Cartilage tears

Basics


Each knee has two menisci. They are commonly called “the cartilages”. There is one on the inner (medial) side of the knee and one on the outer (lateral) side of the knee. They are C or crescent-shaped and serve to cup the thigh bone (femur) as it sits on the shin bone (tibia) to improve the “fit” of the joint.

The main role of the meniscus is to spread the load being put through the two joint surfaces, thereby protecting the joint surface cartilage. They act as shock absorbers of the knee.
The menisci are important. A torn meniscus does not work properly, instability and early wear in the joint may occur.


Diagnosis and Treatment


Once the diagnosis of a torn cartilage (meniscus) is made you may need an operation to treat it, as it is uncommon for these tears to heal.
Symptoms from small tears can settle down, however, over a few weeks. If symptoms last longer than this, surgery is often needed. Larger tears usually need surgical treatment.
The operation performed will usually be a knee arthroscopy or “key hole” surgery.
Depending on the nature of the cartilage tear, it will either have to be repaired, or trimmed to a smooth edge (a partial meniscectomy).


Partial Meniscectomy


More commonly the torn part has to be removed, a procedure called a “partial meniscectomy”. This is done using special instruments through keyhole incisions at the same time as the knee arthroscopy. The amount of cartilage removed depends on the size of the tear. As little as possible will usually be taken out, trying to leave a smooth stable edge of cartilage behind which will still function as a “shock absorber”.


Meniscal repair


A small number of meniscal tears are suitable for repair. If a tear is treated soon after it occurs and the tear itself lies in the outer part of the meniscus, where there are tiny blood vessels, it may be suitable for repair with special sutures or anchors.
In general this is only considered in the relatively younger age group for a number of technical reasons. Over the age of 30, we know that the chance of a meniscus tear healing is reduced.

L.I.A Surgical Technique

Does loosing weight help with knee pain?

The answer to the question is YES.

Scientific research has shown that even small reductions in body weight can significantly reduce the symptoms of joint pain.

Research has shown us that a 5% to 10% reduction of body weight can dramatically reduce joint pain and improve your ability to exercise.

If you are overweight try to look at this as a positive, you can help yourself.

No one is suggesting that losing weight is easy. Weight loss is difficult when you have bad joints; however, there are ways to exercise that do not place too much stress on the joints of your body.

Diet is also important and getting support from your family doctor, dietician or nutritionist can help.

These positive lifestyle choices will have additional health benefits too.

Exercise for Joint Pain:
Exercise is important for people with arthritis here are some examples you may wish to consider:

Pilates:
Pilates is a great way to strengthen the important muscles in the body (the core) in a low-impact, safe manner. Pilates has become a popular tool for injury treatment and prevention even with professional athletes. Pilates is safe for the joints.

Aqua Aerobic:
Working out in the water is  a way to perform normal activities with less impact compared to working out on land. Water workouts can involve aerobics, walking, jogging or just about anything else.

Swimming:
Swimming is great exercise full stop! With swimming, your joints are supported by the water, which can ease arthritis pain.

Cycling:
Cycling is a low-impact exercise, but the motion of cycling is stimulating for the cartilage within a joint. Cycling gives a good muscular and cardiovascular workout and loosens up stiff joints common in people with arthritis.

Weight Machines:
Training with weights can help strengthen muscles and is also an excellent way to stimulate bone health.

Walking:
May not be the best workout for those with arthritis but walking for exercise is certainly better than no exercise at all. The WHO recommend 10,000 steps a day! Try Nordic walking to work the arms and give some support to the knees


Get Out and Exercise

Exercise has been shown to be useful for patients with arthritis both before and after major surgery.

Seek advice from your family doctor, local gym or physiotherapist on starting an exercise programme to help manage your knee pain.


References: Rooks DS, et al. "Effect of preoperative exercise on measures of functional status in men and women undergoing total hip and knee arthroplasty." Arthritis Rheum. 2006 Oct 15;55(5):700-8.