Twisting injuries can cause tears of the medial or lateral menisci. These can occur from a sports-type injury or something as simple as getting out of a chair or standing from a squatting position. The menisci can become brittle as we age and therefore can tear more easily. The symptoms of a torn cartilage can include:
- Pain over the torn area, i.e. inner or outer side of the knee
- Knee swelling
- Reduced motion
Once a meniscal cartilage has torn, it will not heal unless it is a very small tear that is near the capsule of the joint. Once the cartilage has torn it predisposes the knee to develop osteoarthritis over the next 15 to 20 years. Torn cartilage can continue to cause symptoms of discomfort, pain and swelling until the loose or ragged pieces are removed. In arthoscopic surgery, only the torn section is removed. The knee should recover and become symptom free in most cases.
Occasionally, provided the knee is stable and the tear is a certain type of tear in a younger patient, the meniscus may be repaired. If repaired, the patient will be instructed to avoid sports for a minimum of three months.
Articular Cartilage (Surface) Injury
If the articular cartilage is torn, which is most significant as a major shock-absorbing function, that cartilage can be compromised. Large pieces of articular cartilage can float in the knee (sometimes with bone attached) and can cause locking of the joint and further deterioration. Most surface cartilage wear will ultimately lead to osteoarthritis. Mechanical symptoms of pain and swelling due to cartilage peeling can be helped with arthroscopic surgery. This surgery can smooth the edges of the surface cartilage and removes loose bodies.
Anterior Cruciate Ligament Injuries
Rupture of the anterior cruciate ligament (ACL) is a common sports-related injury. Once ruptured the ACL does not repair itself and typically causes knee instability. Arthroscopic ACL reconstruction is can be required whereby a new ligament is fashioned to replace the ruptured ligament. The need for this procedure in ACL injuries is based on the patient age, instability level, severity of injury and activity level.
The arthroscope can be used to treat problems relating to kneecap disorders, particularly mal-tracking and significant surface cartilage tears. Lateral release can be performed in the same operative setting, which can sometimes require an overnight stay in the hospital. The majority of common kneecap problems can be treated with physical therapy and rehabilitation.