| |
Cartilage (Meniscus) Damage
The menisci are two crescent-shaped cartilage structures that sit on top of the shin bone (tibia), between the femur (thigh bone) and tibia within the knee joint. There are two menisci in each knee:
• Medial meniscus – on the inner side of the knee
• Lateral meniscus – on the outer side of the knee
They act as wedge-shaped shock absorbers between the bones and play a vital role in distributing load across the knee during weight-bearing activities.
Causes
The most common cause of meniscal damage is an acute twisting injury to the knee. This is frequently seen in sporting injuries, but it can happen in many everyday situations, such as:
• Twisting the knee during a fall on a slippery floor
• Falling downstairs
• A direct blow or kick to the knee
During this twisting movement, the meniscus can become trapped and compressed between the bones of the knee, causing it to tear.
In older patients, a meniscal tear may also occur without a significant injury. In these cases, the meniscus has often already been weakened by age-related wear and tear (degenerative changes) within the knee.
Symptoms
Patients with a torn meniscus commonly complain of:
• Pain and discomfort, usually on one side of the knee
• Swelling
• Clicking sensations
• A feeling that the knee may give way
In some cases, a torn fragment of meniscus can move within the joint and become trapped between the thigh bone and shin bone, causing the knee to lock. This situation may require more urgent treatment.
Diagnosis
A torn meniscus is usually diagnosed through a specialist clinical examination. Further investigations, such as X-rays and an MRI scan, may be needed to confirm the diagnosis and rule out any other damage within the knee.
Treatment
The meniscus has a limited blood supply, which means that tears are unlikely to heal fully on their own. When the torn meniscus is causing significant pain or mechanical symptoms, surgery is often the most reliable and recommended treatment option.
Surgery is usually performed using arthroscopic (keyhole) techniques.
Surgical Options
1. Arthroscopic (Keyhole) Meniscal Trimming
The first stage of the procedure is to assess the tear, including its size, shape, and location. If the torn fragment is not repairable, it is usually removed during the same operation using keyhole instruments.
This procedure is generally performed as a day-case operation.
Recovery is usually relatively quick, ranging from a few days to a couple of weeks. Mr. Ayoub will assess your individual condition, work requirements, and activity levels to provide a more accurate estimate of your recovery time and return to normal activities.
2. Arthroscopic (Keyhole) Meniscal Repair
In some cases, after full assessment, the tear may be suitable for repair rather than removal. This involves stitching the torn meniscus back into position using keyhole techniques. This procedure is generally performed as a day-case operation, although an overnight stay may occasionally be required.
After surgery, it is important to protect the repair by remaining non-weight-bearing for a period of time and using knee brace and walking aids as advised. This allows the repair the best chance to heal properly.
Recovery from meniscal repair is slower than recovery from meniscal trimming. However, in the long term, preserving the meniscus may be more beneficial. There is evidence to suggest that successful meniscal repair may help delay, or even prevent, the development of arthritis in the affected knee.
Further detailed information will be provided during your consultation with Mr. Khalid Ayoub. Back....
|
|
