Torn Cartilage in Knee

A knee cartilage tear is one of the most common types of knee injuries. It usually occurs when a person twists the knee forcefully while keeping the foot fixed on the ground. Athletes and individuals into contact sports are more prone to sustaining such injuries. A torn knee cartilage can occur due to an injury, gradual wear and tear, or prolonged stress on the knees.

The knee cartilage, also called the meniscus, acts as a shock-absorber between the thighbone (femur) and the shinbone (tibia). The menisci are thick rubber-like pads providing smooth movement and stability to the knee joints. Each knee joint has a C-shaped outer meniscus called the lateral meniscus, and an inner meniscus called the medial meniscus.

They are attached on top of the tibia, and provide cushioning between the upper and lower bones. The slippery surface of these knee cartilages enable the bones to slide on them without any damage.

The knee cartilage usually gets injured while forcefully twisting or rotating the knee, or while stopping or turning suddenly when in motion. Apart from a sudden injury, a meniscus may also tear gradually over time due to degenerative wear and tear.

In case of athletes and sportspersons, a meniscus tear is often accompanied by other knee injuries like ligament tears. The severity of the injury depends on the location of the tear as well as the extent to which the meniscus is torn.

The location of the cartilage tear is an important factor for consideration. Knee cartilages do not heal very well because of inadequate blood supply to them. The outer part of the meniscus has some blood supply, but the rest of the tissue has no blood supply, and so usually does not heal once severely injured.

➤ Pain while twisting or rotating the knees, or while walking, running, or climbing.

➤ Swelling of the knee joints immediately, or within a day or two of the injury. If the tear is due to degeneration, the swelling may increase slowly and persist over a period of months.

➤ Stiffness in the knee joints, and difficulty in straightening the knees.

➤ Locking of the knees.

➤ A popping sensation is felt, especially while climbing stairs.

➤ If some part of the meniscus is torn, a small fragment of the cartilage can get stuck in the small space between the joints of the knees, and cause severe pain while moving them.

➤ Mild tears may not be accompanied by any symptoms.

➤ The health care practitioner will conduct a physical examination to find out the causes of the symptoms. Tenderness along the lines of the joint may indicate a meniscus tear.

➤ The doctor may conduct a test called the McMurray test. It involves bending, straightening, and rotating the knee, to check if a clicking sound is produced each time the knee is moved.

➤ As the symptoms for most knee injuries are the same, the doctor may advise some imaging tests like an X-ray or MRI scan, to confirm the diagnosis.

➤ Although an X-ray of the knee does not show the knee cartilages, it can check for any bone damage that might have resulted along with the meniscus injury.

➤ An MRI scan is the best way to confirm the diagnosis of a meniscus tear.

➤ The doctor may advise the individual to undergo arthroscopy. In arthroscopy, an instrument called an arthroscope is inserted into the knee to get an enlarged image of the inside of the knee on a monitor. This can show the exact nature of the meniscal injury.

The treatment of a torn meniscus depends upon a variety of factors, including the nature, severity, and location of the injury. If the site of the meniscus tear has good blood supply, surgery is usually not advised.

R.I.C.E.
When there is an acute injury to the knees, the first step of treatment is to follow the RICE protocol. RICE stands for Rest, Ice, Compression, and Elevation.

➤ Rest: Take complete rest and avoid moving the injured part.

➤ Ice: Use ice packs on the affected area for 15 - 20 minutes, 5 - 6 times a day for a period of two to three days. Avoid direct application of ice on the affected part.

➤ Compression: Use a compression bandage to reduce the swelling of the affected area.

➤ Elevation: Another way to reduce swelling is elevation, wherein the patient has to lie down with the legs raised higher than the heart.

The patient may be advised to use medications like aspirin and ibuprofen to reduce the pain and swelling. Cortisone injections may also be administered into the knees. If the initial symptoms subside, the doctor may advise the patient to undergo a series of physiotherapy exercises, to strengthen the knee muscles and prevent injuries in the future.

If the symptoms do not subside with non-surgical treatment options, the doctor may advise the patient to undergo a surgery.

➤ If the tear is in a blood-rich area of the meniscus, the surgeon may be able to repair it by stitching the tear back in its place.

➤ If repair is not an option, the torn part of the meniscus may be cut out in order to make the surface of the meniscus smooth.

➤ Knee arthroscopy may be advised. This procedure involves inserting an arthroscope into the knee joint by way of a small incision, and viewing and analyzing the nature of the injury on a monitor.

Once the diagnosis is confirmed, a surgery can be performed by inserting small tools and surgical instruments by making a few more small cuts near the knee. The arthroscopy procedure helps reduce the recovery time to a great extent, although full recovery may take somewhere between four to six weeks.

After surgery is done to mend the knee cartilage, the patient has take special care and precautions for first couple of months. The knee may be put in a cast to prevent it from moving, and allowing it time to heal. After some time, the patient may be advised to undertake physiotherapy exercises to increase strength, stability, and flexibility of the knees.

The whole process of recovery may take months, and may require the patient to take long-term care to keep the knees healthy. Maintaining an ideal body weight, following a healthy diet, and avoiding activities that may injure the knees, can ensure their smooth functioning in the long run.

Disclaimer: This post is for informative purposes only, and does not in any way attempt to replace the advice offered by a medical professional.