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Do You Have Good Shock Absorbers In Your Knees?
Category: Knee Injuries
Jan 27, 2007
One of the most commonly injured parts of the knee, the meniscus, is a wedge-like rubbery cushion where the major bones of your leg connect. Meniscal cartilage curves like the letter "C" at the inside and outside of each knee. A strong stabilizing tissue, the meniscus helps the knee joint carry weight, glide, and turn in many directions. It also keeps your femur (thighbone) and tibia (shinbone) from grinding against each other. In a nutshell, it's a shock absorber within the knee.
Athletes and younger individuals may tear the meniscus by twisting the knee, pivoting, cutting or decelerating. In athletes, meniscal tears often happen in combination with other injuries such as a torn ACL (anterior cruciate ligament). Older people can injure the meniscus without any trauma, as the cartilage weakens and wears thin over time, setting the stage for a degenerative tear. In my practice, I see many baby boomers and weekend warriors who have torn a meniscus in a knee that has also developed some arthritis (cartilage breakdown). I also see a lot of meniscus tears this time of year due to twisting injuries on icy surfaces.
SIGNS AND SYMPTOMS
You might experience a "popping" sensation when you tear the meniscus. Most people can still walk on the injured knee and many athletes keep playing. When symptoms of inflammation set in, your knee feels painful and tight. For several days you have:
* Stiffness and swelling.
* Tenderness in the joint line.
* Collection of fluid ("water on the knee").
Without treatment, a fragment of the meniscus may loosen and drift into the joint, causing it to slip, pop or even lock in one position.
DIAGNOSIS
We can get a good idea of what's going on just by talking to you and examining your knee. X-rays will show us if there's any arthritis; however, an MRI of the knee is almost always needed to confirm a torn meniscus.
TREATMENT
Initial treatment of a meniscal tear follows the basic RICE formula: rest, ice, compression and elevation, combined with nonsteroidal anti-inflammatory medications to reduce pain and inflammation. If your knee is stable and does not lock, this conservative treatment is occasionally all you need.
If your knee continues to be painful, stiff, gets locked, or if you have a certain type of tear, you may need surgical help. If you do need our help, don't panic -- it's minimally invasive, outpatient surgery. We are able to use an arthroscope (camera placed through poke holes) to trim or repair your knee's damaged shock absorber. Occasionally, we even do meniscal transplants.
Dr. Joseph Guettler is an orthopedic surgeon who specializes in sports medicine, as well as surgery of the knee, shoulder, and elbow. His practice, Performance Orthopedics, is located in Bingham Farms.
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