Older people can tear their meniscus in their routine daily activities,
as they tend to have thin, easily torn menisci from years of use. Athletes,
on the other hand, often
present
with a torn anterior cruciate ligament or other knee injury in conjunction
with a torn meniscus, as a result of contact in sports
If you think you may have torn your meniscus, you may have heard a "pop,"
have swelling, tenderness and stiffness in your knee, and a collection
of fluid. See your doctor to be evaluated. If you have a meniscal tear
and you do not treat it, a piece of cartilage may slip into your joint
space, which may cause your knee to lock or slip.
To diagnose the problem, your doctor may order X-rays, a magnetic resonance
imaging (MRI) scan, and/or use an arthroscope to look inside your knee
joint (and potentially treat the tear at the same time).
By way of treatment, your doctor may suggest the conservative, surgical,
or the new transplant approach, depending on your particular tear. The
conservative approach is rest, ice, compression, and elevation (RICE).
The surgical
approach
often entails the use of an arthroscope to visualize, clean up, and repair
the torn cartilage. The transplant approach entails arthroscopic surgery
as well, and donor cartilage, matched for your size, is fixed to your
shin bone. For small tears at the edge of the cartilage, which has a
good
blood
supply,
the
conservative
treatment
approach will
often allow the cartilage to heal on its own. For deeper and larger tears,
however, which do not have as good a blood supply, the surgical approach
may be necessary. For severe tears in younger patients (usually under
the age of 55) who do not have arthritis, meniscal transplant surgery
may be an option.
This latter approach, transplant surgery, carries minimal risk and appears
to have good outcomes. Complications occur at less than 1%, with the
most common
complications being infection and tissue rejection. The donated tissue
is screened for infections such as hepatitis and HIV preoperatively,
which nearly eliminates the risk of infection. In short-term
studies, transplantation has shown to improve activity-related pain and
swelling in 80-90% of patients. Long-term studies are needed to determine
whether or not this procedure affects arthritis progression or development. |
