Meniscal Tears Acute or chronic. Imaged with MRI (95% sensitivity & 81% specificity) Menisci are formed by a composition of radial and circumferential collagen fibers (97% type 1) mixed with cartilage, proteoglycans, etc. 65-75% H2O Aging can lead to meniscal attrition Acute tears are d/t rotational and compressive forces, ACL deficient knees show greater chances of meniscal tears Posterior horn of medial meniscus is m/c torn except in acute A CL tears when the lateral meniscus is m/c torn The meniscus is well vascularized in children. In adults, 3-zones exist: inner, middle and outer (above bottom image) Injury of the inner zone has no chance of healing Injury of the outer zone (25% in total) has some healing/repair Clinical Presentation Pain, locking, swelling Most sensitive physical sign: pain on palpation at the joint line Tests: McMurry, Thessaly, Apply compression in prone Management: conservative vs. operative depends on location, stability, patient

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