meniski

Menisci are two crescent-shaped fibrocartilaginous structures in the knee joint, known as the medial and lateral menisci. They lie between the rounded ends of the femur and the flat top of the tibia, and they help improve joint congruence, distribute load, absorb shock, lubricate the joint, and contribute to stability during movement.

Anatomy and histology: Each meniscus has a body with anterior and posterior horns that anchor to the tibial plateau. The outer third is vascularized, while the inner two-thirds are largely avascular. This anatomical arrangement influences healing potential, with injuries in the outer zone more likely to heal and those in the inner zone healing slowly or not at all.

Function and mechanics: The menisci convert the curved surface of the femoral condyles into a more even contact area with the tibial plateau, reducing peak contact stresses. They also assist in joint lubrication, proprioception, and rotational stability, which is important during activities that involve twisting or cutting motions.

Clinical relevance: Meniscal injuries are common and can occur after twisting injuries or from degenerative changes, especially in older adults. Symptoms often include joint line pain, swelling, catching or locking, and limited range of motion. Diagnosis relies on clinical examination and imaging, with MRI being the most informative.

Treatment options: Nonoperative management includes rest, ice, nonsteroidal anti-inflammatory drugs, and physical therapy, particularly for degenerative tears. Surgical options include arthroscopic partial meniscectomy to remove damaged tissue or meniscal repair to preserve tissue, especially for peripheral tears and younger patients. Total meniscectomy is now rarely performed due to long-term risk of osteoarthritis.

Prognosis: Outcomes depend on tear location and tissue quality. Peripheral tears and prompt treatment have better healing potential, while inner-tear or complex tears may lead to persistent symptoms and increased arthritis risk over time. See also knee joint anatomy and osteoarthritis.