This leads to decreased contact area and increased contact pressure and ultimately results in joint overloading and degenerative changes in the knee similar to a total meniscectomy state. The meniscus is a piece of rubber-like cartilage in the knee situated within the femur and tibia, or thigh bone and shin bone. A gradient-echo T2*-weighted sagittal image demonstrates a tear within the posterior horn of the medial meniscus (arrow). Meniscal tears are categorised as traumatic or non-traumatic (degenerative) on the basis . Barrett GR, Field MH, Treacy SH, Ruff CG. Skeletal Radiol 2007;36:14551. These tendons have poor blood supply and will not heal themselves. 1993;9(1):33-51. Torn meniscus symptoms Symptoms are usually sudden onset, however, can develop gradually over time. Depending on the cut thickness, axial MRI images may display the root tear (Figure 3). Because of their importance and the clinical impact of meniscal tears, assessment of the menisci has become the most common indication for MR of the knee. The described meniscal tears will lead to possible necessary total knee replacement. Types of meniscus tears:(Left) Bucket handle tear. Displacement of the inner rim of the tear (arrowheads) results in the classic "bucket-handle" configuration. what is the treatment for that? This is because this area has rich blood supply and blood cells can regenerate meniscus tissue or help it heal after surgical repair. The degenerative aetiology and reduced vascularisation secondary to ageing also means that meniscal tears in the elderly population are less likely to be amenable to surgical management;7 only about 6% of patients over 40 years of age have operable lesions.24 To prevent re-injury of the meniscus, activity modification is important for example, ceasing sports such as soccer or netball. Those that extend through the entire width of the meniscus are particularly harmful (16a,16b), and even if such tears appear stable following repair, they are unlikely to regain the ability to provide hoop stress to the meniscus.13 Radial tears have therefore classically been treated with partial meniscectomy, though evolving surgical techniques have led to successful reports of the repair of radial tears that communicate with the meniscal periphery.11 A recent report has even described the successful repair of radial tears of the medial meniscal root,14 utilizing a tibial tunnel through which sutures are placed in the avulsed meniscus, a technique similar to that used in patients undergoing meniscal transplantation. The medial meniscus is more frequently torn, partly because of this different shape but also because of its attachment to the medial collateral ligament, whereas the lateral is pulled out of the way of compression between femur and tibia by politeus. (Right) Degenerative tear. A high level of suspicion is required to detect these injuries, and repair is recommended to preserve joint function. In comparison , however, meniscal root tears (MRTs) often go unnoticed and represent a unique injury pattern with unique biomechanical consequences. A comparative study with a short term follow up. Without nutrients from blood, tears in this "white" zone with limited blood flow cannot heal. The Thessaly test is the most sensitive and specific clinical test to diagnose meniscal injury. Meniscal pain occurs during torsional, weight bearing knee movements (classically pivoting on the knee while walking) as a sharp stab lasting several seconds, often followed by a dull ache for several hours. Of note, drilling tibial tunnels may improve healing of the meniscus-bone interface due to the presence of progenitor cells and growth factors derived from the bone marrow. Orthop Clin North Am. Includes interactive tool to help you decide. Arthroscopy. We have also seen complete meniscal root avulsions in the cruciate ligament-injured knee with complete injury of the medial ligament and posterior oblique ligament that opens in full extension. Because these two tear patterns differ greatly in prognosis and treatment approach, vertical is therefore not the preferred descriptor for such meniscal tears, unless paired with the proper category, such as vertical longitudinal. Medial meniscal root tears: Fix it or leave it alone Orthopedics Today | Medial and lateral menisci are crescent-shaped fibrocartilage structures that provide joint congruity, stabilization and. A tear of the anterior horn of the lateral meniscus is damage to the front part of one of the two structures that act as shock absorbers between the thigh bone and the lower leg, explains The Steadman Clinic. If your symptoms persist with nonsurgical treatment, your doctor may suggest arthroscopic surgery. Many tears are repaired with dartlike devices that are inserted and placed across the tear to hold it together. Treatment or management protocols for posterior horn menial meniscus tears are quite challenging. . Coronal proton weighted MRI of horizontal tear of lateral meniscus (white arrow) with complicating ganglion (black arrow) at the lateral margin of the meniscus, Australian Family Physician was the peer-reviewed, scholarly journal of The Royal Australian College of General Practitioners (RACGP) from 1971 to 2017. As stated above, the most common cause of Posterior Horn Medial Meniscus Tear can be trauma to the knee which can be sustained due to a sporting injury, a slip and fall, a blunt trauma to the knee, and in majority of the cases natural degeneration of the meniscus due to the work load of the knee. Following root repair, patients are required to remain non-weight-bearing for 6 weeks. The medial meniscus is an important structure that provides stability, dissipates force and assists to provide normal kinematics of the knee. A meniscus can be split in half, ripped around its circumference in the shape of a C or left hanging by a thread to the knee joint. This "C" shaped cartilage helps disperse impact and displace force exerted upon the knee while walking, running, and other mild to high-energy and impact motions. If you have a follow-up appointment, write down the date, time, and purpose for that visit. https://www.verywellhealth.com/types-of-meniscus-tears-3862073 The most commonly encountered signs are posterior knee pain with deep flexion and joint line tenderness. The first one is traumatic and the second one is a degenerative meniscal tear. Meniscal tears are the most common lesions followed by the meniscal cyst. Skeletal Radiology 2004; 33:260-264. Sekiya JK, West RV, Groff YJ, Irrgang JJ, Fu FH, Harner CD. Arthroscopic repair of meniscal tears extending into the avascular zone in patients younger than twenty years of age. Arnoczky SP, Warren RF, Spivak JM. Strengthening exercises will gradually be added to your rehabilitation plan. Meniscal root tears, less common than meniscal body tears and frequently unrecognized, are a subset of meniscal injuries that often result in significant knee joint disorders. AJSM 2003; 31:216-220. A longitudinal tear is an example of this kind of tear. The medial meniscus has a firmer capsular attachment than the lateral meniscus. The posterior horn it the back portion of the menisci at the end of the curve, where it tapers . Meniscal tears are common sports-related injuries in young athletes and can also present as a degenerative condition in older patients. Reciprocally, an increased force is also placed on an ACL graft with a deficient medial meniscus. This pattern of tear requires resection to prevent propagation of the tear as the flap gets caught within the joint during flexion. Currently, routine MR images do not reveal signal intensity differences between the red and white zones of the menisci. Gillquist J, Hamberg P, Lysholm J. Endoscopic partial and total meniscectomy. meniscal tear / avulsion off tibial plateau CIRCUMFERENTIAL FIBERS basicall equivalent to a total meniscetyomy - try to repair these at all cost! Surgery is typically the only option and works to trim the damaged portion of the meniscus. On MRI, meniscal tears are evident as a linear signal intensity that extends through the meniscal substance to a free edge17 (Figure 4). 17 Old Kings Road N., Suite K Palm Coast, FL 32137, East Coast Surgery Center This tear is usually best seen on the coronal T2-weighted MRI scan (see figure 1), where a fragment of meniscus (black in appearance) is stuck between the medial tibial plateau and the overlying medial collateral ligament.This tear pattern tends to be persistently painful, as the meniscal fragment becomes entrapped between bone and the adjacent soft tissues. Referral is also indicated if the diagnosis is uncertain for review and to access MRI. The preferred nomenclature for this tear pattern is: A gradient-echo T2*-weighted sagittal image, A. The medial meniscus is on the innermost side of your knee (the C-shaped curve faces in toward your body, the opposite knee). Horizontal tears can be sewn together rather than removing the damaged portion. With the realization that even partial meniscectomy leads to accelerated osteoarthritis,2 surgeons have increasingly turned to meniscal repair. Think before you speak. A meniscus tear is an injury to one of the bands of rubbery cartilage that act as shock absorbers for the knee. So the injury as seen in MRI scan means there is an tear in the medial meniscus towards the posterior side, that is towards the back of joint. In some cases, a meniscal repair may also be possible, though this is dependent on the size and location of the tear. Tell your doctor of any recurrent swelling or of your knee repeatedly giving way. Difficulty straightening your knee fully. You will start with exercises to improve your range of motion. As orthopaedic surgeons increasingly consider meniscal repair, accurate pre-operative assessment with MR becomes more important, allowing proper planning on the part of both the surgeon and the patient. Fat-suppressed coronal images demonstrate before and after images following repair of a bucket handle tear. They may not even be apparent with an arthroscopic examination. Top answers from doctors based on your search: Created for people with ongoing healthcare needs but benefits everyone. Disclosures: Blake and Johnson report no relevant financial disclosures. Parrot Beak Tear: MRI The surgery requires a few small incisions and takes about an hour. Disclosures: LaPrade reports he is a consultant for and receives royalties from Arthrex, Ossur and Smith & Nephew. All material on this website is protected by copyright. (3a) A fat-suppressed proton density-weighted axial image through the knee joint demonstrates the C-shaped menisci. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. Biologics injections, such as platelet-rich plasma (PRP), are currently being studied and may show promise in the future for the treatment of meniscus tears. ICD 9 Codes: 717.4 derangement of the lateral meniscus 717.3 derangement of the medial meniscus 836.0 lateral meniscus tear 836.1 medial meniscus tear Case Type / Diagnosis: Functional Anatomy: The menisci are semi lunar shaped cartilages on the medial and lateral sides of the knee joint. The meniscus comma sign has been described for displaced flap tears of the meniscus. This is the most common type of meniscus tear. Likewise, physical exam findings of an effusion, a positive McMurray test and a positive Apley grind test are not usually present. Knees with a deficient medial meniscus and an ACL tear have an increased anterior tibial translation of about 60% at 90 of flexion. Mri of knee shows "oblique tear posterior horn medial meniscus, lateral patellar plica and minimal synovial knee effusion" will i need surgery? The posterior horn is located on the back half of the meniscus. Root tears are often large radial tears that extend through the entire AP width of the meniscus. Oblique tears give rise to flaps which are mechanical unstable and associated with mechanical symptoms. Clin Orthop Related Res 2010;468:11902. Each knee joint has two crescent-shaped cartilage menisci. Garrett WE Jr, Swiontkowski MF, Weinstein JN, et al. Grade 3 meniscus tears usually require surgery, which may include: Tips to help you get the most from a visit to your healthcare provider: Cedars-Sinai has a range of comprehensive treatment options. can he still play tennis with this injury? This technique allows for anatomic reduction and fixation of the meniscal root by restoring the joint contact pressure and area similar to the intact state. Submission to the Department of Health and Ageing. Nonsteroidal anti-inflammatory drugs (NSAIDs), Inability to move your knee through its full range of motion. Rehabilitation time for a meniscus repair is about 3 to 6 months. Other nonsurgical treatment. Physical therapy should start immediately after surgery and include early passive range of motion from 0 to 90 for the initial 2 weeks and progress to full range of motion thereafter. Nonsteroidal anti-inflammatory drugs (NSAIDs). Usually you will be able to leave the hospital the same day. w/severe pain? In addition to the root tear, the MRI often shows chondral loss or fissuring, other areas of meniscal tearing, bone marrow edema or osteophyte formation (Figure 5). True locking is less common, and suggests a bucket-handle tear, with the torn fragment preventing full extension. If mechanical symptoms are present in this subset of patients, a partial or subtotal meniscectomy may improve symptoms; although, these tears are not usually associated with traditional meniscal-based mechanical symptoms. The meniscus can tear from acute trauma or as the result of degenerative changes that happen over time. Medial and lateral menisci are crescent-shaped fibrocartilage structures that provide joint congruity, stabilization and lubrication and act as shock absorbers for joint preservation. When small, conservative therapy or simply rasping the meniscus may result in healing of these tear types. Most oblique meniscus tears are happen in the posterior third of the medial meniscus. The meniscus root attachment aids meniscal function by securing the meniscus in place and allowing for optimal shock-absorbi Superior and inferior branches of the medial and lateral geniculate arteries supply the peripheral third of the menisci via the perimeniscal capillary plexus.3,4, Meniscal tears occur due to a shear force between the femur and tibia. Absence of the medial meniscus (entire medial meniscal root tear) places large stresses on the ACL, the primary ligament that prevents anterior translation of the knee. They will also consider the type, size, and location of the injury. This information is provided as an educational service and is not intended to serve as medical advice. Apley test (grinding) test: The patient lies prone, with their knee flexed to 90 degrees and their hip extended. what is the treatment? Treatment for a meniscus tear will depend on its size, what kind it is, and where it's located within the cartilage. Making a medial meniscal root tear diagnosis is difficult because the typical history of locking, catching or giving way is less likely to be present. Knee Surg Sports Traumatol Arthrosc 2007;15:393401. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. This information is not intended as a substitute for professional medical care. MRI scans show (left) a normal meniscus and (right) a torn meniscus. Longitudinal tears do not disrupt the circumferential architecture of the meniscus, and thus repair of longitudinal tears leads to a meniscus with relatively normal biomechanical function. Meniscal repair is a more difficult surgical technique and requires a motivated, diligent patient in order to be successful. Arthroscopic repair of isolated meniscal tears in patients 18 years and younger. 1165 Dunlawton Ave., Suite 102 Port Orange, FL 32127, Port Orange East & Walk-In Clinic All rights reserved. growth factors) on meniscus tissue is being investigated.2 These are currently only being trialled in younger patients7 and the routine use of most of these technologies is some time away. It is important to describe your symptoms accurately. If your symptoms do not persist and you have no locking or swelling of the knee, your doctor may recommend nonsurgical treatment. These are the menisci. Meniscal pain occurs during torsional, weight bearing knee movements (classically pivoting on the knee while walking) as a sharp stab lasting several seconds, often followed by a dull ache for several hours. You can tear a meniscus during any activity which involves forcefully twisting or rotating the knee. Inferiorly displaced flap tears of the medial meniscus: MR appearance and clinical significance. Oblique tears commonly cause flaps and flaps are generally not good. 2nd edn. He/she will probably recommend surgery. Dr. Warren Strudwick answered Sports Medicine 32 years experience See your doc: Sounds like it will not get better without arthroscopic surgery. Meniscus tears simply do not heal on their own, regardless of conservative treatment. They act as shock absorbers and stabilize the knee. If you have a meniscus tear, this movement may cause pain, clicking, or a clunking sensation within the joint. Arthroscopic total meniscectomy Occasionally, a large tear of the outer meniscus can best be treated by arthroscopic total meniscectomy, a procedure in which the entire meniscus is removed. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. Meniscus tears are among the most common knee injuries. De Carlo M, Armstrong B. The skilled interpreter of MR of the knee must do more than simply identify the presence of a meniscal tear. Figure 4. Meniscal tears may be categorized into five common configurations, including horizontal, longitudinal, radial, oblique (parrot-beak), and complex.5 Horizontal tears, the most common meniscal tear pattern, lie parallel to the tibial plateau and separate the meniscus into upper and lower parts (4a,4b). Read before you think. Complex or degenerative tears are where two or more tear patterns exist. Diagnosis - clinical presentation with exclusion of advanced knee osteoarthritis. It absorbs about 50% of the shock of the medial compartment. Knee pain: Depending on your duration of symptoms you can at least start off with physical therapy, a knee sleeve, and if there is arthritis present consider a c Read More oblique tear of the posterior horn and body of the medial meniscus involving inferior articular surface and peripheral meniscal margin. McMurray (Figure 1) and Apley tests (Figure 2) are often positive, although these are specific but not sensitive specificity being 5798% and 8099%, and sensitivity being 1066% and 1658% respectively.2,9 The most useful clinical test for meniscal injury is the Thessaly test, which is demonstrated in Figure 3. It is generally divided into 3 separate portions, the anterior horn, the mid-body and the posterior horn. swelling - this usually happens several hours after you injure your meniscus. AJR 2000; 174:161-164. With regard to tear morphology, the classic ideal candidate for meniscal repair is the peripheral longitudinal tear. A meniscus tear can occur when the knee is suddenly twisted while the foot is planted on the ground. The meniscus is a C-shaped cartilage disk that is found in the knee. For patients whose procedures have not yet been rescheduled:What to Do If Your Orthopaedic Surgery Is Postponed. Extrusion of the medial meniscus (MM) is associated with knee joint pain in osteoarthritic knees. If the knee is still painful, or if it locks, your doctor may recommend surgery. With proper diagnosis, treatment, and rehabilitation, patients often return to their pre-injury abilities. Symptomatic treatment with rest, ice, NSAIDs and/or an unloader brace may help alleviate symptoms in some cases. Fat suppressed proton density-weighted (15a) coronal and (15b) sagittal images reveal a tibial sided flap tear of the body of the medial meniscus, with displacement of the undersurface component (arrows) into the inferior gutter. Have swelling, stiffness or tightness in your knee. Note: the cartilage deficit more anteriorly on the medial femoral condyle and altered subchondral cortical bone interface, Figure 5. During weight-bearing activities, the menisci dissipate axial loads and contain hoop stresses. We describe the technique of diagnosis and treatment of a large displaced lateral meniscus flap tear, presenting as a meniscus comma sign. Lim HC, Bae JH, Wang JH, Seok CW, Kim MK. Vincken PW, ter Braak AP, van Erkel AR, et al. There are numerous treatments for meniscus tears, but treatment generally begins conservatively depending on the location, type, and size of the tear. An MMPH repair in an ACL-deficient knee showed a significant decrease in anterior-posterior tibial translation at all flexion angles except 60 compared with the ACL-deficient/MMPH tear state . Knowledge of these classifications and the potential contraindications to meniscal root repair can aid the . A magnetic resonance imaging (MRI) scan is often used to diagnose meniscal injuries. Chahla and Geeslin report no relevant financial disclosures. 5 Jee WH, McCauley TR, Kim JM, et al. Both of these factors increase contact forces across the joint, leading to accelerated osteoarthritis and predisposing the patient to the development of subchondral insufficiency fractures.7. Other established anatomical variants include the transverse meniscal ligaments and the meniscofemoral ligaments, which mimic meniscal tears at their meniscal attachment sites. Imaging tests X-rays. This is what my MRI says: Radial tear poster medial meniscus, degeneration fraying medial meniscus, moderate bone contusion medial tibial plateau with degenerative changes, moderate bakers cyst.My doctor says I should get a clean-up on my knee. The meniscus is a piece of C-shaped cartilage that helps cushion the knee. Although an X-ray will not show a meniscus tear, your doctor may order one to look for other causes of knee pain, such as osteoarthritis. (Right) Flap tear. Orthopaedic Basic Science: Foundation of Clinical Practice. Pain may wake the patient from sleep as the tender medial aspect of the knee strikes the other side as the patient rolls over in bed. An awkward twist when getting up from a chair may be enough to cause a tear in an aging meniscus. (11a) A 3D illustration of a bucket handle tear demonstrates that these tears actually are longitudinal in nature (arrows), coursing parallel to the c-shaped fibers of the meniscus. Sagittal peripheral meniscal images demonstrate the normal anatomical 'bow-tie configuration' (the central meniscal body with the anterior and posterior horns as well circumscribed triangles. Posterior medial meniscal root tears are often times degenerative, but these can also occur with multi-ligament knee injuries in the acute setting. Meniscus tears are extremely common knee injuries. 1) [50], [51], [52].Its reported prevalence in middle-aged (45-55 years) individuals . Physiotherapy at two visits per week for at least 8 weeks is recommended.20 There is little evidence for strapping of meniscal injuries and this is not currently recommended. See this post to learn more about how a meniscus functions . (Lateral one = ACL, medial one= chondral injury) MR is also able to assess the stability of meniscal tears,6 an important factor, as unstable tears require operative treatment for symptom relief. Only a small peripheral rim of meniscal tissue (arrowhead) is present at the native site of the lateral meniscus. Get the latest news and education delivered to your inbox, Receive an email when new articles are posted on, Please provide your email address to receive an email when new articles are posted on. Clin Sports Med 2010;29:81106. Your doctor will hold your heel while you lie on your back and, with your leg bent, straighten your leg with his or her other hand on the outside of your knee as he or she rotates your foot inward. Tears are typically vertical in young patients and horizontal in the elderly (Figure 5). Although surgical repair has led to improved patient-reported function, there are conflicting reports on the progression of cartilage degeneration. The menisci of the knee have several important roles: The medial meniscus is 'C' shaped whereas the lateral is a shorter incomplete circle with closer spaced 'horns'. Symptoms of a meniscus tear. It has been reported that the force experienced by the medial meniscus in the ACL-deficient knee increased by 52% in full extension and by 197% at 60 of flexion under a 134-N load. Because a torn meniscus is made of cartilage, it won't show up on X-rays. These meniscus tears are displaced into the tibia or femoral recesses and can be often difficult to diagnose intraoperatively. As the risk of osteoarthritis is increased if meniscal structures are not optimally functional,7 it may also be appropriate to refer all young patients for opinion if symptoms do not rapidly improve. They are most frequently seen at the posterior horn of the medial meniscus. The clinician applies axial pressure to the foot and rotates the tibia internally and externally. A lateral meniscus tear (torn meniscus) is a tear of the semicircular fibrous cartilage discs in the knee. Oblique tears combine features of radial and longitudinal tears in that they lie perpendicular to the free edge of the meniscus but then curve such that a portion of it lies parallel to the c-shaped fibers of the meniscus. Tears that lie within or contact the red zone are also more likely to be amenable to meniscal repair. By the time people reach their twenties or thirties, intrasubstance changes of the meniscus tissue are common. In some cases, your doctor may suggest an arthroscopyto examine and possibly treat your knee. This often signals a tear. McMurray test: The patient lies supine on the bed with the hip and knee both flexed. Severe pain and swelling may occur up to 24 hours afterward. However, whether they will respond well to surgery depends on the type of tear, the location, and blood flow in the area where the tear occurred. In case of an open or unstable fracture, the bone may protrude out of the skin surface and be exposed to environmental contaminants. Deep leg presses and squats greater than 70 of knee flexion should be avoided for at least 4 months after surgery. The menisci are two rubbery disks that help cushion the knee joint. Normal knee anatomy. However, anyone at any age can tear the meniscus. Younger and elderly patients typically sustain different types of tears. Complex tears like this are likely to be unstable. The posterior horn of the medial meniscus is especially likely to develop tears as we get older. Peripheral meniscal tears are among the most common causes of meniscal pathology, particularly occurring in conjunction with anterior cruciate ligament (ACL) injury or deficiency. If you undergo surgery it will likely be followed by physical therapy to optimize knee strength and stability. Ask if your condition can be treated in other ways. The lateral meniscus has a symmetrical C-shape, whereas the medial meniscus is more crescentic (3a), as the posterior horn of the medial meniscus is always larger than the anterior horn. One or two other small incisions are made for inserting instruments. There are numerous types of meniscus tears, including: This type of tear is often a sign of degenerative changes in the meniscus tissue. The treatment of these type of tears can be either arthroscopy (surgery through a tiny hole in knee) or conservative. A barely noticeable tear may resurface years later, triggered by something as simple as tripping over a sidewalk curb. RICE. Two bones meet to form your knee joint: the femur and the tibia. Repair of such lesions can result in dramatic clinical as well as MR imaging results (17a,17b). https://www.verywellhealth.com/types-of-meniscus-tears-3862073, https://www.webmd.com/pain-management/knee-pain/meniscus-tear-injury, https://orthop.washington.edu/patient-care/articles/sports/torn-meniscus.html, A sensation that the knee is locked in place. If you continue to use this site we will assume that you are happy with it. Most likely, your doctor will recommend that you rest, use pain relievers, and. Horizontal cleavage, oblique, and complex meniscal tear patterns have traditionally been poor candidates for meniscal repair. Anti-inflammatory drugs such as aspirin, ibuprofen, and naproxen help reduce pain and swelling. Ercin E, Kaya I, Sungur I, Demirbas E, Ugras AA, Cetinus EM. An oblique tear (7a,8a) is often referred to as a parrot-beak tear, as the tear shape resembles a parrots beak. While visualization of the meniscal root may be difficult due to MRI slice size, type of MRI and strength of MRI, an extrusion larger than 3 mm highly correlates with a root tear. This often causes the knee to become stuck due to a portion of the meniscus blocking the knees normal motion. (6a) A radial tear of the body of the lateral meniscus also appears vertical on sagittal MR images (arrow), though in the case of radial tears, the lesion is oriented perpendicular to the c-shaped fibers of the meniscus. Knee Surg Sports Traumatol Arthrosc 2011 Aug 11. A case also can be made for medial meniscal root repairs for a symptomatic acute and possibly a chronic medial meniscal root tear in a non-obese patient older than 40 years with a MRI that does not have early arthritic changes. 2. Bring someone with you to help you ask questions and remember what your provider tells you. The outer one-third of the meniscus has a rich blood supply. Knee Surg Sports Traumatol Arthrosc 2008;16:4826. This is a large horizontal tear of the meniscus. Recovery and rehabilitation take a few weeks. Radiology 2000; 217:193-200. (386) 255-4596 Tears that are stable, < 1 cm in length, and that do not cause significant .
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