Anybody with an active lifestyle involving sports or weight bearing daily activities – such as bending and lifting – is always at risk of injuries, especially to their musclesand joints. In fact, one of the most common forms of orthopedic injuries that doctors treat includes those related to the knee. Meniscal injuries, in particular, tend to dominate these injuries.
“Menisci are c-shaped pieces of rubbery cartilage located between thighbone and shinbone. There are two in every knee, one medially and one laterally. When observed in a cross section, they appear as triangular wedges. The function of the menisci is to act as shock absorbers in the knee; they also contribute to the stability of the joint, and provide essential lubrication.
“Meniscal tears can be acute and these occur when the knee is bent and forcefully twisted, especially when it is in a weight bearing position. Degenerative tears of the meniscus are seen in older people over the age of 60, as the menisci weaken and are prone to more wear and tear,” said Dr. Jussi Rantanen, Consultant Orthopaedic Surgeon, Burjeel Hospital of Advanced Surgery in Dubai.
Depending on the extent of the meniscus injury, pain experienced by an individual could range from mild to severe. People who have these injuries often experience swelling and a throbbing or sharp pain in the knee/s. Popping or clicking sounds when moving the knee is also a common symptom. If the injury is small, symptoms will usually go away without treatment.
“In the past, it was a common procedure to remove a damaged meniscus after a knee injury. The true function and significance of the menisci were overlooked until the ’80s and early ’90s and the cartilage was removed without much consideration of the consequences. This, unfortunately, increases the chances of arthritis and other degenerative conditions such as ‘bow legs’ as well. However, it’s also a common misconception that all meniscal injuries require surgery. The requirement for surgery depends on the intensity of damage or trauma; where the injury is located within the meniscus; the pattern of the tear and the cause. Today, we understand the value of the menisci and preserve all meniscal tissue we possibly can.
“Advances in magnetic imaging (MRI) have made it possible to diagnose even the smallest meniscal injuries, as well as those producing no significant symptoms. That is why the ground rule today is that not all meniscal injuries detected by MRI need treatment. Patients should be aware that even though there is pathology (signs of damage) in the MRI images and your doctor suggests surgery, a second opinion should be sought, as knees without proper symptoms of a meniscal tear should not be operated on unless it is absolutely necessary,” added Dr. Rantanen.
Dr Rantanen recommends a detailed and thorough discussion with your doctor, including the description of the injury and procedure, as well as the rationale for the treatment or surgery suggested. “You should be made aware of what can be expected, including benefits from surgery, and what the likely long term consequences are,” he added.
“There are several treatment protocols that can be used to treat meniscal injuries that do not require surgical intervention. One is RICE: which stands for rest, ice, compression and elevation. This practice is used for most sports-based injuries. Non-steroidal anti-inflammatory medicines are the other option,” said Dr Rantanen. He added that if surgery is ultimately required, a patient should opt to go with a doctor and hospital that has the skill and expertise in treating these injuries successfully.