. This procedure, which is currently very limited in our country, has a 10-year follow-up success rate of 60-80%. Meniscus transplantation, which requires a major surgical procedure, may also require bone-related surgery. Despite these studies, the risk of disease transmission is approximately 3 in a million. Research is ongoing to produce and transplant synthetic meniscus tissue instead of tissue harvested from another person.