You squat down to line up a putt and feel a slight pop and a twinge of pain along the side or back of your knee. As you continue your round of golf, your knee stiffens and becomes sore. You may limp a bit, and it becomes harder to squat. By the next morning, your knee is puffy or swollen. Thinking back, you realize you have had some mild aching in your knee after your morning jog the past few weeks.
This is a typical history for a tear of the meniscus cartilage in your knee. If your symptoms are fairly minor, you may try conservative treatment in the form of RICE (Rest, Ice, Compression and Elevation). If your symptoms persist or worsen, you should consult your orthopedic surgeon. After obtaining a history of your injury and examining your knee, your physician may order X-rays and possibly an MRI exam. If your physician makes a diagnosis of a meniscus tear, he or she may recommend arthroscopic surgery.
There are two menisci in each knee, one on each side. Each meniscus is a c-shaped wedge of fibrous cartilage between the round end of the femur (thigh bone) and the fairly flat tibia (leg bone). The most important function of the meniscus is to act as a cushion. A healthy meniscus protects the articular cartilage, which caps the ends of the femur and tibia.
A tear of the meniscus reduces its ability to act as a cushion and can cause the joint to become inflamed. It increases the forces in the knee and can cause damage to the articular cartilage. This may ultimately lead to arthritis (loss of cartilage).
Meniscus tears can be caused by a specific injury or by repetitive wear and tear. They rarely heal if left untreated because of poor blood supply to the meniscus.
Arthroscopic surgery for symptomatic tears of the meniscus is one of the most common orthopedic procedures in the United States. The goal of the surgery is the preserve as much of the meniscus as possible. If the meniscus tissue is degenerative and does not have good potential for healing, then the goal of surgery is to remove only the torn part of the meniscus, leaving as much healthy tissue as possible. This results in a relatively quick recovery, but removal of part of the meniscus increases the risk of arthritis in the future. If the meniscus tissue around the tear is relatively healthy, then it can be repaired with several arthroscopic techniques. This results in a longer recovery after the surgery but saves the meniscus and is preferable for the long-term function of the knee.
Dr. Boublik is a board-certified orthopedic surgeon, team physician for the Broncos and founding partner at the Steadman Hawkins Clinic Denver. He can be reached at 303-694-3333.
