Knee

Meniscal injury

Mechanism

In younger people a twisting movement on a loaded, flexed knee; in older people more often a degenerative tear without a clear moment. The medial meniscus is affected more often because it is attached to the capsule and the medial collateral ligament and can therefore move less.

Recognition

Pain on the joint line, swelling that comes up only after hours, and sometimes locking or a sense of giving way. No single test is decisive; the combination counts.

Course

For a degenerative tear without locking, exercise therapy is as effective as arthroscopic surgery, and that is the most important shift in thinking of the past fifteen years.

Structures

• Medial meniscus of the knee (Body, anterior horn, posterior horn)
• Lateral meniscus of the knee (Body, anterior horn, posterior horn)
• Medial collateral ligament of the knee (MCL / Tibial collateral ligament)

Joints involved

• Knee joint

Clinical tests

• McMurray test
• Joint line tenderness

Sources

• Magee DJ, Manske RC. Orthopedic Physical Assessment, 7e editie. Elsevier. 2021