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"What types of knee injuries are there? In the knee, there are several structures: the collateral ligaments, the cruciate ligaments, the articular (joint) cartilages and the menisci.  If there is injury to the knee, it is possible that more than one of these structures may be injured at the same time. What are the menisci?  In the knee joint there are two half-moon-shaped pieces of cartilage called menisci that lie firmly on the shin bone. The outer or external meniscus is called the lateral meniscus. The inner or internal is called the medial meniscus. The cross section of these menisci are shaped like a red blood corpuscle, ie are concave on both articular surfaces and triangular in cross section.  The main function of the meniscus is to act as a load distributor when we walk or run. If the menisci were not there, the articular cartilage would be too heavily loaded and could be damaged.  The menisci also help to keep the knee stable.  How do meniscus injuries occur?  There are two main types of meniscal injuries:  One is an acute twisting injury, which normally occurs in younger active patients. In this type of injury, the meniscus gets caught between the thigh bone and the shin bone and is subsequently damaged. This type of injury is common if someone is tackled during a football game. More common injuries are wear and tear-type injuries to the leading edge of the meniscus.   What are the symptoms of a meniscus injury?  Shortly after the event has happened it is difficult to diagnose whether a meniscus injury has occurred unless the knee is locked. Swelling may occur, but not always. Even the most classical symptoms may fail to appear at first.  The classic symptom is a locked knee that cannot be straightened, eg if one has been sitting with bent knees.  The knee can suddenly lock on twisting and then unlock with an audible click.  Another classic symptom is pain and swelling of the knee a few hours after the injury has occured.  The knee joint is a complicated structure comprising of three separate joints together with multiple ligament namely the collateral and cruciate ligaments and also the posterolateral corner and two type of cartilages namely menisci and the lining or articular cartilage.  An injury to the knee, one or more of these structures can be injured simultaneously.  Articular cartilage injuries, damage to the knee can cause lesions to the articular cartilage or hyaline cartilage which covers the bony surfaces of the knee.  An isolated injury to this articular cartilage will not normally be apparent on an X-rays but will be found by means of an MRI scan.  An arthroscopy may show up subtle surface articular cartilage lesions not visualised by an MRI scan.  Injury to the cartilage will normally produce symptoms of pain, swelling, clicking, sometimes locking and sometimes sensations of instability.  Articular cartilage injures are normally treated initially conservatively with physiotherapy. If the patients symptoms fail to respond to this then arthroscopic surgery can be utilised to stimulate neo-cartilaginous or fibro cartilaginous healing of the articular surface defect.  Such techniques are types of marrow stimulant procedures to release stem cells from the bone marrow to encourage healing of these articular cartilage defects.  The different type of marrow stimulation techniques include drilling, micro fracturing and abrasion chondroplasty. Normally after the bone at the base of the articular cartilage defect has been stimulated in this way patients are treated by a physiotherapy programme, normally non weight bearing for six weeks during which time the new plug or scab of healing cartilage forms and matures.  This treatment is normally successful in approximately 80 per cent of patients. If it fails then the treatment can be repeated, or bigger surgery such as cartilage transplant surgery can be performed.  How does a doctor diagnose a meniscus injury?  First and foremost it is important to find out how the injury occurred and whether the knee was locked.  The doctor will take a history, then feel along the knee&amp;#039;s joint-lines to examine the knee for swelling, focal tenderness and range of movement. On moving the knee a little, the meniscus-click might be felt or heard.  Specific tests to stress the menisci and reproduce pain may be performed. Typically a McMurray&amp;#039;s test is carried out \u2013 local pressure is applied to the injured meniscus combined with flexion of the knee and rotation. This will normally reproduce the patient&amp;#039;s symptoms.  Finally, an arthroscopy of the knee may be carried out. This is usually done under general anaesthesia. A diagnosis can be made and the meniscus tear attended to.  In recent times it has become more common for an MRI scan to be performed instead of an arthroscopy. The MRI scan will confirm the diagnosis and severity of the meniscal injury and also look for any other associated injuries in the knee which can occur.  How is a meniscus lesion treated? There is no standard treatment of meniscus lesions. However, as a rule of thumb, as much of the meniscus as possible will be saved.  Minor lesions in the meniscus are usually treated with a combination of rest, anti-inflammatory drugs and physiotherapy instead of surgery.  Larger tears require surgery and every effort will be made to preserve the torn cartilage using meniscal repair techniques. These techniques include arthroscopic suturing.  As the blood supply to the meniscus is limited, not all large tears are amenable to repair. Attempted repair is often tried in young people. If the meniscus has been repaired, weight-bearing is limited for three weeks. It will be six weeks before a full range of movement is achieved.  If a repair is not possible then a simple arthroscopic menisectomy or removal of the torn fragment is performed \u2013 a procedure called partial menisectomy. After this procedure, the patient will be able to walk again as normal.  Larger tears of the menisci normally require surgery and now every effort will be made. This includes of the torn meniscus.  Not all such tears however are amenable to this type of surgery, but whenever possible this is undertaken as preserving the meniscus protects the knee long term. The repairs are normally limited to younger patients with larger peripheral tears.  Other people also read: Knee injuries \u2013 the articular cartilage: Find out what treatment is available? Knee injuries \u2013 cruciate ligament: How do injuries to the cruciate ligaments occur?  Arthroscopy: What happens during an arthroscopy? Anaesthesia: What does the anaesthetist do?  Based on a text by Hans Gad Johansen, specialist, Ejnar Kuur, consultant  Last updated 08.05.2014 "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.netdoctor.co.uk/conditions/aches-and-pains/a5098/knee-injuries-8211-meniscus/>