Acute Meniscal Tear of the Knee N067
Current RMA Instruments
| Reasonable Hypothesis SOP [1] | 25 of 2019 |
| Balance of Probabilities SOP [2] | 26 of 2019 |
Changes from previous Instruments
SOP Bulletin 207 [3]
ICD Coding
- ICD-9-CM Codes: 836.0, 836.
- ICD-10-AM Codes: S83.2.
Brief description
This condition is an acute tear of meniscal cartilage of the knee. There are two menisci in each knee that are shaped in the form of a crescent or half moon (semilunar).
Meniscal tears are described with reference to their appearance as bucket handle; longitudinal; radial; horizontal; vertical; oblique; transverse; flap; parrot beak, etc.
Acute meniscal tears either become asymptomatic over a period of several months or persist with symptoms. A chronic (non-degenerative) meniscal tear is covered by the SOP for internal derangement of the knee.
Confirming the diagnosis
This diagnosis is made at arthroscopy or on CT scan or MRI scan. This diagnosis cannot reliably be made clinically or on the basis of a plain X-ray or nuclear bone scan. Note also that reported MRI signal change in the meniscus without a discrete tear to the articular surface is not considered as a reliable indication of a meniscal tear given the high incidence of false positives.
The relevant medical specialist is an orthopaedic surgeon.
Additional diagnoses that are covered by SOP
- Nil
Additional diagnoses that may be covered by SOP
- Meniscal cyst where the cyst is physically located close to the site of the meniscal tear.
Conditions that are excluded from SOP
- Acute articular cartilage tear*
- Chronic meniscal tear* - internal derangement of the knee SOP
- Congenital defects#
- Degenerative meniscal tears, ICD code 715 (osteoarthritis), N.I.F. (No Incapacity Found), or 717.5 (non-SOP).
- Discoid meniscus#
- Internal derangement of the knee*
- Capsule tear; ligament tear; muscle tear; or tendon tear* - sprain and strain SOP
- Meniscal pseudo tears#
- Osteoarthritis*
- Plica, N.I.F.
- Radiological findings such as MRI signal change in the meniscus without a discrete tear to the articular surface. These findings have a high incidence of false positives when later investigated by arthroscopy which is considered as the ‘gold standard’ for diagnosis of meniscal tears.
* another SOP applies
# non-SOP condition
Clinical onset
Clinical onset will be at the time of the sudden onset of knee pain, associated with injury or physical activity, that is subsequently found to be due to acute mensical tear.
Clinical worsening
The only SOP worsening factor is for inability to obtain appropriate clinical management.
Factors in CCPS as at 10 June 2012 (N067)
- Log in [4] to post comments
Important Information
- The investigation questions displayed here are based on factors that were current at the time that they were incorporated into the CCPS application.
- There may have been new instruments for this SOP condition issued after they were added to the CCPS application.
- Please ensure that you refer to and use the latest instruments for this SOP condition (acute meniscal tear of the knee).
Current Statements of Principles
- Please refer to the Repatriation Medical Authority (RMA) Website to confirm the most recent instruments for this SOP condition (acute meniscal tear of the knee).
- The acute meniscal tear of the knee instruments at the RMA Website (Page 'A' [5]) will contain the latest SOP Factors.
The following acute meniscal tear of the knee factors were last reviewed for CCPS on 10 June 2012.
Inability to obtain approropriate clinical management for acute meniscal tear of the knee
Acute meniscal tear of the knee - Inability to obtain approropriate clinical management for acute meniscal tear of the knee Factor
In the case of an acute meniscal tear of the knee, appropriate clinical management may include a range of treatments. This may consist of any of the following:
- Treatment with anti-inflammatories or paracetamol
- Arthroscopic surgery for partial menisectomy
- Surgery for total menisectomy, meniscal replacement or total knee replacement in severe cases, (usually once there is progression to Osteoarthritis)
With arthroscopic surgery recovery and rehabilitation periods are quite short. Patients are usually able to walk after a couple of days and can resume normal activities 2-3 months following surgery.
Full surgical repair or knee replacement takes longer, and patients may need knee braces and crutches for an extended period of months before being able to undertake weight bearing activities.
Inability to obtain appropriate clinical management
Last reviewed for CCPS 10 June 2012.
Preliminary questions [41886]
11109 the condition under consideration has been accepted on the basis of inability to obtain appropriate clinical management for the condition under consideration.
7066 there is some evidence that an inability to obtain appropriate clinical management for the condition under consideration may be a factor in the worsening of the condition under consideration.
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
7378 the veteran was unable to obtain appropriate clinical management for the condition under consideration at some time.
7379 the inability to obtain appropriate clinical management for the condition under consideration contributed to the clinical worsening of the condition under consideration.
11233 the veteran satisfies the occurrence provisions for the inability to obtain appropriate clinical management for the condition under consideration and VEA service for the clinical worsening of the condition under consideration.
898 the veteran has some operational service.
or
899 the veteran has some eligible service.
11234 the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and VEA service for the clinical worsening of the condition under consideration.
11235 the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and operational service for the clinical worsening of the condition under consideration.
or
11236 the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and eligible service for the clinical worsening of the condition under consideration.
Clinical worsening and operational service [11235]
7384 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during operational service.
21084 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during operational service, as a causal result of operational service.
7387 the veteran's inability to obtain appropriate clinical management for the condition under consideration during operational service was due to the veteran's serious default, wilful act or serious breach of discipline.
or
7389 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, because of an illness or injury which is identifiable.
7390 the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to operational service.
7392 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related.
Clinical worsening and eligible service [11236]
7385 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during eligible service.
7386 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during eligible service, as a causal result of eligible service.
7388 the veteran's inability to obtain appropriate clinical management for the condition under consideration during eligible service was due to the veteran's serious default, wilful act or serious breach of discipline.
or
7389 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, because of an illness or injury which is identifiable.
7391 the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to eligible service.
7393 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related.
Significant physical force
Acute meniscal tear of the knee - Significant physical force Factor
There are now a number of SOPs which have a significant physical force factor.
All of the factors require a significant physical force applied to or through the affected joint at the time of clinical onset or clinical worsening of the condition.
There is no further definition of what constitutes a significant physical force. However this could include direct, or indirect trauma, twisting, wrenching or stretching the joint ligaments, muscles or tendons, or a combination of these.
The circumstance of any stated injury will need to be considered in each case as to whether the injury would constitute the significant physical force as required.
Establishing the onset of the injury
The history of a significant physical force should have been noted on the medical records, although medical attention may not have been sought immediately for the resulting injury. Therefore, a reliable history of an injury the meets the relevant description at the time of the onset of the condition being considered will generally be accepted unless there is contradictory evidence. If the evidence is unclear, seek medical advice.
Last reviewed for CCPS 10 June 2012.
Investigative Documents
|
Type |
Title |
PDF Format |
Word Format |
|---|---|---|---|
| Claimant Report | Significant Physical Force |
CR9325.pdf [6] |
 CR9325.docx [7] |
| Medical Report | Significant Physical Force |
MR9428.pdf [8] |
MR9428.docx [9] |
Preliminary questions [41910]
41876 the veteran had a significant physical force applied to or through side and site of the body at some time.
41954 the veteran had the significant physical force applied to or through side and site of the body at the time of the clinical onset of the acute meniscal tear of the knee.
41911 the veteran satisfies the occurrence provisions for the significant physical force and VEA service for the clinical onset of the acute meniscal tear of the knee.
898 the veteran has some operational service.
or
899 the veteran has some eligible service.
41912 the veteran has established the causal connection between the significant physical force and VEA service for the clinical onset of the acute meniscal tear of the knee.
41913 the veteran has established a causal connection between the significant physical force and operational service for the clinical onset of the acute meniscal tear of the knee.
or
41914 the veteran has established a causal connection between the significant physical force and eligible service for the clinical onset of the acute meniscal tear of the knee.
Clinical onset and operational service [41913]
41915 the veteran had the significant physical force applied to or through side and site of the body at the time of the clinical onset of the acute meniscal tear of the knee, on operational service.
41916 the significant physical force applied to or through side and site of the body that the veteran experienced at the time of the clinical onset of the acute meniscal tear of the knee, on operational service, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
41917 the significant physical force applied to or through side and site of the body that caused the acute meniscal tear of the knee was due to an illness or injury which is identifiable.
41918 the veteran had the significant physical force to side and site of the body at the time of the clinical onset of the acute meniscal tear of the knee as a consequence of the identified illness or injury.
41919 the identified illness or injury that caused the acute meniscal tear of the knee due to the significant physical force to side and site of the body is causally related to operational service.
Clinical onset and eligible service [41914]
41920 the veteran had the significant physical force applied to or through side and site of the body at the time of the clinical onset of the acute meniscal tear of the knee, on eligible service.
41921 the veteran had the significant physical force applied to or through side and site of the body at the time of the clinical onset of the acute meniscal tear of the knee, on eligible service, as a causal result of eligible service duties.
41922 the significant physical force applied to or through side and site of the body that the veteran experienced at the time of the clinical onset of the acute meniscal tear of the knee, on eligible service, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
41917 the significant physical force applied to or through side and site of the body that caused the acute meniscal tear of the knee was due to an illness or injury which is identifiable.
41918 the veteran had the significant physical force to side and site of the body at the time of the clinical onset of the acute meniscal tear of the knee as a consequence of the identified illness or injury.
41923 the identified illness or injury that caused the acute meniscal tear of the knee due to the significant physical force to side and site of the body is causally related to eligible service.
Links
[1] http://www.rma.gov.au/assets/SOP/2019/025.pdf
[2] http://www.rma.gov.au/assets/SOP/2019/026.pdf
[3] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20207.pdf
[4] https://clik.dva.gov.au/user/login?destination=comment/reply/63196%23comment-form
[5] http://www.rma.gov.au/SOP/alpha_ind/a.htm
[6] https://clik.dva.gov.au/system/files/media/CR9325_0.pdf
[7] https://clik.dva.gov.au/system/files/media/CR9325.docx
[8] https://clik.dva.gov.au/system/files/media/MR9428.pdf
[9] https://clik.dva.gov.au/system/files/media/MR9428.docx