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Inside the knee joint there is cartilage tissue called meniscus which acts like a shock absorber to reduce impacts on the joint. Cartilage also covers the ends of the long bones which meet in the knee joint and are known as articular cartilages. Injury can occur to either or both types of cartilage in the knee joint, causing significant issues for the patient.
Knee joints consist of medial and lateral meniscus, which resemble tough, rubber-like pads of thick cartilage tissue. The menisci protect the knee joint from impacts caused by the upper leg pushing down upon the lower leg, and they also assist in performing smooth movements and knee stability. A knee cartilage injury usually relates to the meniscus, but damage can also occur to the articular cartilage, which covers the end surfaces of the bones that meet in the knee joint. Cartilage is a flexible tissue perfect for curved and shaped body parts such as the outer ears and nose.
Knee joints are commonly injured through playing sports - in particular, football, rugby, skiing and water skiing. A forceful knee movement with weight bearing on that leg can cause a meniscal tear. For example, in football a player dribbling the ball past another player might quickly twist the knee while having his weight on that leg. In snow or water sports, when the foot is attached to a binding and the body rotates while the ski or board remains facing forward, this can cause the meniscus to partially or fully tear. The severity of the injury depends upon how much of the knee cartilage is torn and where exactly the tear is located.
It isn’t only sudden injuries which lead to a meniscal tear. A tear can develop due to degeneration - the wear and tear of the joint more commonly seen in older people - or it can occur when small injuries are repeated time and time again. In severe injuries you may find damage to other parts of the knee such as a tear or sprained ligament.
Once torn, meniscal cartilage is notoriously hard to heal, mainly due to its lack of a decent blood supply. While the outer edges of each meniscus have some blood vessels, there is no direct blood supply to the centre. This is why the severity of the injury depends upon the exact site of the tear. Given time, small outer cartilage tears may heal, but a larger tear or one situated in the middle of the menisci will tend not to heal or might not heal completely.
Not all knee cartilage injuries have symptoms. If meniscal tears are due to degeneration, people may not be aware they exist. However, for most, a meniscal tear is a painful injury quite often associated with swelling of the knee joint, a reduced range of movement and stiffness in the joint. Pain often increases when straightening the leg. Severe pain may occur if a small fragment of meniscus is torn off. An MRI scan will confirm this type of knee injury.
Complete the following easy PRICE method if you suspect you have torn your knee cartilage:
These initial actions, along with taking painkillers, will allow the pain and swelling to subside. Further treatment then depends upon the severity of symptoms, the size and exact location of the tear, how the symptoms affect your life and your overall health and your age.
Small tears tend to take around six weeks to heal and will do so by themselves. Some tears may not heal but also may not cause too much discomfort to the patient, with only mild or intermittent symptoms occurring. Physiotherapy may be recommended in order to strengthen and support the muscles adjoining the knee such as the hamstrings and quadriceps. Physiotherapy can also encourage healing and reduce the formation and development of scar tissue. Non-steroidal anti-inflammatory drugs (NSAIDs) may also be prescribed to reduce swelling and pain.
If the injury is a major one or continues to give troublesome symptoms, you may be advised to have surgery. Commonly, the knee joint is operated on with keyhole surgery known as anthroscopy, and the exact procedure performed will depend on the severity of the tear. It may involve removing any loose bits of cartilage or even transplanting new cartilage into the injured area. In the most serious of cases, the entire knee may be replaced with an artificial joint. This procedure is known as a knee replacement. Following any knee surgery, a physiotherapist will assist you and give you exercises to ensure the knee joint is kept active to encourage the healing process and to build strength in the surrounding leg muscles that give support and strength to the recovering knee.
This is difficult to answer, as many people suffer cartilage damage yet don’t seek medical help for their condition. It is believed to be quite common, though. In the UK, around 10,000 people a year have a knee cartilage injury severe enough to require medical attention. Accidental damage seems to be most common in people 35 years and under. This is due to the injury occurring most commonly in the sporting arena. Damage to the cartilage associated with osteoarthritis is most common in people aged 50 and over. It is also more prevalent in women than in men.
Once a weakness has been created by an injury to the knee, you are more likely to have further problems, and prevention is a good form of defence against this. Wearing a supportive knee brace, especially while participating in sports, can provide you with protection for this area of weakness. Many sports professionals choose to wear protective supports and braces in order to strengthen and protect vulnerable areas of their body. This is particularly relevant to snowboarding and wakeboarding, where riders have their feet bound to the board.