Diagnosis and therapy

The diagnosis of a meniscus lesion requires a medical history and a subsequent clinical examination. During this examination different meniscus signs can be tested. These include the Steinmann I sign (pain occurs in an inner meniscus lesion when the outer meniscus is rotated and in an outer meniscus lesion when the inner meniscus is rotated), the Steinmann II sign (pain moves dorsally when the knee joint is bent), the Payr sign (when sitting cross-legged, pressure on the inner joint space causes pain when the inner meniscus is torn), the Apley test (the patient lying on his stomach feels pain when the knees are bent at a 90° angle and pressure is applied to the sole of the foot in this position during internal or external rotation) and the triggering of varus and valgus stress, which provokes pain through compression if there is an injury to the meniscus.

In addition, in some cases it may be useful to take an X-ray to detect any bony injuries. In addition, an arthroscopy of the knee is performed (whereby the use of magnetic resonance imaging (MRI) is no longer necessary in the case of a torn meniscus), which usually includes treatment. When arthroscopic surgery of the knee is performed, either parts of the meniscus can be removed (meniscectomy), whereby care should be taken to remove as little tissue as possible in order to avoid later arthrosis of the knee joint, or meniscus tears should be sutured, a technique that should be performed especially in younger patients.

Depending on the extent of the damage and the corresponding therapy, the long-term prognosis of the affected patients is determined. It is advisable to consult a physician or physiotherapist in this case to ensure that the knee is regained appropriately and not too quickly. Often the ability to actively participate in sports is restored after about three months, but some patients never regain their previous ability to bear weight in the knee after a torn meniscus.

MRI can diagnose over 95% of meniscus tears, and MRI is the gold standard for detecting meniscus tears without invasive surgery. In the MRI, the resulting contrast in the tissue creates a three-dimensional image without any radiation exposure. Unfortunately, some meniscus tears cannot be visualized in the MRI, or tears are more severe under arthroscopy than is suspected on the MRI. Due to the constant improvement of the MRI technique, the error rate in MRI for meniscus tears has decreased significantly.