MENISCUS
A meniscus is a cushioning structure in the knee located between the round surface of the thigh bone and the flat surface of the shin bone. They consist of fibrous cartilage (a very tough but pliable material like the soft tip of a nose).
There are two menisci in each knee:
Medial meniscus - On the inner side of the knee.
Lateral meniscus - On the outer side of the knee.
Together, they act as shock absorbers and stabilizers in the knee joint. 

REASONS FOR A MENISCUL INJURY
Meniscus tears happen in one of two main ways: 
• Trauma - Injury to the meniscus is often found among athletes. The menisci are especially vulnerable to injuries in which there is both compression and twisting applied across the knee.
• Degeneration - Many meniscus tears are the result of deterioration coupled with minor trauma. Young meniscal cartilage is very flexible, like soft rubber. As it gets older,
it becomes hard, less flexible, and more brittle. These degenerative tears can occur with a fairly minor injury like squatting or through repetitive activities like running.

SYMPTOMS OF MENISCUS TEARS
When the meniscus is torn, many people feel a painful “popping” sensation. Most can still walk on the injured knee and many athletes keep playing. When inflammation sets in, it may lead to the following symptoms:
• Pain–May be felt along the joint line where the meniscus is located or it may be more vague and involve the whole knee.
• Popping
• Swelling
• Giving way
• Locking
Without treatment, a fragment of the meniscus may loosen and drift into the joint and thereby cause cartilage damage.

DIAGNOSIS
An injury to the meniscus can be diagnosed based upon the history that the patient provides and a physical examination of the knee. The history will try to determine where the pain is located, whether locking has occurred, and if any clicks or pops occur as the knee is moved. Additional tests maybe necessary to verify the diagnosis. The orthopedic surgeon may require an MRI which provides images of the inside of the knee joint. However, the most accurate and effective way to diagnose and treat a meniscal injury is through arthroscopy.

TREATMENT
The decision to repair or remove a meniscal tear is based on many factors including the risk of further injury if left as is, location and pattern of the tear, age of the patient, and predictability of whether the injury will be able to heal. Arthroscopy is an effective, safe, minimally invasive, outpatient surgery used to repair torn menisci. In an arthroscopic examination, local anesthesia is administered to eliminate pain. The orthopedic surgeon makes small incisions in the skin and then inserts the arthroscope (a drinking straw sized and shaped instrument containing a light and small camera) to illuminate the structures inside the joint. The surgeon can then reliably determine the amount of injury and repair or remove the problem portion of the meniscus. If there are no other problems in the knee, the results of arthroscopy are excellent and the recuperation is usually just a few days.

RECOVERY
One can usually expect to be back in sports within one week after the meniscectomy. Everyone recovers from injury at different rates. Recovery depends on several factors including the level of strength before the operation and the severity of the tear.
If arthroscopy is performed, the surgeon will recommend a rehabilitation program to optimize a quick recovery and prompt return to normal activity. Therapy begins immediately after the surgery and is gentle so as not to cause any pain.

Advantages of Arthroscopy

• Arthroscopy requires only small incisions causing minimal scarring at most, as opposed to the large incision needed in standard open surgery that may cause noticeable scarring.

• Arthroscopy is an outpatient procedure that not only allows the patient to go back to the comfort of their home within a few hours of surgery, but also provides a savings by not requiring an overnight hospital stay.

• Arthroscopy lends to a much quicker recovery time than open surgery. This allows the patient to return to their previous lifestyle in a shorter time frame.