What is a meniscus injury?
The menisci are fibrocartilage structures in the knee that distribute load and help stabilize the joint. Meniscal tears may be traumatic or degenerative and can coexist with knee osteoarthritis.
Common symptoms
Symptoms include pain along the inner or outer joint line, swelling, difficulty squatting or climbing stairs, clicking and reduced range of motion. Inability to fully straighten the knee after injury warrants prompt orthopedic assessment.
Diagnosis
A clinical examination is essential. MRI may be indicated to assess a suspected tear; X-rays help assess associated osteoarthritis, while ultrasound can detect effusion or synovitis. Ultrasound cannot reliably exclude all meniscal tears.
When can intra-articular injections help?
Hyaluronic acid
It may be considered selectively for symptoms in patients with a degenerative meniscal lesion and coexisting osteoarthritis. Evidence is limited and guidelines differ on routine use for knee osteoarthritis. Hyaluronic acid does not heal the meniscal tear.
Corticosteroids
An injection may offer short-term relief in an osteoarthritis or synovitis flare, but it does not repair meniscal tissue. Infection and other contraindications must be ruled out; extra caution is needed in people with diabetes.
Platelet-rich plasma (PRP)
Evidence for PRP in meniscal injuries remains under investigation, and healing cannot be guaranteed.
Ultrasound-guided injections
Ultrasound guidance can improve needle placement accuracy, but accurate delivery does not itself mean that the torn meniscus will heal.
Non-surgical rehabilitation
Many degenerative tears are managed initially with targeted exercise, quadriceps strengthening, activity modification, weight management where appropriate, and pain control. Displaced tears or a truly locked knee may require surgical evaluation.
When to seek medical advice
Persistent pain, recurrent swelling or reduced movement call for assessment. A hot, red knee accompanied by fever requires urgent medical evaluation.
Irakli Shelia — Rheumatologist, MD, PhD
Gudushauri National Medical Center, 66 Ljubljana Street, Tbilisi, Georgia
Phone: 555 787 772