Common Knee Problems :: Meniscus Injuries (Torn Cartilage)
A common cause of knee pain in adults is a torn cartilage, or a torn meniscus. A "torn cartilage" usually refers to a tear or rip in the medial or lateral meniscus. The menisci are C-shaped cartilages that are found between the femur (thigh bone) and tibia (shin bone). They have a number of functions, including serving as cushions between the femur and tibia to help absorb some of the force transmitted through the knee when we stand, walk, or run. They also help the rounded end of the femur move smoothly on the relatively flat end of the tibia. When one of the menisci tears, the torn piece acts much like a rock in your shoe to irritate and cause pain when putting weight on the leg.The patient with a torn meniscus may or may not recall a specific moment when he/she was injured. This may be as obvious as a collision in a High School or college football player, or a more subtle twisting injury or misstep in an older patient. Usually the knee swells, giving a sensation of tightness, especially when bending the knee. Sharp, stabbing pain with any twisting of the knee, and a catching sensation are also common. A sensation of catching which prevents them from fully straightening their knee, which resolves with a twist, flex, or other manipulation of the knee, may be present.
What treatment options exist for the patient with a "torn cartilage?" The most important initial treatment, in my opinion, is rehabilitation. Many patients will recover completely with rehabilitation, and most patients will benefit from a course of supervised, formal rehabilitation to restore strength, range of motion, and coordination. Anti inflammatory medications may also be beneficial. Use of any medication, however, should be coordinated with your physician.
Patients whose symptoms do not resolve with the rest, anti inflammatory agents, and rehabilitation are candidates for arthroscopic surgery of the knee. Arthroscopic surgery is a procedure done in an operating room to look inside the knee. A fiber optic device about the diameter of a pencil is used to look around the inside of the knee. Special instruments are also used to trim out the torn piece of cartilage or to remove a loose body. Patients usually go home the day of surgery, and recovery may be quite fast. Some patients have a large tear in their meniscus and require a repair of meniscus. Twenty to thirty years ago large tears were frequently treated with removal of the meniscus. Today we know that removal of the meniscus leads to early onset of arthritis, and we try to avoid removing the meniscus, if possible. If needed, the arthroscope is used, along with specialized instruments, to put sutures or stitches in to the meniscus. The recovery time from this procedure may be longer.
In summary, many knee injuries will heal well with non surgical treatments. If necessary, the arthroscope is an excellent tool for treating the patient with a meniscus tear and can return patients to full function quickly. Remember, any decision for surgery should be made in consultation with your surgeon.
