Medial meniscus (cartilage) problems are very much more common than the lateral ones. I will describe the medial one.

HISTORY

The cartilage will only be injured while the knee is in flexion (bent). The history tends to be the same i.e.

1. The foot was on the ground at the time of injury.

2. The knee was bent.

3. There was an inward rotation of the thighbone on the bent and outward rotated tibia and this is usually followed by a sudden straightening of the knee.

These circumstances open up the joint on the inner side and the medial meniscus is drawn into the joint between the joint surfaces.

SIGNS

Afterwards there will be swelling of the knee. The knee will be locked in a bent position. The gait will be characteristic of the injury. The person is unable to fully straighten the knee so the weight is taken on the forefoot and will walk with the knee partly bent. There will be acute pain at the front inner aspect of the joint especially when you try to straighten the knee.

TREATMENT

A practitioner needs to exercise great care when dealing with meniscus problems. A straightforward displacement may be reduced quite easily. However, if the meniscus is displaced again too easily, it is advisable to see your doctor for orthopaedic referral. It is almost a certainty that you are dealing with a bucket-handle tear and repeated reduction is laying the patient open to problems later on.