The meniscus functions as the shock absorbers and stabilizers in the knee by forming two wedges of cartilage between the three bones in the knee. Meniscus tears are one of the most common sports-related knee injuries. While most people have heard of them, they don’t know exactly what they are or how they’re treated. In order to learn more, let’s talk about how orthopedic surgeons classify and treat meniscus tears.
Classifying Meniscus Tears
The meniscus is divided into two regions:
The red zone refers to the outer third of the meniscus. The term red is used to signify that this zone receives an adequate amount of blood supply. Thus, meniscus tears in this zone can sometimes heal without surgery.
The white zone refers to the inner two-thirds of the meniscus. Unlike the red zone, receives very little blood supply and tears in this area are unlikely to heal. Tears in the white zone usually require some form of surgery.
Illustration 1– There can be some overlap in meniscal zones. The red-red and red-white zones receive the most amount of blood.
Meniscus tears can occur medially or laterally (inside or outside) in the red zone, white zone, or in both. There are four types of tears:
- A longitudinal tear occurs in the red zone along the outer rim.
- A bucket handle tear is a vertical tear that can occur in either zone. This type of tear resembles a “bucket handle” and can flip, or fold, backward to disturb the integrity of the knee joint. This can sometimes be appreciated by “clicking” or “locking” of the knee when bending.
- A transverse tear is a tear extending across both zones.
- An anterior or posterior horn tear refers to a tear of the end of the meniscus.
Illustration 2- Three of the four types of meniscus tears. A flap and bucket handle tear can be considered one in the same.
Treatment options are always dependent on the type of meniscus tear, location of the tear, functional limitations caused by the pain and the recommendation of an orthopedic surgeon.
Treating Meniscus Tears
As previously mentioned, the zone that the tear occurs in plays an important role in treatment.
Non-surgical treatment options are generally used for white zone tears and include:
Significant tears, or those extending across both zones usually require arthroscopic surgery in the form of a:
- The part of the meniscus that is torn is removed.
Illustration 3- The torn meniscus is removed
- Meniscus repair. Suturing or stitching is used to reattach torn pieces and restore the meniscus.
The type of surgery performed is based on an examination of the meniscus as well as imaging studies.
Contacting an Orthopedic Surgeon
If you’ve sustained a knee injury, please don’t hesitate to contact one of the OSM Center’s 5 Fairfield County offices. One of our orthopedic specialists will be able to accurately diagnose your injury and come up with a treatment plan that’s right for you. If your injury is a meniscus tear, you’ll be in great hands and we will work with you to get you back to your chosen activity.