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Orthopaedic Surgeon Werribee

Meniscal Tears

Meniscal tears are one of the most frequently reported injuries to the knee joint. The meniscus is a C-shaped fibro cartilaginous structure in the knee incompletely covering the surface of the tibia where it articulates with the femur. It consists of the medial meniscus, on the inner part of the knee, and the lateral meniscus on the outer aspect of the knee.

The menisci act as shock absorbers protecting the articular surface of the tibia as well as assisting in rotation of the knee. As secondary stabilizers, the intact menisci interact with the stabilizing function of the ligaments and are most effective when the surrounding ligaments are intact.

The majority of the meniscus has no blood supply and for that reason, when damaged, the meniscus is unable to undergo the normal healing process and often requires surgical repair.

In addition, a meniscus begins to deteriorate with age, often developing degenerative tears. Typically, when the meniscus is damaged, the torn pieces begin to move in an abnormal fashion inside the joint.

Menisci may tear because of many reasons as mentioned below:

  • Twisting motion
  • Over flexing the knee joint
  • Pivoting such as in sports activities
  • Sudden stopping or deceleration

Degenerative Changes that occur over time can weaken and thin the menisci resulting in meniscal tears.
Also, the menisci may tear in different ways. Treatment options will depend upon the type of tear, location of the tear, and the extent of the tear.

Following a twisting type of injury the medial or lateral meniscus can tear. This results either from a sporting injury or may occur from a simple twisting injury when getting out of a chair or standing from a squatting position. Our cartilage becomes brittle as we get older and therefore can tear easier.

The symptoms of a meniscal tear include:

  • Pain over the inner or outer side of the knee where the tear occurred
  • A “popping” may be felt at the time of injury
  • Knee swelling, stiffness and tightness
  • Reduced range of motion

Locking can occur if the torn cartilage gets caught between the femur and tibia preventing straightening of the knee.

Evaluating the source of knee pain is critical in determining your treatment options for relief of the pain. Knee pain should be evaluated by an orthopaedic specialist for proper diagnosis and treatment.

Your physician will perform the following:

  • Medical History
  • Physical Examination
  • Diagnostic test such as X-rays and MRI scan

Ligament Injuries

The knee is a complex joint which consists of bone, cartilage, ligaments and tendons that make joint movements easy and at the same time more susceptible to various kinds of injuries.

Knee problems may arise if any of these structures get injured by overuse or suddenly during sports activities. Pain, swelling, and stiffness are the common symptoms of any damage or injury to the knee. Common causes of knee injury include:

  • Fracture of the femur (thigh bone) or tibia and fibula (leg bones)
  • Torn ligament (either anterior or posterior cruciate ligament)
  • Rupture of blood vessels following a trauma that leads to accumulation of extra fluid or blood in the joint
  • Dislocation of knee cap (patella)
  • Torn quadriceps or hamstring muscles
  • Patellar tendon tear

ACL tear

An ACL injury is a sports related injury that occur when the knee is forcefully twisted or hyperextended. An ACL tear usually occurs with an abrupt directional change with the foot fixed on the ground or when the deceleration force crosses the knee. Changing direction rapidly, stopping suddenly, slowing down while running, landing from a jump incorrectly, and direct contact or collision, such as a football tackle can also cause injury to the ACL.

MCL tear

The medial collateral ligament (MCL) is the ligament that is located on the inner part of the knee joint. It runs from the femur (thigh bone) to the top of the tibia (shin bone) and helps in stabilizing the knee. Medial collateral ligament (MCL) injury can result in a stretch, partial tear, or complete tear of the ligament. Injuries to the MCL commonly occur as a result of a pressure or stress on the outside part of the knee.

PCL tear

PCL injuries are very rare and are difficult to detect than other knee ligament injuries. Cartilage injuries, bone bruises, and ligament injuries often occur in combination with PCL injuries. Injuries to the PCL can be graded as I, II or III depending on the severity of injury. In grade I the ligament is mildly damaged and slightly stretched, but the knee joint is stable. In grade II there is a partial tear of the ligament. In grade III there is a complete tear of the ligament and the ligament is divided into two halves making the knee joint unstable.
The PCL is usually injured by a direct impact, such as in an automobile accident when the bent knee forcefully strikes the dashboard. In sports, it can occur when an athlete falls to the ground with a bent knee. Twisting injury or overextending the knee can cause the PCL to tear.

Treatment

Immediately following a knee injury before being evaluated by a doctor, you can initiate the R.I.C.E. method of treatment:

  • Rest: Rest the knee as more damage could result from pressure on the injury
  • Ice: Ice packs can be applied to the injured area to reduce swelling and pain. Never place ice directly over the skin. Ice should be wrapped in a towel and applied to the affected area for 15-20 minutes four times in a day for several days
  • Compression: Wrapping the knee with an elastic bandage or compression stocking can help minimize the swelling and support your knee
  • Elevation: Elevating the knee above the heart level will also help reduce swelling and pain.
    It is important to seek your doctor’s advice if you hear a popping noise or feel as if your knee has given way at the time of injury and if you are unable to move your knee because of severe pain.
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