Ask the sports doc: A knee in need
Published 8:31 pm Tuesday, June 15, 2010
EF asks: Dear Dr. Patel, I am a 32-year-old male who was recently diagnosed with a cartilage tear in the knee. I have a medial meniscus tear in my left knee. My knee keeps swelling and locking as well. I injured my knee while playing basketball.
My family doctor referred me to an orthopedic surgeon for possible surgery evaluation. I am a bit nervous and was wondering do I really need the surgery?
Dr. Patel writes: The knee has a major cartilage called the meniscus. There are two menisci in the knee (medial and lateral). The meniscus is a C-shaped cartilage that helps to distribute stress evenly across the knee.
The blood supply of the meniscus comes from the periphery. The central two-thirds of the meniscus has a poor blood supply.
If the meniscus is torn, it may need to be addressed. Many patients as they get older may develop a tear that is degenerative in nature. This means that the tear occurred over time from wear and tear.
Depending on the age of the patient, sometimes nothing more has to be done. Because the blood supply is tenuous to the meniscus, it usually does not heal on its own.
A tear in your situation does need to be addressed surgically. The fact that you are having locking of the knee is a not a good sign to treat this condition conservatively.
Depending on the pattern of the tear, a repair of your meniscus should be attempted. If the tear is in the outer one-third area of the meniscus then a repair may be feasible. The decision to repair would be made during the surgery.
If a repair cannot be performed then only the portion of the meniscus that is torn should be removed arthroscopically. Hope this helps ease your worries.