The meniscus also assists with knee stability, and contributes to the nutrition of articular cartilage by enhancing synovial fluid distribution. Meniscal tears in young people are usually longitudinal and peripheral, and involve the medial meniscus. The torn non-discoid meniscus usually presents with medial or lateral pain, associated with activity and relieved by rest, with a history of trauma to the knee. Swelling and mechanical symptoms of locking or giving way may be present. On physical examination, joint line tenderness is present, but in children this is frequently due to osteochondritis dissecans or patellofemoral stress syndrome.
Plain radiographs are only useful for eliminating other possibilities, such as a loose body.
Arthroscopy of the knee joint may be used, but tears of the posterior horns are often difficult to detect. However, rasping or debridement of the edges of the tear may enhance healing by improving vascular access. Other tears should be repaired if there is no degenerative component. Meniscus-allograft transplant is an attractive option but not acceptable due to the paucity of reliable trials, and problems with sterilization of cadaveric grafts. Meniscal cysts may be associated with horizontal or cleavage plane tears, usually of the lateral meniscus.