{"id":5879,"date":"2021-06-01T12:52:32","date_gmt":"2021-06-01T10:52:32","guid":{"rendered":"https:\/\/www.physiotutors.com\/?post_type=clinical_pattern&#038;p=5879"},"modified":"2024-03-04T12:02:21","modified_gmt":"2024-03-04T11:02:21","slug":"meniscus-tear","status":"publish","type":"clinical_pattern","link":"https:\/\/www.physiotutors.com\/clinical-patterns\/meniscus-tear\/","title":{"rendered":"Meniscus Tear"},"featured_media":5881,"template":"","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":""},"tracking_tag":[2197],"class_list":["post-5879","clinical_pattern","type-clinical_pattern","status-publish","has-post-thumbnail","hentry","tracking_tag-knee"],"acf":{"free_access":"unfree","app_link":"https:\/\/app.physiotutors.com\/add-ons\/43d74ec5-14ec-4307-94fb-4d08d6cdd3fa","sections":[{"acf_fc_layout":"page-header-detail-page","background":{"background_image":5882,"background_image_alt_text":"Meniscus Tear"},"heading":"Meniscus Tear","subheading":"Meniscus Tear","content_editor":"","button_type":"internal_link","button_label":"","button_style":"button-one","button_internal_link":"","button_anchor":"","button_url":"","button_file":null,"label":""},{"acf_fc_layout":"submenu","links":[{"button_type":"anchor","button_label":"Body Chart","button_internal_link":null,"button_anchor":"section-number-3","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Background Information","button_internal_link":null,"button_anchor":"section-number-4","button_url":"","button_file":null},{"button_type":"anchor","button_label":"History & Physical Examination","button_internal_link":null,"button_anchor":"section-number-5","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Treatment","button_internal_link":null,"button_anchor":"section-number-6","button_url":"","button_file":null},{"button_type":"anchor","button_label":"References","button_internal_link":null,"button_anchor":"section-number-8","button_url":"","button_file":null}],"dropdown_label":"Go to","button_right":{"button_type":"internal_link","button_label":"","button_style":"button-link-one","button_internal_link":"","button_anchor":"","button_url":"","button_file":null},"button_description":""},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h2 class=\"heading-four\">Body Chart<\/h2>"},"column_right":{"content_editor":"<img class=\"alignnone wp-image-5880 size-full\" src=\"https:\/\/www.physiotutors.com\/wp-content\/uploads\/2021\/06\/meniscus-tear-pain-diagram.png\" alt=\"Meniscus tear pain diagram\" width=\"1206\" height=\"1128\" \/>\r\n<ul>\r\n \t<li>At height of the joint line (medial or lateral)<\/li>\r\n<\/ul>"}},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h2 class=\"heading-four\">Background Information<\/h2>"},"column_right":{"content_editor":"<h3>Patient Profile<\/h3>\r\n<ul>\r\n \t<li><span lang=\"EN-US\">Acute injury rather in young people engaging in sports<\/span><\/li>\r\n \t<li><span lang=\"EN-US\">Degenerative tears in older people without trauma in history<\/span><\/li>\r\n<\/ul>\r\n<h3><\/h3>\r\n<h3>Pathophysiology<\/h3>\r\nAcute: Hyperextension trauma or flexion-rotation-trauma under load (sports, work, ADL)\r\n\r\nDegenerative changes over the years and repetitive normal movement without trauma\r\n\r\n&nbsp;\r\n\r\n<strong>Acute: Pain- and tissue healing mechanisms align\r\n<\/strong>Inflammation phase: Dominant inflammatory nociceptive: signs of inflammation, night pain, pulsating, immobilization leads to stiffness, sometimes increases with rest\r\n\r\nProliferation phase: Dominant mechanical nociceptive: clear on\/off behavior, load dependent pain, local, decreases with rest\r\n\r\n&nbsp;\r\n\r\n<strong>Chronic: Pain- and tissue healing mechanisms do not align\r\n<\/strong>Dominant mechanical nociceptive: clear on\/off behavior, load dependent pain, local, decreases with rest\r\n\r\n&nbsp;\r\n<h3>Course<\/h3>\r\n<strong>Aggravating\r\n<\/strong>Acute: Pain is movement dependent \u2013 Flexion\/extensionChronic: Under increasing load \u2013 Compression &amp; shear forces\r\n\r\n<strong>Easing\r\n<\/strong>Acute: Rest, icingChronic: Reduce activities, avoid overload &amp; shear forces\r\n\r\n<strong>24 Hour\r\n<\/strong>Acute: Night pain due to local inflammation\r\nChronic: More pain at night, possible intraarticular swelling"}},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h2 class=\"heading-four\">History &amp; Physical Examination<\/h2>"},"column_right":{"content_editor":"<h3>History<\/h3>\r\nHistory of knee trauma; knee exposed to high loads in work, sport, ADL Usually trauma; older patients also inadequate trauma (degenerative tear)\r\n<ul>\r\n \t<li>\u201cGiving way\u201d possible but not main symptom<\/li>\r\n \t<li>Typically no feeling of instability<\/li>\r\n \t<li>Acute: Locking in Flex\/Ext, limited ROM, local pain, stinging, deep<\/li>\r\n \t<li>Chronic: Degeneration pain, \u201ccracking\u201d or \u201cpopping\u201d, dull pain<\/li>\r\n<\/ul>\r\n&nbsp;\r\n<h3>Physical Examination<\/h3>\r\n<strong>Inspection<\/strong>Acute: Signs of inflammation medial side, possible hemarthrosis, intraarticular swelling, protective postureChronic: Quadriceps\/gastrocnemius atrophy, barely any swelling\r\n\r\n<strong>Functional Assessment<\/strong>Acute: not possible due to symptomsChronic: Deep squat, climbing stairs, cutting motion, \u201cgiving way\u201d rather described than demonstrated\r\n\r\n<strong>Active Examination<\/strong>Acute: limited ROM in Flex\/Ext\/Rot and pain upon small loadChronic: end of range limitation in Flex\/Ext; high loads in combination with these movements is painful.\u00a0B<span lang=\"EN-US\">alance problems \u2013\u00a0<\/span><span lang=\"EN-US\">single leg stance, step-up<\/span>\r\n\r\n<strong>Passive Examination<\/strong>Acute: PROM limited, swellingChronic: End or range ROM can be limited, structural instability apparent\r\n\r\n<strong>Special Testing<\/strong>\r\n\r\n[embed]https:\/\/youtu.be\/lwDFPAyGGgI[\/embed]\r\n\r\n[embed]https:\/\/youtu.be\/6Z_9lfX_Pc8[\/embed]\r\n<h3>Differential Diagnosis<\/h3>\r\n<ol>\r\n \t<li>Subchondral injury<\/li>\r\n \t<li>Damaged cartilage<\/li>\r\n \t<li>Gonarthrosis<\/li>\r\n \t<li>Avulsion fracture biceps femoris<\/li>\r\n \t<li>Tibial plateau fracture<\/li>\r\n \t<li>Unhappy triad<\/li>\r\n \t<li>Pes anserinus irritation<\/li>\r\n \t<li>Patella luxation<\/li>\r\n \t<li>PFPS<\/li>\r\n \t<li>Quadriceps tendon rupture<\/li>\r\n \t<li>Patella tendon rupture<\/li>\r\n \t<li>Osgood Schlatter<\/li>\r\n<\/ol>"}},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h2 class=\"heading-four\">Treatment<\/h2>"},"column_right":{"content_editor":"<h3><strong>Strategy<\/strong><\/h3>\r\nConservative: coper, isolated injury, &gt;45 years old, linear sportsSurgical: non-coper, multidirectional injury, &lt;45 years old, high risk sports\r\n\r\n&nbsp;\r\n<h3><strong>Interventions<\/strong><\/h3>\r\nPost-OP: Adapt interventions\/load to tissue healing phasesConservative: Identify deficits in strength, neuromuscular control, passive structuresPrinciples: concentric before eccentric, slow to fast, low load + high rep to high load + low rep, two-legged to one-legged, pay attention to sport specific demands"}},{"acf_fc_layout":"cta-big","heading":"Download the new Physiotutors App","subheading":"PHYSIOTUTORS APP","content_editor":"Are you ready for a learning revolution?\r\n\r\nExperience the Physiotutors content you love in our new app.","form_toggle":false,"form":"92","number_of_buttons":"one","button_1":{"button_1_button_type":"internal_link","button_1_button_label":"DOWNLOAD NOW","button_1_button_style":"button-two","button_1_button_internal_link":16662,"button_1_button_anchor":"","button_1_button_url":"","button_1_button_file":null},"button_2":{"button_2_button_type":"internal_link","button_2_button_label":"","button_2_button_style":"button-one : 1","button_2_button_internal_link":null,"button_2_button_anchor":"","button_2_button_url":"","button_2_button_file":null},"image":17728,"image_alt_text":"","overlay":false},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h2 class=\"heading-four\">References<\/h2>"},"column_right":{"content_editor":"<ol>\r\n \t<li>Elbaz, A., Beer, Y., Rath, E., Morag, G., Segal, G., Debbi, E. M., Debi, R. (2013). A unique foot-worn device for patients with degenerative meniscal tear. Knee Surg Sports Traumatol Arthrosc, 21(2), 380-387. doi: 10.1007\/s00167-012- 2026-2<\/li>\r\n \t<li>Goossens, P., Keijsers, E., van Geenen, R. J., Zijta, A., van den Broek, M., Verhagen, A. P., Scholten-Peeters, G. G. (2015). Validity of the Thessaly test in evaluating meniscal tears compared with arthroscopy: a diagnostic accuracy study. J Orthop Sports Phys Ther, 45(1), 18-24, B11. doi:10.2519\/jospt.2015.5215<\/li>\r\n \t<li>Howell, R., Kumar, N. S., Patel, N., Tom, J. (2014). Degenerative meniscus: Pathogenesis, diagnosis, and treatment options. World J Orthop, 5(5), 597-602. doi: 10.5312\/wjo.v5.i5.597<\/li>\r\n \t<li>Katz, J. N., Brownlee, S. A., Jones, M. H. (2014). The role of arthroscopy in the management of knee osteoarthritis. Best Pract Res Clin Rheumatol, 28(1), 143-156. doi: 10.1016\/j.berh.2014.01.008<\/li>\r\n \t<li>Lange, A. K., Fiatarone Singh, M. A., Smith, R. M., Foroughi, N., Baker, M. K., Shnier, R., Vanwanseele, B. (2007). Degenerative meniscus tears and mobility impairment in women with knee osteoarthritis. Osteoarthritis Cartilage, 15(6), 701-708. doi:10.1016\/j.joca.2006.11.004<\/li>\r\n \t<li>Neogi, D. S., Kumar, A., Rijal, L., Yadav, C. S., Jaiman, A., Nag, H. L. (2013). Role of nonoperative treatment in managing degenerative tears of the medial meniscus posterior root. J Orthop Traumatol, 14(3), 193-199. doi: 10.1007\/s10195-013-0234-2<\/li>\r\n \t<li>Noyes, F. R., Heckmann, T. P., Barber-Westin, S. D. (2012). Meniscus repair and transplantation: a comprehensive update. J Orthop Sports Phys Ther, 42(3), 274-290. doi: 10.2519\/jospt.2012.3588<\/li>\r\n \t<li>Powers, C. M. (2010). The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. J Orthop Sports Phys Ther, 40(2), 42-51. doi: 10.2519\/jospt.2010.3337<\/li>\r\n \t<li>Snyder-Mackler, L., Risberg, M. A. (2011). Who needs ACL surgery? An open question. J Orthop Sports Phys Ther, 41(10), 706-707. doi: 10.2519\/jospt.2011.0108<\/li>\r\n \t<li>Stensrud, S., Roos, E. M., Risberg, M. A. (2012). A 12-week exercise therapy program in middle-aged patients with degenerative meniscus tears: a case series with 1-year follow-up. J Orthop Sports Phys Ther, 42(11), 919-931. doi:10.2519\/jospt.2012.4165<\/li>\r\n \t<li>Zazulak, B. T., Hewett, T. E., Reeves, N. P., Goldberg, B., &amp; Cholewicki, J. (2007). Deficits in neuromuscular control of the trunk predict knee injury risk: a prospective biomechanical-epidemiologic study. Am J Sports Med, 35(7), 1123-1130. doi: 10.1177\/0363546507301585<\/li>\r\n<\/ol>"}}]},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Meniscus Tear - Physiotutors<\/title>\n<meta name=\"description\" content=\"Learn about the diagnosis, prognosis and treatment of Meniscus Tears in our Clinical Pattern for Physiotutors Members\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.physiotutors.com\/clinical-patterns\/meniscus-tear\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Meniscus Tear - Physiotutors\" \/>\n<meta property=\"og:description\" content=\"Learn about the diagnosis, prognosis and treatment of Meniscus Tears in our Clinical Pattern for Physiotutors Members\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.physiotutors.com\/clinical-patterns\/meniscus-tear\/\" \/>\n<meta property=\"og:site_name\" content=\"Physiotutors\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/facebook.com\/physiotutors\" \/>\n<meta property=\"article:modified_time\" content=\"2024-03-04T11:02:21+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.physiotutors.com\/wp-content\/uploads\/2021\/06\/meniscus-tear-featured-image.png\" \/>\n\t<meta property=\"og:image:width\" content=\"560\" \/>\n\t<meta property=\"og:image:height\" content=\"466\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:site\" content=\"@physiotutors\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.physiotutors.com\\\/clinical-patterns\\\/meniscus-tear\\\/\",\"url\":\"https:\\\/\\\/www.physiotutors.com\\\/clinical-patterns\\\/meniscus-tear\\\/\",\"name\":\"Meniscus Tear - 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