The meniscus is a rubbery, flexible piece of cartilage that provides cushioning between the bones in the knee, and is essential to a health knee joint.
The meniscus acts as a shock absorber and helps stabilize the joint, and any injury to the meniscus can impact the joint and increase load on the cartilage predisposing patients to developing osteoarthritis.
Meniscus tears are among the most common knee injuries, and anyone at any age can tear the meniscus. Tears can occur from acute trauma or as a result of degenerative changes that happen over time. When people talk about "torn cartilage" in the knee, they are usually referring to a torn meniscus.
Patients may feel a "pop" when you tear the meniscus, and usually the joint will swell and become more stiff and swollen.
The most common symptoms of a meniscus tear are:
In addition to examining the joint, x-rays may show narrowing of the joint or bone spurs if there is degenerative changes and associate arthritis. A MRI or ultrasound is often needed to confirm the diagnosis.
Symptomatic meniscal tears are often treated with activity
modification, bracing, physical therapy and injections. In cases that do
to therapy, different meniscal repair techniques have also been described and typically fall into 2 categories: repair of the meniscus or meniscectomy. These surgeries are not without complications and may predispose the joint to early-onset arthritis.
Regenerative medicine is a potential alternative to joint replacement surgery, including viscous supplementation or hyaluronic acid injections, platelet rich plasma (PRP) injections or autologous stem cell injections.
Autologous platelet rich plasma (PRP) injections release multiple growth factors, cytokines and other signaling proteins that play an important role in healing. PRP has been shown to help partially or full heal the meniscus on MRI in 60% of patients.
Adult mesenchymal stem cells derived from bone marrow aspirates showed evidence of meniscus regeneration and improved pain
Lipogems or micro-fragmented adipose tissue (MFAT) injections include mesenchymal stem cells (MSCs) harvested from adipose tissue and act as trophic mediators to stimulate differentiation of tissue intrinsic stem cells or reparative cells. MFAT has shown encouraging results as a lipofiller in degenerative meniscal tears.