The meniscus acts like a gasket between the femur and the tibia to spread out the weight being forces transferred from the thigh above to the leg below. Meniscus injuries can occur in any age group, but the causes are somewhat different for each age group. If you live in the Augusta GA, Martinez GA or Evans, GA area, you can either call us at (706) 814-5053 or schedule an appointment with an experienced chiropractor in Augusta GA on our Georgia Clinic of Chiropractic website.
Georgia Clinic of Chiropractic successfully treats a wide range of conditions, from sports injuries such as a torn meniscus or tendonitis, to more chronic conditions such as TMJ and neck pain.
Augusta GA Chiropractors Georgia Clinic of Chiropractic provides customized chiropractic treatments to the Augusta GA, Martinez GA, and Evans GA communities. Choose several options to schedule your appointment: call (706) 814-5053, use our online voicemail, or use our online form. Georgia Clinic of Chiropractic, LLCChiropractors in Augusta GA and Chiropractors in Evans GA offering personalized treatments for each individual patient.
Meniscal lesions are commonly seen in the young athletic population due to the high strain put on the knee during movements like twisting, pivoting and cutting. The menisci are two semi-lunar shaped pieces of cartilage that lie between the femoral condyles and the tibia in the knee. Meniscal tears are fairly common knee injuries, especially in the athletic and active population. A detailed patient history is extremely helpful in determining the presence of a meniscal lesion. The causes of meniscal injuries can be either macro-traumatic (meaning one acute event caused the injury) or micro-traumatic (meaning over time, repetitive small traumatic events led up to injury, or degenerative changed occurred to create injury).
A full knee exam should be performed when a meniscal lesion is suspected in order to rule in or rule out the presences of ligamentous injuries as well. The examiner palpates along the tibiofemoral joint line as the patient is supine with the knee flexed to 90 degrees. Nonoperative treatment of a meniscal tear is rarely effective in the young, highly active patient due to the slow healing time and necessity for the patient to return to sport4. Surgery for a torn meniscus is highly indicated if the patient experiences a completely locked knee due to a fragment of the meniscus impeding the motion3 or if the patient is highly active and must return to sport4.
Surgery is performed using arthroscopic techniques and the most common methods are partial meniscectomy and arthroscopic repair which may be done using different suture techniques. Partial Meniscectomy: This method is used in place of a total meniscectomy and is indicated when the meniscus is too damaged for repair to be feasible. Arthroscopic Repair: This is the preferred method of surgical treatment of a meniscal tear as it preserves the meniscus and creates an optimal situation for the meniscus to heal. Goals of rehabilitation after a meniscal repair include decreasing pain and swelling, regaining full range of motion and strength, improve balance and returning to normal activity12. If you found this article helpful, you may also be interested in Meniscus TearsMeniscus Tears (topic.cfm?topic=AV0012).
Verlies van meniscus versnelt de normale leeftijdsgebonden slijtage door verlies van deze functies.
We onderscheiden een stabiele scheur waarbij het gescheurde deel weinig beweeglijk is en instabiele scheuren met lossere beweeglijke fragmenten die in het gewricht blokkeren.
Indien de klachten te ernstig en invaliderend zijn dat de dagelijkse activiteiten worden verstoord, dan kan men opteren voor een kijkoperatie. De contactvlakken van deze drie beenderen zijn bekleed met een gladde en elastische bekleding : het kraakbeen. Deze menisci zijn in feite een soort schokdempers die mee de belastingsverdeling bij het gebruik van de knie regelen. Verder bevinden zich centraal in de knie ook twee belangrijke gewrichtsbanden: de voorste en de achterste kruisband. De binnenste en buitenste gewrichtsband bevinden zich net buiten de knie en kunnen bij een arthroscopie niet gezien noch behandeld worden. Dit heeft tot gevolg dat na de meeste arthroscopies de knie direct volledig mag bewogen en belast worden. De artroscopie kan gebeuren onder volledige of plaatselijke verdoving (ruggenprik : waarbij de benen verdoofd worden). Een ontstekingsremmer of een eenvoudige pijnstiller (bv dafalgan) wordt U na de ingreep voorgeschreven. Te sterke inspanningen kunnen immers leiden tot vocht in de knie wat de verdere evolutie zal afremmen.
Normaal gezien, afhankelijk van wat er juist bij de arthroscopie gedaan dient te worden en afhankelijk van het soort werk, varieert de werkonbekwaamheid tussen de 2 en de 4 weken.
The menicus acts as a "shock absorber" between your femur (thighbone) and tibia (shinbone). Meniscal tears, also called cartilage tears, occur when the “shock absorber” or the cartilage between the femur (thigh bone) and the tibia (lower leg bone) is injured.
How your orthopaedic surgeon treats your tear will depend on the type of tear you have, its size, and location. It has semilunar (sickle) shape and it’s main purpose is to deepen the relatively flat surface of the upper end of the shin bone. The ability of the meniscus to spread out the force on the joint surfaces as one walks is important because it protects the articular cartilage from excessive wearing.
The entire inner rim of the medial (inner) meniscus can be torn in what is called a bucket handle tear. It involves removing part of the meniscus and suturing or scaffolding a graft, possibly a collagen implant, in the knee to promote the growth of new tissue. We will conduct a thorough examination for a proper diagnosis, and if your condition is treatable with chiropractic care, we will recommend the most appropriate course of treatment.


Georgia Clinic of Chiropractic is one of the few clinics in the Augusta area certified to treat extremities, such as a knee, ankle, or wrist, using the Activator Protocol. There are many different types of lesions that can occur in the meniscus and other structures in the knee such as the anterior cruciate ligament are commonly injured along with the meniscus.
They serve to increase the concavity of the relatively flat tibial plateau in order for a better articulation with the femoral condyles1. Each year, about 60 to 70 per 100,000 individuals sustain a meniscal tear with a higher incidence in males than females4. A patient’s description of his or her symptoms along with the mechanism of injury and select clinical tests have been shown to be more accurate than an MRI in diagnosing a meniscal tear5. Micro-traumatic meniscal injuries have been linked to excessive kneeling For example, a person who kneels for work such as a floor layers are at a greater risk to sustain a micro-traumatic meniscal injury6. The following tests have been shown to be the most reliable when diagnosing a meniscus lesion.
Note that the sensitivity and specificity values are gathered from many studies and are presented in a range due to the different results found by the studies. The examiner passively flexes the patient’s knee to full flexion and as the examiner palpates the joint line, he or she medially rotates the tibia (to test the lateral meniscus) and extends the knee. The patient’s knee is flexed to 90 degrees and the examiner applies an axial load through the tibia as he or she rotates the tibia medially and laterally. The examiner cups the patient’s heel in one of his or her hands and supports under the patient’s knee with the other hand. However, conservative treatment may be indicated for middle-aged patients suffering from degenerative changes in the meniscus10. For example, when there are loose fragments that are impeding the joint’s movement, but are unable to be sutured back onto the rest of the meniscus. The three types of suture techniques are chosen based on the location of the tear and each surgeon’s preference.
Patients are often mobilized quickly after surgery to increase range of motion and will begin weight-bearing exercises to reduce atrophy12.
Soms is er nachtelijke pijn vooral bij scheuren van de binnenmeniscus wanneer men met de knieën op mekaar ligt.
In uitzonderlijke gevallen kan een infiltratietest met een lokaal anesteticum in het gewricht helpen met het onderscheid maken: een antalgische blokkage verdwijnt dan door het pijnstillend effect maar een mechanische bloccage in principe niet (volledig). Bij een geluxeerde hengselscheur is er gewrichtsblokkage en kan de knie niet volledig gestrekt worden. Indien deze omvangrijk wordt kunnen de afvoerende vaten gecomprimeerd worden en kan er zwelling van het onderbeen of een trombose ontstaan.
Een meniscusscheur is zoals gewrichtsbandletsels van de knie NIET zichtbaar op radiografie.
Deze lens staat in verbinding met een camera die op zijn beurt verbonden is met een beeldscherm. Het grote voordeel van arthroscopies is dat de knie niet volledig moet geopend worden en dat daardoor het chirurgisch trauma veel beperkter is dan bij de vroegere ingrepen. In dit geval kan de huisarts een wondcontrole doen en eventueel nieuwe steristrips aanbrengen. Preventieve bloedverdunners worden dan ook enkel gegeven als er duidelijke risicofactoren bestaan.
Without the meniscus, the concentration of force into a small area on the articular cartilage can damage the surface, leading to degeneration, called osteoarthritis. The meniscus can also have a flap torn from the inner rim, or the tear can be a degenerative tear where a portion of the meniscus is frayed and torn in multiple directions. Tears in the meniscus in patients under the age of thirty usually occur as a result of a fairly forceful twisting injury.
Meniscal tears in the older age group occur as a result of a fairly minor injury, even from the up and down motion of squatting.
This surgery is a last resort, and while it generally has good results, non-invasive chiropractic care should be your first choice as it involves a lesser risk of side effects. Click here to watch the story of a local Augusta athlete and how they incorporated their chiropractic care into their training regimen. Conservative treatment may be used for meniscal lesions however, due to the lack of blood supply to most of the meniscus, healing often takes a long time and surgery may be indicated. The lateral meniscus generally attaches to the anterior and posterior aspect of the tibial plateau and the joint capsule2, but some variants of the anatomy show that it attaches to the meniscofemoral ligaments of Wrisberg and Humphrey, as well as the popliteal ligament allowing it to have more motion than the medial meniscus3. The symptoms typically present in a patient with a meniscus tear are knee “catching” or “locking”, limited joint mobility about the knee, daily pain lasting more than one month, effusion (swelling), a feeling of instability in the knee and tenderness around the joint line5. Macro-traumatic injuries to the meniscus are often sustained during pivoting, twisting while weight-bearing, or extreme valgus or varus force to the non-weight-bearing leg4. However, it is important to note that not one single test by itself is reliable enough to definitively indicate the presence of a tear. The test is repeated with lateral rotation of the tibia in order to test the medial meniscus. The patient’s knee is then passively flexed, and the extended in one quick motion by the examiner releasing the hand that is supporting on the back of the knee.
Conservative treatment consists of RICE (rest, ice, compression and elevation), non-steroidal anti-inflammatory drugs, as well as stretching and strengthening of the lower extremity muscles and proprioceptive exercises to minimize the biomechanical factors that may be adding to the degeneration of the meniscus4.
Previously, surgeons would completely remove the meniscus when it was torn (total meniscectomy), but over time, physicians realized that this caused more damage to the underlying cartilage and resulted in a higher incidence of osteoarthritis11. The inside-out technique is the most popular technique as it can be used to treat all types of tears.
When a patient undergoes an ACL reconstruction at the same time as meniscal repair, he or she will likely follow the rehabilitation protocol designed for the ACL reconstruction, but may wear a brace that locks the knee into extension during weight-bearing and will be advised to avoid hyperflexion of the knee11.


History, clinical findings, magnetic resonance imaging, and arthroscopic correlation in meniscal lesions. Occupational kneeling and meniscal tears: A magnetic resonance imaging study in floor layers. Anatomy and physical examination of the knee menisci: A narrative review of the orthopedic literature. Arthroscopic or conservative treatment of degenerative medial meniscal tears: A prospective randomised trial. Depending on the level of injury on the meniscus , surgeon will then recommend or to advise on the suitable treatment.
Bij een traumatische scheur van de rand van de buitenmeniscus kan een bloeduitstorting in het gewricht aanwezig zijn. In dit geval is het ook best de knie niet te veel te plooien tot de insteekgaatjes droog zijn. Treedt er toch een pijnlijke belangrijke zwelling van het onderbeen richt u dan tot uw huisarts of orthopedisch chirurg om een trombose uit te sluiten. Even a small twist when getting up from a chair may be enough to cause a degenerative meniscus tear. Degenerative tears of the meniscus are commonly seen as a part of the overall condition of osteoarthritis of the knee in the older population.
Due to this movement, the lateral meniscus is more likely to follow the contours of the lateral femoral condyle and is therefore less likely to be injured than the medial meniscus which is firmly attached anteriorly and posteriorly to the tibia and joint capsule2.
Macrotraumatic injuries (acute trauma) to the meniscus occur most commonly in males between the ages of 21 and 30, and in females between 11 and 20 years old3. A medial meniscus lesion is often a concomitant injury associated with chronic ACL tears while a lateral meniscus lesion may be sustained during an acute ACL lesion4. One meta-analysis7 has found joint line tenderness to be the most accurate test in diagnosing meniscal pathology, but the most reliable diagnosis comes from a combination of performing joint line palpation, McMurray’s Test and Apley’s Compression test. A positive sign would be a snap or click felt by the examiner, or a pain response by the patient. A positive sign is indicated if, during the compression test, the examiner notices any restriction in movement compared to the unaffected side, or if the patient reports pain. A positive sign is indicated by a sharp pain felt along the joint line which may radiate throughout the leg.
In a prospective randomized trial, Herrlin et al.10 found that exercises such as calf raises, lunges, hamstring curls, long arc quads, stair walking, rocker board balance, stationary biking, and stretching of the knee flexors and extensors over an 8 week time period produced the same amount of improvement as arthroscopic surgery in a population of middle-aged patients with degenerative damage to the meniscus.
The disadvantages of this technique include the fact that an extra incision needs to be made and the neurovascular structures around the knee such as the peroneal nerve, popliteal artery, popliteal vein and tibial nerve on the lateral side, and branches of the saphenous nerve on the medial side are at risk of becoming damaged. Weight-bearing in the extended position reduces the chance that the meniscus repair will fail because in flexion, the menisci undergo more shearing forces and have a greater chance of pulling the sutures apart12. There are different treatments depending on condition which Dr.Kevin yip will advise during the consultation, if there is a need for a treatment or surgery. Cysten kunnen ook aan de rand van de meniscus ontstaan en voelbaar zijn aan binnen-of buitenzijde ter hoogte van de gewrichtsspleet. Het kniegewricht wordt gevuld met een zoutoplossing om ruimte te krijgen zodat in de knie kan gewerkt worden en om een continue spoeling van het gewricht te verkrijgen. In many cases, there is no one associated injury to the knee that leads to the meniscal tear. The blood supply to the meniscus is provided by the medial and lateral geniculate arteries, however only the outer 10-30% of the menisci is vascularized1. Microtraumatic injuries (degeneration) are seen most commonly in men 40-70 years old and in females consistently after 20 years old3. MRI may also be used to aid in diagnosis of a meniscal lesion, but the accuracy of this exam is greatly debated5. If pain is noted during the distraction test as well, this may be indicative of a ligamentous injury.
It is important to note that surgery may still be indicated if conservative treatment is ineffective. Extreme skill is required in the positioning of the instruments in order to preserve these structures and reduce the chance of complications. A typical rehabilitation program will last about 8 weeks and will consist of closed-chain quadriceps strengthening, ankle pumps, electrical stimulation for muscle reeducation, and stretching for the first few weeks progressing to walking, swimming, stair climbing, and eventually running, jumping and plyometric training12.
SamuelsonBilateral Knee Replacement Back in Action Story, One Year Later- Operation Walk USA- Dr. This is an important consideration when treating meniscus lesions because based on the location of the tear, the cartilage may take a greater amount of time to heal. In order to return to sport-related activities, it is recommended that the patient achieve 120 degrees of flexion and 80% strength of the lower extremity as compared to the unaffected side12. Without the meniscus, the round femur would be able to slide on top of the flat tibial surface.
There are three “zones” in the meniscus and they are classified based on the amount of blood supply to the area4.
An all-inside technique may be chosen for an unstable tear of the posterior horn of the meniscus in a longitudinal vertical fashion. The “red-red zone” is located on the very outer edge of the meniscus and receives the most blood. The “white-white” zone is the innermost aspect of the meniscus and comprises the avascular portion.



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