Meniscus tears can be classified according to various criteria:

1. By the shape of the tear:
   • Longitudinal tear: A tear running parallel to the longitudinal axis, often caused by acute twisting movements.
   • Horizontal tear: A horizontally running tear, often due to degenerative causes.
   • Bucket handle tear: A larger longitudinal tear where part of the meniscus is displaced and can block the joint.
   • Radial tear: A vertical tear from the inner to the outer meniscus region.
2. By location:
   • Medial meniscus tear: More common, as the medial meniscus is less mobile and more stressed.
   • Lateral meniscus tear: Less common, often occurs in sports injuries.
3. By cause:
   • Traumatic: Caused by sudden twisting movements, falls, or collisions.
   • Degenerative: Age-related wear or chronic overuse of the meniscus.

The main causes of meniscus tears can be divided into traumatic and degenerative factors:

• Traumatic causes:
  • Sudden twisting movements of the knee, as commonly seen in sports like soccer, basketball, or skiing.
  • Direct impact on the knee, e.g., during falls or collisions.
• Degenerative causes:
  • Wear and tear from years of stress on the knee joint, especially in older people.
  • Chronic overuse from occupational activities or repeated stresses like prolonged kneeling or jumping.
• Biomechanical misalignments:
  • Misalignments such as bowlegs or knock-knees that unevenly stress the meniscus.

The symptoms of a meniscus tear can vary depending on the type and extent of the injury:

- **Pain:** Localized pain on the inside or outside of the knee, which becomes more intense with strain or rotational movements.

- **Swelling:** Often rapidly occurring swelling of the knee joint due to fluid accumulation (effusions).

- **Locking sensation:** The feeling that the knee is "catching" or locked, especially with a bucket handle tear.

- **Movement restrictions:** Difficulty in straightening or bending the knee.

- **Cracking:** Audible or palpable noises during knee movements.

- **Instability:** A feeling of insecurity in the knee, especially when bearing weight on uneven surfaces.

The diagnosis of a meniscus tear is made through a combination of medical history, clinical examination, and imaging techniques:

- Medical History:

- The doctor inquires about the accident, the nature of the symptoms, and any possible pre-existing conditions.

- Clinical Examination:

- Specific tests such as the McMurray test, the Steinmann test, or the Apley grinding test are used to check the stability of the meniscus.

- Imaging Techniques:

- MRI: Provides detailed images of the meniscus and shows tears or accompanying injuries such as ligament tears.

- X-ray: To rule out bony changes or osteoarthritis.

- Ultrasound: Helps assess joint effusions or soft tissue changes.

Conservative Therapy

Smaller or degenerative tears can often be treated without surgery:

• Physiotherapy:
  • Exercises to strengthen the surrounding muscles and improve stability.
• Medication Therapy:
  • Painkillers and anti-inflammatory drugs (NSAIDs).
• Cooling:
  • Cold packs for pain relief and reduction of swelling.
• Knee Braces:
  • Support of the knee joint with special bandages.

Surgical Therapy

Larger or unstable tears often require surgical treatment:

• Arthroscopic Meniscus Repair:
  • Minimally invasive restoration of the torn meniscus.
• Partial Meniscectomy:
  • Removal of damaged parts when a repair is not possible.
• Meniscus Transplantation:
  • Replacement of the meniscus with donor tissue in cases of irreparable damage.

To prevent meniscus tears, the following measures are recommended:

1. Strengthening the thigh muscles: Stabilizes the knee joint and protects against overload.
2. Regular stretching exercises: Promotes flexibility to prevent injuries.
3. Correct execution of movements: Avoiding abrupt twisting movements in sports with a high risk of injury.
4. Protective clothing: Use of knee pads or similar protection during high-risk activities.
5. Recovery phases: Avoiding overload through sufficient breaks and recovery times.