Possible meniscus injury


Q: For the past six years, my job has required an up and down pumping motion of my right leg to lift my exam bed to examine patients. many of the patients are obese to morbidly obese. For the past several months I have had increased swelling and occassional pain to the knee. I was walking in the hallway at the hospital and my knee popped and I could not bear weight on my right leg. i had severe pain. I am waiting for MRI results but my orthopedic surgeon is quite sure I have torn my meniscus. I have never injured my knee. I am not overweight. I walk 4-5 miles every day. Is is possible that the repetitive motion contributed to the tear?


A:    The menisci are C-shaped wedges of fibro cartilage located between the tibia and femur, and very close related to knee ligaments and attached also to the joint capsule. They are susceptible to get injured with leg rotation movements or rotational forces applied to them, and the lesion produced can be partial or complete tear. Meniscus injuries are common in active people as you, who are involved in sporting or physical activities. Locking or buckling is a common symptom after a meniscus lesion develops. Locking usually occurs at 20-45° of joint extension. If a torn fragment has been trapped within the joint, extension may feel limited against a rubbery resistance. Joint inflammation or capsular involvement also may resemble locking. A more reliable indicator of meniscus 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. Spontaneous healing is common because of the rich blood supply in the meniscus periphery. Successful recovery from a meniscus tear is helped by a gradual resolution of symptoms over 6 weeks with a return to normal activity by 3 months. Many menisci tears heal spontaneously, also, can be treated with casting depending of the severity of the tear. With time the symptoms tend to  improve.

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