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Meniscus injury-suspected

Meniscal tears have been estimated to affect 60–70 per 100,000 of the population.  They can affect younger patients with higher functional demand as well as older patients who may have pre-existing degeneration in the knee.

In the absence of mechanical symptoms of locking, most patients presenting with a suspected meniscal injury should first undergo at least three months of nonoperative treatment. For patients not responding to this nonoperative treatment an orthopaedic referral should be considered.

Signs

  • Post trauma or twisting mechanism of injury
  • Prolonged hyperflexion of the knee
  • Increased BMI
  • Poor lower limb control
  • Localised pain over the joint line or posterior joint
  • Feeling of catching
  • Locking

Tests

  • Positive duck walk,
  • Positive Thessaly’s
  • Positive Mcmurrys
  • Pain on squatting
  • Age 15-30

Possibly lacking full range of movement 

Management

  • X-ray
  • Conservative trial of Physiotherapy for 12 weeks
  • Activity modification
  • Weight loss
  • If true locking and blocked movement then immediate referral onto orthopaedics