### Description: - a rupture of the [[medial meniscus]] and/or the [[lateral meniscus]] of the knee ### Clinical Features: - #pain/knee-pain and #Rheum/joint-swelling/knee-swelling (can sometimes be delayed, e.g., 1-2 days after injury) - #MSK/pain-with-weightbearing - #MSK/joint-locking (i.e., unable to straighten the leg fully) - #MSK/knee-instability ### Differential Diagnosis: - ### Investigations: ###### Physical Exam - [[McMurray's test]] - [[Thessaly's test]] - joint line tenderness ###### Imaging - x-rays (usually normal, but helpful to look for [[knee osteoarthritis]] if you suspect a degenerative mechanism of injury) - MRI if the patient fails conservative management or if you suspect a very large tear ### Treatment: ###### Conservative Management - active physiotherapy (to maintain/improve ROM, strengthen the [[quadriceps femoris muscles|quads]] and [[posterior compartment of the thigh|hamstrings]] to improve knee joint stability) - oral [[NSAIDs]] (to ↓ pain and promote movement/physiotherapy) - [[intra-articular steroid injection|IA steroid injection]] (to ↓ pain and promote movement/physiotherapy) - knee braces or activity modifications to accommodate the injury (only helpful in older patients with arthritis, NOT recommended for young patients ) ###### Surgery *If [[knee osteoarthritis]] is present:* - meniscal repair or arthroscopic debridement is NOT helpful - [[knee arthroplasty]] is a last resort if conservative management fails *If patient is young / post-traumatic meniscus injury:* - [[meniscal repair]] for injuries in the red or red-white zone, large tears, "bucket handle" tears, meniscal root tears, and for younger patients - [[meniscal resection]] for injuries in the white zone, or that are chronic/degenerative ### Prognosis: - return to play is variable, depending on whether they have had a [[meniscal repair]] or a meniscectomy - anywhere from 6 weeks to 3 months ### Causes: - can occur as a result of degeneration (i.e., "wear and tear") - can occur due to rotation or twisting with the foot planted ### Notes: -