Lateral Meniscus Torn/Lateral Meniscus Injury is a crescent-shaped two semilunar fibrocartilaginous tissue, comprised of both a medial and a lateral component positioned between the corresponding femoral condyle and tibial plateau, and plays important roles in the knee joint, including force transmission, shock absorption, joint lubrication, and the provision of joint stability.[rx] Together with the medial meniscus, the lateral meniscus provides a concave surface for the convex femoral condyles to articulate superior to the relatively flat tibial plateaus.
The lateral meniscus (external semilunar fibrocartilage) is a fibrocartilaginous band that spans the lateral side of the interior of the knee joint. It is one of two menisci of the knee, the other being the medial meniscus. It is nearly circular and covers a larger portion of the articular surface than the medial. It can occasionally be injured or torn by twisting the knee or applying direct force, as seen in contact sports.
Anatomy of Lateral Meniscus Torn
The anterior and posterior horns of the lateral meniscus both attach to the tibia. The anterior horn of the lateral meniscus inserts anterior to the intercondylar eminence next to the attachment site of the ACL, while the insertion of the posterior horn lies posterior to the lateral tibial spine and anterior to the insertion of the posterior horn of the medial meniscus. The meniscofemoral ligaments attach the posterior horn of the lateral meniscus to the lateral part of the medial femoral condyle. Although the lateral meniscus is attached to the majority of the anterior and posterior capsule of the knee joint, there is an area posterolaterally in the region of the popliteus tendon where the lateral meniscus is not attached to the joint capsule. This arrangement allows the lateral meniscus more mobility than the medial meniscus and is one reason why the lateral meniscus is less susceptible to tearing than its medial counterpart. The lateral meniscus is also larger than the medial meniscus and carries a more significant percentage of the lateral compartment pressure than the medial meniscus carries for the medial compartment.[rx]
The cells of the menisci are termed fibrochondrocytes since they appear morphologically to be a mix of fibroblasts and chondrocytes. Cells in the superficial layers of the meniscus appear more fibroblastic in nature, whereas cells deeper in the meniscus are more chondrocyte. The meniscal extracellular matrix (ECM) is composed primarily of water and collagen with a small percentage of proteoglycans, noncollagenous proteins, and glycoproteins. The collagen found in the meniscus is almost all type I collagen, with some variable amounts of types II, III, V, and VI. Collagen fibers located in the deeper layers of the meniscus are oriented circumferentially, parallel to the peripheral border, while the more superficial layers contain more radially oriented fibers. These radially oriented fibers are interspersed in the deeper layers as well to provide structural integrity. The proteoglycans found in the ECM provide hydration to the tissue, which allows the meniscus a high capacity to resist compressive loads. As a result, the highest concentration of these glycosaminoglycans is present in the primary weight-bearing areas, the meniscal horns and inner half of the menisci.[rx]
Types of Lateral Meniscus Torn
- Longitudinal tear or injury – This is a tear that occurs along the length of the meniscus
- Bucket handle tear or injury – This is an exaggerated form of a longitudinal tear where a portion of the meniscus becomes detached from the tibia forming a flap that looks like a bucket handle
There are two categories of meniscal injuries – acute tears and degenerative tears.
- An acute tear – usually occurs when the knee is bent and forcefully twisted, while the leg is in a weight-bearing position. Statistics show that about 61 of 100,000 people experience an acute tear of the meniscus.
- Degenerative tears – of the meniscus are more common in older people. Sixty percent of the population over the age of 65 probably has some sort of degenerative tear of the meniscus. As the meniscus ages, it weakens and becomes less elastic. Degenerative tears may result from minor events and there may or may not be any symptoms present.
A meniscal tear can be classified in various ways, such as by anatomic location or by proximity to the blood supply. Various tear patterns and configurations have been described.[rx] These include
- Radial tears
- Flap or parrot-beak tears
- Peripheral, longitudinal tears
- Bucket-handle tears
- Horizontal cleavage tears
- Complex, degenerative tears
These tears can then be further classified by their proximity to the meniscus blood supply, namely whether they are located in the “red-red,” “red-white,” or “white-white” zones.
The functional importance of these classifications, however, is to ultimately determine whether a meniscus is repairable. The repairability of a meniscus depends on a number of factors. These include:
- Activity level
- Tear pattern
- Chronicity of the tear
- Associated injuries (anterior cruciate ligament injury)
- Healing potential
Causes Of Lateral Meniscus Torn
- Inward (valgus) force – Usually, the medial collateral ligament, followed by the anterior cruciate ligament, then the lateral meniscus (this mechanism is the most common and is usually accompanied by some external rotation and flexion, as when being tackled in football)
- Outward (varus) force – Often, the lateral collateral ligament, anterior cruciate ligament, or both (this mechanism is the 2nd most common cause of lateral meniscus injury.
- Anterior or posterior forces and hyperextension – Typically, the cruciate ligaments and lateral meniscus.
- Weight-bearing and rotation at the time of injury – Usually, lateral meniscus
- Motor vehicle accidents – A dashboard injury occurs when the driver’s or passenger’s bent knee slams against the dashboard, pushing in the shinbone just below the knee and causing the lateral meniscus tear.
- Contact sports – Athletes in sports such as football and soccer can tear their lateral meniscus ligament when they fall on a bent knee with their foot pointed down. The shinbone hits the ground first and it moves backward. Being tackled when your knee is bent also can cause this injury.
- The knee is hit directly – especially during sports like soccer, rugby, and football
- A person lands on a bent knee – such as during a fall or misstep
- Landing directly on the front of the shinbone – such as when a dancer comes down from a leap and falls
- A person makes cutting or pivoting maneuvers – such as when an athlete plants a foot and shifts directions
- A person lands on one leg – which can happen after a jump in basketball or volleyball
- A direct blow to the bent knee in an automobile injury
- A sports-related injury in which the knee bends
- Pulling on the ligament in a twisting injury or hyperextension
- A misstep on uneven terrain
Symptoms Of Lateral Meniscus Torn
If you’ve torn your meniscus, you might have the following signs and symptoms in your knee:
- Localized pain near the area of the tear – In tears of the lateral meniscus, this discomfort will be present along the outside edge of the knee. The pain will manifest on the inside edge of the injured knee for tears of the medial meniscus.
- Immediate pain after the injury – A torn lateral meniscus will often be obvious from the moment that the injury occurs. In these instances, the tearing of the meniscus is typically accompanied by the feeling of a pop or snap within the leg during an overexerting twisting or stretching motion.
- Slow onset of symptoms – Conversely, for some, the meniscus can tear without much of a sign or initial pain. This slow onset of symptoms is more common in older individuals and those with damaged knee cartilage from osteoarthritis.
- Pain with movement – The pain will reflect the location of the tear but extend throughout the knee with movement. In the event that the knee has locked, bending it will cause searing pain to worsen.
- Pain after resting – Pain will likely diminish somewhat with rest; however, it will return with movement in most cases. Movement may also exacerbate swelling.
- Fluid accumulation within the knee joint – This accumulated fluid will cause the entire area to swell up and reduce mobility. This symptom, which may occur as a result of a number of knee injuries, is known as water on the knee.
- Knee locking – If a piece of the meniscus breaks free of the disc structure due to a tear, it may lodge within the joint of the knee itself. This lodging can cause knee locking, in which a person loses the ability to fully straighten the leg when sitting or standing.
- Feeling of your knee giving way
- Pain in the knee
- A popping sensation during the injury
- Difficulty bending and straightening the leg
- A tendency for your knee to get “stuck” or lock up
- Tenderness or pain around the lateral surface of the knee joint
- Swelling- usually within 24-48 hours of injury
- Pain, particularly when bending the knee
- Pain when rotating and pressing down on the knee in the prone position.
- Audible popping, cracking or clicking sounds
- Positive ‘McMurray’s‘ test
Diagnosis of Lateral Meniscus Torn
The physical examination must be carried out thoroughly and methodically. Patients with medial meniscal injuries complain of pain in the medial aspect of the knee. McMurray test, Apley grind test, and the bounce home test are positive in medial meniscopathy.
- McMurray test – The patient lies supine, the knee is fully flexed. The surgeon grasps the heel. The leg is rotated on the thigh with the knee in full flexion. The leg is flexed to 90° while the foot is maintained first in full internal rotation and then rotated in full external rotation. In patients with a torn meniscus, a click occurs and the patient complains of pain.
- Apley grind test – With the patient lying prone, the surgeon grasps the foot, rotates it externally as far as possible, and flexes the knee to 90°. The foot is rotated internally, and the knee is extended. The surgeon then applies his left knee to the back of the patient’s thigh. The tibia is then compressed onto the knee joint while being externally rotated. If the addition of compression produces an increase in pain, this grinding test is positive, and meniscal damage is diagnosed.
- Bounce home test – With the patient lying supine, the surgeon grasps the foot, flexes completely the knee. The knee is then passively allowed to extend. The knee should extend completely or bounce home into extension with a sharp endpoint. A positive test occurs when full extension cannot be attained.
Imaging tests may be ordered to confirm a tear of the lateral meniscus. These include
- This test won’t show a meniscus tear. However, it can be helpful to determine if there are any other causes of your knee pain, like osteoarthritis and other associated symptoms.
- An MRI uses a magnetic field to take multiple images of your knee. An MRI will be able to take pictures of cartilage and ligaments to determine if there’s a lateral meniscus tear.
- While MRIs can help your doctor make a diagnosis, they aren’t considered 100 percent reliable. According to a study from 2018 published in the Journal of Trauma Management & OutcomesTrusted Source, the MRI’s accuracy for diagnosing lateral meniscus tears is 77 percent.
- Sometimes, meniscus tears may not show up on an MRI because they can closely resemble degenerative or age-related changes. Additionally, a doctor may make an incorrect diagnosis that a person has a torn meniscus. This is because some structures around the knee can closely resemble a meniscus tear.
- An ultrasound uses sound waves to take images inside the body. This will determine if you have any loose cartilage that may be getting caught in your knee pain with a lateral meniscus injury.
- If your doctor is unable to determine the cause of your knee pain from these techniques, they may suggest arthroscopy to study your knee. If you require surgery, your doctor will also most likely use an arthroscope.
- With arthroscopy, a small incision or cut is made near the knee. The arthroscope is a thin and flexible fiber-optic device that can be inserted through the incision. It has a small light and camera. Surgical instruments can be moved through the arthroscope or through additional incisions in your knee.
- After an arthroscopy, either for surgery or examination, people can often go home the same day.
Treatment of Lateral Meniscus Torn
- Protection – the joint from further injury by taping/strapping the knee joint, or wearing knee support which has additional support at the sides.
- Rest – Avoid activities that aggravate your knee pain, especially any activity that causes you to twist, rotate, or pivot your knee. If your pain is severe, using crutches can take the pressure off your knee and promote healing.
- Ice – Ice can reduce knee pain and swelling. Use a cold pack, a bag of frozen vegetables, or a towel filled with ice cubes for about 15 minutes at a time, keeping your knee elevated. Do this every four to six hours the first day or two, and then as often as needed. Ice your knee to reduce pain and swelling. Do it for 15-20 minutes every 3-4 hours for 2-3 days or until the pain and swelling are gone.
- Elevate your knee – with a pillow under your heel when you’re sitting or lying down. It helps to reduce swelling and fluid accumulation in knee joint
- A stabilized knee brace – has flexible springs in the sides for additional support or for more severe injuries a hinged knee brace with solid metal supports linked by a hinge will help protect the joint from sideways or lateral movement. Compression will also help reduce swelling.
- Rest the knee – Limit activities to include walking if the knee is painful. Use crutches to help relieve pain.
- Compress your knee – Use an elastic bandage or a neoprene type sleeve on your knee to control swelling.
- Use stretching and strengthening exercises to help reduce stress to your knee – Ask your doctor to recommend a physical therapist for guidance.
- Avoid impact activities such as running and jumping
- Full weight-bearing is not permitted for 1 – 6 weeks – after surgery, depending on the type of injury and repair. Crutches will be used initially following surgery. Many surgeons brace the knee and restrict motion for 6 weeks, to prevent excessive flexion and extension.
- Range of motion exercises – begin anywhere from 0 – 6 weeks after surgery, depending on the type of repair.
- Strengthening exercises – begin once full range of motion has returned.
- Return to vigorous activities – such as sports, may begin 3 – 4 months after repair.
- Continuous Passive Motion – Clinicians can consider using continuous passive motion in the immediate postoperative period to decrease postoperative pain.
- Early Weight Bearing – Early weight-bearing can be used for patients following ACL reconstruction without incurring detrimental effects on stability or function.
- Knee Bracing – The use of functional knee bracing appears to be more beneficial than not using a brace in patients with ACL deficiency. The use of immediate postoperative knee bracing appears to be no more beneficial than not using a brace in patients following ACL reconstruction. Conflicting evidence exists for the use of functional knee bracing in patients following ACL reconstruction. Knee bracing can be used for patients with acute posterior cruciate ligament (PCL) injuries, severe medial (tibial) collateral ligament (MCL) injuries, or posterior lateral corner (PLC) injuries.
- Immediate Versus Delayed Mobilization – Clinicians should consider the use of immediate mobilization following ACL reconstruction to increase range of motion, reduce pain, and limit adverse changes to soft tissue structures.
- Cryotherapy – Clinicians should consider the use of cryotherapy to reduce postoperative knee pain immediately post-ACL reconstruction.
- Therapeutic Exercises – Clinicians should consider the use of non–weight-bearing (open chain) exercises in conjunction with weight-bearing (closed-chain) exercises in patients with knee stability and movement coordination impairments.
- Neuromuscular Electrical Stimulation – Neuromuscular electrical stimulation can be used with patients following ACL reconstruction to increase quadriceps muscle strength.
- Neuromuscular Reeducation – Clinicians should consider the use of neuromuscular training as a supplementary program to strength training in patients with knee stability and movement coordination impairments.
- Accelerated” Rehabilitation – Rehabilitation that emphasizes early restoration of knee extension and early weight-bearing activity appears safe for patients with ACL reconstruction. No evidence exists to determine the efficacy and/or safety of early return to sports.
- Eccentric Strengthening – Clinicians should consider the use of an eccentric exercise ergometer in patients following ACL reconstruction to increase muscle strength and functional performance. Clinicians should consider the use of an eccentric squat program in patients with PCL injury to increase muscle strength and functional performance.
- Electrotherapy i.e ultrasound, laser therapy, and TENS.
- Manual therapy
- Once the pain has subsided, exercises to increase range of movement, balance, and maintain quadriceps strength may be prescribed. These may include: squatting, single calf raises, and later, wobble-board techniques.
If the pain is a serious and intolerable or acute injury the following medicine may prescribe in the lateral meniscus injury
- Take anti-inflammatory medications. Non-steroidal anti-inflammatory drugs (NSAIDs), like will help with pain and swelling. However, these drugs can have side effects, such as an increased risk of bleeding and ulcers. They should be only used occasionally unless your doctor specifically says otherwise.
- Antibiotic – Cefuroxime or Azithromycin, or Flucloxacillin or any other cephalosporin/quinolone antibiotic must be used to prevent infection or clotted blood remove to prevent furthers swelling and edema.
- NSAIDs – Prescription-strength drugs that reduce both pain and inflammation. Pain medicines and anti-inflammatory drugs help to relieve pain and stiffness, allowing for increased mobility and exercise. There are many common over-the-counter medicines called non-steroidal anti-inflammatory drugs (NSAIDs). They include and Ketorolac, Aceclofenac, Naproxen, Etoricoxib.
- Corticosteroids – Also known as oral steroids, these medications reduce inflammation.
- Muscle Relaxants – These medications provide relief from associated muscle spasms.
- Neuropathic Agents – Drugs(pregabalin & gabapentin) that address neuropathic—or nerve-related—pain. This includes burning, numbness, and tingling.
- Opioids – Also known as narcotics, these medications are intense pain relievers that should only be used under a doctor’s careful supervision.
- Topical Medications – These prescription-strength creams, gels, ointments, patches, and sprays help relieve pain and inflammation through the skin.
- Calcium & vitamin D3 – to improve bone health and healing fracture. As a general rule, men and women age 50 and older should consume 1,200 milligrams of calcium a day, and 600 international units of vitamin D a day.
- Antidepressants – A drug that blocks pain messages from your brain and boosts the effects of endorphins (your body’s natural painkillers).
- Glucosamine & Diacerein, Chondroitin sulfate – can be used to tightening the loose tension, cartilage, ligament, and cartilage, ligament regenerates cartilage or inhabits the further degeneration of cartilage, ligament. They are structural components of articular cartilage, and the thought is that a supplement will aid in the health of articular cartilage.
- Intra-articular corticosteroid injections – may be useful for symptomatic meniscus injury especially where there is a considerable inflammatory component. The delivery of the corticosteroid directly into the knee may reduce local inflammation associated with a meniscus injury and minimize the systemic effects of the steroid.
- Intra-articular hyaluronic acid injections (HA) – injections are another injectable option for knee meniscus injury. HA is a glycosaminoglycan that is found throughout the human body and is an important component of synovial fluid and articular cartilage. HA breaks down during the process of meniscus injury and contributes to the loss of articular cartilage as well as stiffness and pain. Local delivery of HA into the joint acts as a lubricant and may help increase the natural production of HA in the joint.
- Nowadays, total meniscectomy is not a common procedure. However, previously it was a popular procedure, and short term outcome results of this technique were regarded as excellent. In 1948, Fairbank first[rx] described the potentially damaging effects of total meniscectomy. The long-term results of total meniscectomy showed unfavorable long-term outcome results.
- When meniscal repair is not possible, partial resection of the meniscus is indicated. To avoid the long-term consequences of total meniscectomy, general guidelines have been published.[rx] However, these guidelines have not been tested in a systematic manner, and are to be regarded at best as an expert opinion. A number of studies reported 80%–90% satisfactory clinical results after arthroscopic partial meniscectomy at short-term follow-up (<2 years).
- Autologous tissues such as fat pad, tendon, periosteum, synovial flap and perichondrium have been used as an autograft in preclinical animal or clinical studies. However, satisfactory results were rarely obtained owing to compromised mechanical properties, inferior vascularization, and differences in the shape and internal structure of the repair tissue.[rx] Therefore, it can be concluded that these issues are not a good option for the effective replacement of the meniscus.
- Meniscal allograft transplantations have been widely performed for a meniscal deficiency after total or nearly total meniscectomy. The meniscal transplantation emerges as a good indication for patients with a stable joint, appropriate alignment, and with early osteoarthritis of the knee, while these procedures are contraindicated for patients with severe osteoarthritis.[rx]
- The meniscal repair has evolved from open to arthroscopic techniques, which include the inside-out and outside-in suture repairs and the all-inside techniques.[rx] Inside-out and outside-in techniques involve a mini-incision and securing the meniscus to capsule with suture. The all-inside technique includes several options, including arthroscopic suture tying and absorbable fixation devices with names as an arrow, fastener, dart, and staple.[rx,rx]
- Open repair of meniscus tears has provided successful long-term results ranging from 84%–100%. The open meniscal repair offers the advantage of better preparation of the tear site. However, only the most peripheral of tears in the red-red zone are amenable to this technique because of exposure and accessibility. Long-term follow-up of open meniscal repairs has revealed good success rates.[rx] In this technique, a small incision is performed, similar to that made in an arthroscopic inside-out meniscus repair. The capsule and synovium are incised, allowing direct observation of the tear.
Arthroscopic inside-out repair
- Henning first described the inside-out technique of arthroscopic meniscal repair. The inside-out meniscal repair technique involves fixation of a tear by placing sutures from inside the knee to a protected area on the outside of the joint capsule.
- Inside-out techniques use zone-specific cannulas to pass sutures through the joint and across the tear. The sutures are swaged onto flexible needles. A small posterior joint line incision is used to retrieve the sutures and tie directly on the capsule. The use of a posterior retractor, such as a gynecologic speculum, is vital in order to protect the posterior neurovascular structures.[rx,rx]
Arthroscopic outside-in repair
- The outside-in techniques have been described by Warren and Morgan and Casscells.[rx] Outside-in techniques involve passing sutures percutaneously through spinal needles at the joint line across the tear, and then retrieving the sutures intra-articularly under arthroscopic observation. The needles are passed through the meniscus rim and then through the meniscus body fragment.
- A small incision is then made at the joint line, where the protruding suture ends are retrieved and tied directly on the capsule. An alternative technique is to retrieve the intra-articular portion of the suture with another pass across the tear using a wire snare and tying the suture back on itself on the capsule. A potential disadvantage of the outside-in technique is difficulty in reducing the tear and opposing the edges while passing the sutures.
Arthroscopic all-inside repair
- The all-inside technique was traditionally used to perform repairs of the far posterior horns, where a posterior accessory portal is used, along with passing a suture with a suture hook device.[rx,rx] The suture would then be tied intra-articularly.
- More recently, arthroscopic all-inside meniscal repair techniques recently have become popular because they seem to avoid many of the potential complications of other meniscal repair techniques and decrease operative time. Technologic advances include a number of implantable anchors, arrows, screws, and staples that facilitate meniscal repair without the need for accessory incisions or portals.
- These devices can be made of permanent or absorbable materials. Although the pullout strength of some of these devices approximates those of mattress sutures in cadaveric studies,[rx] there have been no long-term clinical studies that compare them to more traditional repair techniques.
- Meniscal transplantation is generally accepted as a management alternative option for selected symptomatic patients with previous complete or near-complete meniscectomy. Four methods of graft type have been described, including fresh allograft, fresh-frozen, cryopreserved and freeze-dried ( lyophilized).
- Human immunodeficiency virus (HIV), hepatitis B and C, and syphilis are potentially transferable diseases with meniscal transplant surgery via graft material. The documented risk for HIV transmission is estimated to be at 1 in 8 million.[rx] Secondary sterilization of allografts has previously been undertaken using gamma radiation, ethylene oxide, or chemical sterilization.
After successful surgery for treating the destroyed part of the meniscus, patients must follow a rehabilitation program to have the best result. The rehabilitation following a meniscus surgery depends on whether the entire meniscus was removed or repaired.
If the destroyed part of the meniscus was removed, patients can usually start walking using a crutch a day or two after surgery. Although each case is different, patients return to their normal activities on average after a few weeks (2 or 3). Still, a completely normal walk will resume gradually, and it’s not unusual to take 2–3 months for the recovery to reach a level where a patient will walk totally smoothly. Many meniscectomy patients don’t ever feel a 100% functional recovery, but even years after the procedure they sometimes feel tugging or tension in a part of their knee. There is little medical follow-up after meniscectomy and official medical documentation tends to ignore the imperfections and side-effects of this procedure.
If the meniscus was repaired, the rehabilitation program that follows is a lot more intensive. After the surgery a hinged knee brace is sometimes placed on the patient. This brace allows controlled movement of the knee. The patient is encouraged to walk using crutches from the first day, and most of the times can put partial weight on the knee.
There are three phases that follow meniscal surgery. Each phase consists of rehabilitation goals, exercises, and criteria to move on to the next phase. Phase I starts immediately following surgery to 4–6 weeks or until the patient is able to meet progression criteria. The goals are to restore normal knee extension, reduce and eliminate swelling, regain leg control, and protect the knee (Fowler, PJ and D. Pompan, 1993). During the first 5 days following the surgery, a passive continuous motion machine is used to prevent a prolonged period of immobilization which leads to muscular atrophy and delays functional recovery.[rx] During the 4–6 weeks post-surgical, active and passive non-weight bearing motions that flex the knee up to 90° are recommended. For patients with meniscal transplantation, further knee flexion can damage the allograft because of the increased shear forces and stresses.
This phase of the rehabilitation program is 6 to 14 weeks after the surgery. The goals for Phase II include being able to restore full ROM, normalized gait, and performing functional movements with control and no pain (Fowler, PJ, and D. Pompan, 1993). Also, muscular strengthening and neuromuscular training are emphasized using progressive weight-bearing and balance exercises. Exercises in this phase can increase knee flexion for more than 90°.[rx] Advised exercises include stationary bicycle, standing on a foam surface with two and one leg, abdominal and back strengthening, and quadriceps strengthening. The proposed criteria include normal gait on all surfaces and single-leg balance longer than 15 seconds (Ulrich G.S., and S Aroncyzk, 1993).
Patients begin exercises in phase III 14 to 22 weeks after surgery. Phase III’s goal and final criteria is to perform sport/work specific movements with no pain or swelling (Fowler, PJ, and D. Pompan, 1993). Drills for maximal muscle control, strength, flexibility,[rx] movements specific to patient’s work/sport, low to high rate exercises, and abdominal and back strengthening exercises are all recommended exercises (Ulrich G.S., and S Aroncyzk, 1993). Exercises to increase cardiovascular fitness are also applied to fully prepare the patients to return to their desired activities.
Tips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down the questions you want to be answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also, write down any new instructions your provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also, know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.
Although it’s hard to prevent accidental knee injuries, you may be able to reduce your risks by:
- Warming up and stretching before participating in athletic activities
- Exercising to strengthen the muscles around your knee
- Avoiding sudden increases in the intensity of your training program
- Wearing comfortable, supportive shoes that fit your feet and your sport
- Wearing appropriate protective gear during activities, including athletic activities, in which knee injuries are common (especially if you’ve had knee injuries before).
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