Small tear, big problem

2015; Right fielder Chris Coghlan (8) slides into the left knee of Pittsburgh Pirates shortstop Jung Ho Kang (27) Credit: Charles LeClaire-USA TODAY Sports / Reuters Picture Supplied by Action Images

Meniscal tears are fairly run of the mill in athletic populations. However, as Chris Mallac explains in our continuing series on uncommon injuries, a tear near the root, or attachment of the meniscus, results in severe pain and disability. Root tears often accompany other knee injuries such as anterior or posterior cruciate ligament tears. Because the roots anchor the meniscus in place, when torn, the meniscus can extrude from the joint, resulting in painful bone on bone contact (see figure 1). Athletes complain of pain along the joint line and during deep squats.

As Mallac points out, diagnosis usually requires magnetic resonance imaging (MRI). Rarely managed conservatively, these tears usually require surgery, due to the increased risk of developing arthritis. Initiate physical therapy immediately post operatively to regain strength and progress joint movement. Most recommend limiting knee flexion to 90 degrees for the first two weeks after the surgery, and progressing the range of motion as tolerated after that time. Initiate weight bearing as tolerated and begin cycle ergometer after six weeks. The entire rehab process may last up to six months, with return to play even further beyond that. Watch for next month’s article with a continuation of this topic, emphasizing rehab protocols and return to play criteria.

Figure 1: Meniscal root tears


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