Meniscal tear

The menisci are crescent-shaped cartilage structures in the knee joint. There are two menisci — medial (internal) and lateral (external) — situated between the tibia and the femur. Composed of dense collagen fibres, the menisci resist compression and provide elasticity. They absorb shocks, distribute load over a wider surface area, protect the articular cartilage from excessive pressure, and contribute to knee stability.

Meniscus tears can occur at any age, though they are frequently seen in athletes and are often considered a sports injury. Most injuries happen during sudden twisting or rotational movements.

In young individuals, meniscal tissue is robust, so significant trauma is required to produce a tear. In older adults, degenerative changes weaken the meniscus, making tears possible even with mild trauma.

Pain is the primary clinical finding. It typically occurs during knee flexion. Depending on tear size, patients may also report locking or catching sensations in the knee. Because the meniscus is compressed during stair climbing and squatting, pain increases in these positions and locking may occur when the knee is bent.

Joint effusion is common — patients describe a sense of swelling or fullness in the knee. Early diagnosis is important; prolonged meniscal tearing can lead to knee instability, cartilage damage, and osteoarthritis.

Physiotherapy is used as conservative treatment for incomplete meniscus tears. The goals are to eliminate pain, swelling and joint restriction, and to strengthen the muscles around the knee.

Physiotherapy plays a critical role in oedema control, prevention of muscle atrophy, pain management, and returning the patient to normal daily activities.

Advanced meniscus tears are now treated surgically. Depending on the tear's location and characteristics, the procedure is either meniscal repair or meniscectomy (removal of the torn meniscus).

After surgery, physiotherapy is essential. The duration varies from 2 weeks to 6 weeks depending on the surgical technique. The main goals are reducing pain and inflammation, increasing muscle strength and endurance, and helping the joint regain function — since the articular cartilage must adapt to functioning without meniscal protection.

Physical therapy modalities and appropriate exercise programmes are used for this purpose. Exercises are progressed gradually in the postoperative period and are tailored to the patient's condition; they should not be performed without professional guidance.