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health
Torn Cartilage – what’s it all about?
What are these cartilage things? There
are two types of cartilage in some
joints. Firstly, there is the articular cartilage
which covers the ends of most bones. This
forms the smooth, shiny slippery surface
which allows movement. This can wear out
in arthritis but does not tear.
Secondly, in the knee (and a few other joints) there
are also two menisci (singular = meniscus) which
support and stabilise the knee. They are shaped like
crescent moons, and are wedged into the joint. One
of their main functions is to increase the contact
surface area in the knee and thereby distribute the
load. They are made of tough fibro-cartilage, but
sometimes it is not tough enough and they tear.
Why do they tear?
Usually due to a twisting force on the knee while
weight bearing.
This is the classic
footballer’s injury.
Sometimes they tear
due to degeneration
and very minor
trauma.
symptoms
An acute traumatic tear is usually very painful, but
occasionally one can carry on playing sport with it.
The knee will swell over a few hours. Thereafter the
knee will often lock, give way or be stiff.
do you need a scan?
Most post-traumatic knee problems will require at
least an X-ray. If the history and physical examination
are classic, an MRI scan may not be necessary, but if
there is any doubt it may be advisable. It may also
be necessary to exclude or confirm other associated
injuries such as a torn cruciate ligament. Top tipsometimes
scans show tears which do not in fact
exist – they are not infallible!
Will it need surgery?
Tears come in all shapes and sizes. Some cause few
symptoms while others can be very disabling. Not
Meniscal Cinch procedure
all tears need surgery. The decision as to whether
surgery is necessary or not is complex and there are
many factors to take into account. This should be
discussed with your surgeon.
What does the operation involve?
It is usually possible to deal with torn cartilages
using keyhole surgery. There are two main options
– excision or repair. Excision is relatively straightforward,
but it can be difficult to decide how much
to remove. Take out too little and the symptoms
can recur. Take out too much and there is a higher
chance of arthritis
later in life.
Occasionally it may
be possible to repair
a torn cartilage.
This depends very
much on the shape
and position of the
tear, as well as how old it is. If a repair is attempted
recovery is slower and there is an increased chance
of repeat tears. However, if it is technically possible
this may be worthwhile as to remove a torn cartilage
leads to early wear and tear arthritis.
Mr Phillip Edge
Consultant
Orthopaedic Surgeon
Based at:
The Manor Hospital,
Biddenham.
For all enquiries call Tina on: 07974 514793
E: ortho.edge@o2.co.uk W: www.bedfordortho.co.uk
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