The treatment for a miniscule tear depends
on the size of the tear, whether it’s unstable, whether it’s associated with other ligamentous
injuries such as an ACL ligament injury and whether it’s causing any locking or jamming
of the knees or mechanical symptoms. We normally get an MRI scan of the knee before deciding
on what’s the best way forward and what’s the best treatment. The initial treatment
in all stages, in all cases, should involve rest, ice, compression and elevation of the
knee. We then get an MRI scan and we assess the type of tear, the size of the tear, the
location of the tear, whether it’s unstable or not and whether there are any other associated
structures that are injured, and we ask the history about whether there are episodes of
locking or the knee giving way and based on that we decide on whether this needs intervention.
Normally tears that are due to wear and tear which usually occur at the back of the meniscus,
usually the medial side, are treated conservatively unless they’re unstable or associated with
locking episodes. The more complex tears or the unstable tears are associated with the
ACL injury. We try to either repair them or we debride them if they’re not repairable.
By doing that, we try and preserve as much of the knee function especially by repairing
the meniscus which is associated to the lower incidence of arthritis or wear and tear in
the long term. So, it all depends on the type of tear, the location of the tear, whether
it’s stable or unstable, weather there’s associated locking or mechanical symptoms.