Possible meniscus and ACL injury in a teenager after playing soccer


Q: About three years ago, I was playing soccer and I suddenly turned, and I heard and felt a pop in my knee. My knee had and still has a huge lump below my knee cap. It hurt really bad, but I kept going because it was a tournament and I needed to play. Afterwards, my parents took me to a physical therapist, who told me to just take medicine and put ice on it, and that no excercise was necessary. My knee still gives me constant problems, and it has not gotten better since the incident. Was this an ACL injury, and does it have to be checked on by a doctor?


A:   Sometimes when a Meniscus injury occurs it associates with a ligament lesion, this might be your case, acute knee pain after an injury and related symptoms may be caused by damage to one or more of the soft tissue structures that stabilize and cushion the knee joint (ligaments, muscles, tendons, and menisci). Meniscal injuries are a common problem in sports and in young active individuals; they are the most frequent injury to the knee joint. The menisci are C -shaped fibro cartilaginous structures attached to the tibia and their main functions to enhance the contact between the two articular surfaces of the knee: femur and tibia ones. The thick outline of menisci allows for a firm attachment to the joint capsule. A reliable indicator of meniscal lesion is a click or snaps after the joint unlocks, it can be or not associated with pain. A sensation of giving way may occur when the loose fragment becomes lodged for a moment in the knee joint, causing a sense of buckling. This finding should be distinguished from the sensation of giving way due to joint instability (e.g., ACL tear) or buckling secondary to decreased activity of the quadriceps femoral muscle. Spontaneous healing is common because of the rich blood supply in the meniscal periphery. Successful recovery from a meniscal tear is helped by a gradual resolution of symptoms over 6 weeks with a return to normal activity by 3 months. Many meniscal tears heal spontaneously. Also, it can be treated with casting depending of the severity of the tear. With time the symptoms improve. If there is no significant improvement you should get a clinical (orthopedic surgeon) and Imaging (MRI) evaluation of your knee.

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