The shock absorbing cartilage around the knee bones is called the meniscus, and when this gets torn, it can catch in the joint and lock it up. Meniscus tears are frequently experienced by players of contact sports. Older people are especially at risk as the meniscus weakens with age.
There might be a popping sound when the injury happens. It will be difficult to bend or straighten the leg, especially if the knee locks up. The knee will be painful and swollen.
Mild or moderate tears are usually able to heal in their own time, complemented by the RICE protocol. If the meniscus is split, or large bits of cartilage are torn, Mr. Samarji uses arthroscopic surgery to trim and remove damaged parts. This can be done in day surgery. The long-term effects of this operation are excellent. Removal of the entire meniscus, however, may lead to arthritis in later life.
Once the cartilage has been torn and is painful it is unlikely that the cartilage tear will heal of its own accord. This is because most of the injuries occur in an area of the cartilage where there is no blood supply and it is not possible for it to heal. 80% of injuries occur in this area and hence if it is painful and causing symptoms such as locking, it is usually advisable to undergo keyhole surgery to trim out the cartilage tear in order to get rid of the pain and other symptoms such as locking. The final choice rests with the patient following a consideration of what surgery would involve and other options. Sometimes a steroid injection may help. Full consideration of the options at the consultation is discussed.
Knee arthroscopy to deal with a cartilage tear in the knee is generally carried out as a day-case procedure. Two small incisions are made at the front of the knee in order to allow a scope to be placed inside the knee along with a small instrument to trim the tear. The operation is carried out usually quite quickly and takes approximately twenty to thirty minutes to carry out.
The operation is usually carried out as a day case. It is generally carried out under general anaesthetic. You will be able to put your full weight on the leg after the operation. A large amount of local anaesthetic is placed in an around the joint which usually results in very good pain relief.
It is usually possible to get back to work within seven to ten days of having the arthroscopy done. Getting back to sports is usually possible six weeks after the procedure.
Most patients following an arthroscopy will not need any extensive physiotherapy. A small amount of physiotherapy may be needed following an arthroscopy in some cases.
All surgery carries an element of risk. The risks of surgery include infection, deep vein thrombosis, pulmonary embolism, bleeding and complex pain. The risks of complication are very low, but nevertheless need to be taken into account alongside the potential benefit of surgery and chance of success which is very high.