knee pain, Meniscus Tear ,types- Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes knee pain, types of meniscus tears.
It also explains about 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
- The first type is called: Vertical Longitudinal Tear, you can see in the diagram hoe it will look like, this is the tear that probably will need repair, peripheral tear is vascular and probably will need repair.
Tears in the peripheral 25%, in the red zone will heal, the smaller the rim width of the tear, the better the healing.
This longitudinal or peripheral tear is the type you see with ACL tear, and also you can see it with tibial plateau fractures.
- Another peripheral tear type called: Incomplete Longitudinal or Peripheral tear, it doesn’t go through the entire meniscus it goes through part of the thickness of the meniscus.
- The vertical or peripheral tear are called bucket handle tear when they are complete and unstable.
Complete tears are usually longer that 1 cm, will usually displace into the joint and causes mechanical symptoms, possibly block of extension, and it’s called: locked knee.
How do you know the locked knee of this patient is from a meniscal tear?
You will be able to tell that from the history and examination of the patient.
If you have a history of an injury and you have a joint line tenderness and some effusion, the patient probably has a meniscal tear.
So we got: 1- complete longitudinal peripheral vertical tear. 2- The bucket handle.
3- The displaced bucket handle: In the medial side that can give you the double PCL sign.
Double PCL sign on MRI is 100% specific for a bucket handle meniscal tear.
You can also see it on the MRI as fragment on the notch sign because one fragment is displaced, or you can see absent bow tie sign.
In the other type it’s called Parrot Beak tear, this is an oblique tear, and they are a group of types:
- Peripheral tears: 1- incomplete longitudinal tear, 2- complete longitudinal tear, 3- bucket handle tear, 4- displaced bucket handle tear.
- Oblique tears: 1- parrot beak tear, 2- flap tear, 3- displaced flap tear.
Parrot Beak occur at the junction of the posterior horn and the body of the meniscus, it can cause mechanical symptoms and the treatment is usually partial excision to stable them, because you can’t repair them.
If the tear is bigger it could be a flap then it can be a displaced flap that causes mechanical symptoms.
We have seen the Peripheral tear, the Oblique tear, now we will see the Radial tear:
The Radial tear can’t be repaired, and in this case we lost the circumferential fiber integrity, it usually starts centrally and proceeds peripherally, it can lead to a flap tear or double flap tear.
The Horizontal Cleavage Tear: occurs more in the older population and may be associated with the meniscal cyst.
Complex tear: means the combination of all these types and it usually occur in the older population.
Why do we look at the types?
Because some of them may be repairable if they are peripheral tears.
Some of them may cause mechanical symptoms, such as displaced bucket handle tear.
Some of them may not be repaired at all, they may need just trimming or partial excision to stabilize them, like the radial tear, or the flap tear.
Some of them may have meniscal cyst like the horizontal cleavage tear.
Some of them may be complex degenerative tears as in older population and arthritis, and they may want to start treating that conservatively.
So knowing the type of the tear may help you in planning your treatment.

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[marksiahaya]

This is by the best video on meniscus tears that I have seen. Thanks

[SongOfSongsOneTwelve]

Thank you, Professor Dr. Ebraheim. Great lecture. I could have watched an hour straight of your teaching, but this was short and sweet! 😊You have a great gift of knowledge and for teaching. God bless you. ❤

[petersherrouse]

I've spent two days self diagnosing and coming to understand my options for a menisci tear. Your videos are wonderful and I can't believe how few people what to understand their injury! Thank you for putting this up.

[leew]

Great explanation of tears.
Most of these tears can be repaired nowadays however, which is great

[ishmaelhassa]

Excellent. Thank you for the simple explanation. I'm now better informed about my problem.

[NB-Philly]

Fantastic video Dr Enraheim. This has given me a clear understanding of the types of tears so I understand the results of my MRI. Thank you again!

[SportGuyDMV]

I had a bucket handle tear in my medical meniscus. It's a devastating injury for young people. You'll most likely have to get surgery cause the mechanical symptoms are not going anywhere

[alexanderwilson]

Hey doc. Love the video. Really explained well. If you have a second, here is the report from my MRI: “Horizontal oblique tear at body of lateral miniscus involving inferior surface with several 0.2-1.3 parameniscal cysts and vertical longitudinal tear at posterior horn of lateral miniscus involving superior and inferior surfaces of red-red zone” My issue is that the private hospitals here in Thailand are renowned for putting you straight into surgery for the money. My doc told me I must get this “repaired” as soon as possible with a 3 hour surgery and 3 days in patient. Now, I only experience swelling and pain on the lateral joint every couple of months so it is not debilitating in everyday life, I like to do strength training (including squats and deadlifts etc) and have not so far tried physio to prevent the pain from returning. From your video, one of the tears would have to be cleaned up or taken out and one could be fixed. If the pain is not always debilitating and I start physio to build the muscles around the knee and improve mobility, is surgery necessary?

[elyssiamathias]

Thank you, that was a simple and clear video. :)

[Mrcabbage]

Thanks for the upload..as always fantastic uploads with complete overview of the subject but I was wondering if there are any meniscus tears that cannot be repaired and then the alternatives..thanks so much and stay well.

[ts.nathan]

My doctor suggested to stitch the miniscus and stem cell treatment by making a small hole in the bone near the knee joint, through which stem cells will pour in to the joint from the bone marrow, that would heal the miniscus.

[mukeshchoudhary]

sir plss tell me the horizontal tear lateral meniscus excercise. ..?

[thangminlunkhongsai]

I have Peripheral tear medial meniscus right knee . Can it b repair sir?

[chucho]

I have a small delicate oblique tear of posterior horn on my left knee medial meniscus. I play soccer and it’s been about 4 weeks since I’ve been able to play. What do you recommend? My doctor said I just need some physical therapy.

[mourinho]

I have a medial flap and ciste and femural distal grad4 hondrial lezia please advise what to do

[rohitjamble]

I have one question do complex tear can heal by surgery plz do reply if any one knows

[gaganthakre]

Sir. I have longitudinal horizontal tear in medial meniscus can it heals automatically ?? Or not sir plssss tell

[francodominguez]

Can horizontal tears be repaired or heal

[imbertwijbenga]

Parrot beak and radial tears CAN be repaired. No need for menisectomy.

[t-mac]

My oblique tear fail twice, now I can't have another op to repair it. Can only have tkr🤦‍♀️😭