meniscus tear , knee injury ,lateral meniscus - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes knee pain examination of the meniscus. Knee pain diagnosis and knee pain treatment .It describes knee injury meniscus tear, meniscus pain, meniscus tear symptoms .it also describes meniscus tear tests and meniscus tear surgery and recovery.

The meniscus is a cushion that distributes the load and reduces the stress being placed on the knee joint. These menisci protect the hyaline cartilage and prevent arthritis of the knee joint.
There are two menisci; the lateral and the medial. We are going to discuss the lateral meniscus because the lateral meniscus has very special features that make it appealing for exam questions.
The lateral meniscus is circular in shape. The anterior and posterior horns of the lateral meniscus are close together. The lateral meniscus covers about 70% of the lateral tibial plateau. The medial meniscus is “C” shaped and covers about 50% of the medial tibial plateau. The lateral meniscus has less peripheral soft tissue attachment, therefore it has twice the excursion of the medial meniscus (lateral meniscus is more mobile). The medial meniscus is less mobile and has three times the incidence of injury. The lateral meniscus is not injured as often as the medial meniscus.
The lateral meniscus is involved with acute ACL tear. Tear of the ACL is usually peripheral and can be missed on MRI. In tibial plateau fractures, the lateral meniscal tear is more common than medial meniscal tears. The lateral meniscal tear is usually associated with a Schatzker Type II fracture, which is a split depression fracture.
If you see a depression or widening greater than 5 mm in the tibial plateau, then it is probably associated with a lateral meniscal tear.
The lateral meniscus has the hiatus for the popliteus tendon. The fibula identifies the lateral meniscus on MRI. The fibular is lateral and posterior.
The lateral meniscus can be involved with multiple tear types.
There are some special conditions that we need to be aware of:
• Tear Type
• Pathological condition of the meniscus.
• Bucket handle tear of the lateral meniscus
- Will give you the double anterior horn sign of the lateral meniscus on sagittal view MRI.
• Meniscal Cyst
- Usually occurs from a horizontal tear of the lateral meniscus.
• Discoid meniscus
- Occurs more on the lateral meniscus.
• Meniscal repair on the lateral side can injury the peroneal nerve and popliteal vessels
- The popliteal vessels are behind the posterior horn of the lateral meniscus.
- Keep the approach and the dissection anterior to the biceps femoris tendon.
• Tears of the peripheral 25% of the lateral meniscus (red zone)
- This area is vascular and will heal if we repair/suture the meniscal tear.
- There is a risk associated with suturing the peripheral tear.
- The success rate associated with lateral meniscus repair increased with simultaneous ACL reconstruction.
McMurray’s Test
• Classic test that helps in the diagnosis of meniscal tears.
• With tear of the lateral meniscus, you will have a positive McMurray’s test with internal rotation of the knee.
Some structures may mimic a tear of the lateral meniscus (false positive MRI).
• Meniscofemoral Ligament
- Connects the meniscus into the PCL
- Arises from the posterior horn of the lateral meniscus and it has two parts (Humphrey is anterior and the Wrisberg is posterior to the PCL).
• Transverse Meniscofemoral Ligament
- Connected to the lateral meniscus anteriorly
• Fluid around the sheath of the popliteus tendon may mimic a tear

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[wesleydeer]

Thank you. I wish more medical professionals would make videos like this. I have spent months researching my knee injury, and you're one video helped me understand more than months of googling.

[michaelstapleton]

After nearly 10 years of dealing with knee pain, I’m just getting diagnosed. MRI soon. Will get a full diagnosis.

[lissettbonilla]

Tank you Doctor very detail. I am glad we have the chances of learn through your explication and the video. 😊

[nessa]

Where's is the video about medial meniscus bucket handle tear????

[muhammadqkhankhan]

Thank you dr for your great job jazak Allah khair

[balabharatb]

Hi Doctor,

My daughter aged 10 years has "complex tear of the lateral meniscus with a flipped eniscal fragment lying posteriorly" in her right knee. She donot have any pain or swelling.Nor she has knee locked. Doctor suggested to go for Arthroscopic surgery. Please let us know if she really needs operation as she has normal knee.

She had ungergone Arthroscopic surgery for her left knee 6 months back due to "Discoid lateral meniscus with complex tear" as her knee got locked. Couple of days back we took MRI of her right knee just to make sure her right knee is fine.

Please let us know if she needs Arthroscopy to her right knee.

[SamaahZohair]

Thank you so much for sharing this. Stay blessed.

[jomaretang]

What procedure is needed for this findings "there is complex tear seen in both lateral meniscus with lateral extrusion of the body of the lateral meniscus, measuring 4.5mm away from the inner tibial plateau." I'm from philippines sir.

[samirupadhyay]

SIR THANKS FOR THIS VIDEO, PLS SHARE FOR MEDIAL MENISCUS INJURY AS WELL. ALSO DIFFERENCE BETWEEN TEAR AND GRADE II SIGNAL AS PER MRI REPORT

[ersyedrehan]

Sir I m rehan...my MRI report shows Moderate Mucoid degeneration of ACL...WAHT is the treatment in this case

[strivinghard]

Thanks doc for the info, has any one ever told u u sound like the guy from the 2012 movie…. I’m listening though…

[clarissafoster]

I have lateral miniscus large tear with para meniscal cyst, I just had MRI is why I'm watching what's next after MRI, thanks!

[sanyk]

Hello Dr, I am 30yrs old and having grade 3 posterior horn of medial meniscus tear on my MRI, will it be fixed without surgery? I don't have any pain but when I bend my leg full while sitting the it gets locked.

[t-mac]

My repair on lateral menscius failed twice and has added new tears to it😭

[englishfatafat]

Dear Sir, i m your big fan.Once i was watching your vidio where you had said that orthopedic is my life.I like that too much. S Sir, i feel egg crack sound when i flex or extend my leg.what would be there? Kindly make a vidio about this.

[Nenad-ICXC-Shuput-GFAMMA]

Don't do the surgery. hot laser class IV therapy works. It worked for me, they told me I have to have surgery to scope it out.

[vishnu_pradyu]

Sir I have Oblique tear of anterior horn of lateral meniscus
Symptoms: Light pain in front & below knee joint
Do I need to undergo surgery ?

[praveenpatil]

Sir I had injure of grade 2 tear of anterior horn of lateral meniscus. Can I do this exercise which made me out from surgery..?

[NakulKumar-vhcx]

Medail meniscus grade 2 tear recovery quickly plz tell me