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I was limping along (literally) for quite a while before my doctor examined me and said I have a torn medial meniscus in my knee. I'm a senior citizen and no athlete. How did this happen? I'm not involved in any sports or athletics of any kind.

The meniscus is a commonly injured structure in the knee. The injury can occur in any age group. In younger people, the meniscus is fairly tough and rubbery, and tears usually occur as a result of a forceful twisting injury. The meniscus grows weaker with age, and meniscal tears can occur in aging adults as the result of fairly minor injuries, even from the up-and-down motion of squatting. Women seem to be affected more often than men. About one-third of all meniscal tears actually occur when other damage is sustained by the knee (e.g., fractures, anterior cruciate ligament (ACL) tears). But without a significant injury, older adults can indeed find themselves limping along with no idea why their knee hurts. Sometimes there is a popping or catching sensation or the knee locks up, gives way, or buckles underneath the person. There may be tenderness along the joint line with or without swelling. It isn't until the surgeon reviews the X-rays and MRIs that a final diagnosis is made. Those imaging studies can tell the surgeon a lot about how this happened. X-rays show any fractures or loose fragments in the joint. X-rays also help the physician see what kind of shape the joint is in, how much degeneration has occurred, and any signs that the joint is thinning. MRIs show the pattern of meniscal tears. This helps the surgeon plan treatment. The tear could be across the meniscus (vertical), the length of the meniscus (horizontal), or at a diagonal (oblique). The severity of the tear can also be assessed with MRIs (mild, moderate, severe). Any other features such as the shape of the tear (e.g., flap tear, parrot-beak tear, or complex configuration) can be seen as well. You don't have to be an athlete to sustain a meniscal tear. The degenerative aging process helps level the playing field so-to-speak. Over the age of 50, we are all susceptible to this kind of injury with or without the glory of a home run, winning soccer goal, or perfect tennis score.

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