Knee injuries

Meniscus Tear Injury

If you have had knee pain recently, or periodically for months or years, it's possible that you have a meniscus tear, also referred to as "torn cartilage".

A meniscus tear often occurs during a twisting or pivoting motion with the foot planted on the ground - for example, when playing tennis or football - and can also occur from lifting.  A tear can occur at any time during life, but it is rarely seen in young children. With age, the menisci, or cushion pads made of cartilage, become worn and may tear more easily.

Meniscus Tear

The symptoms of a meniscus tear depend on the size and location of the tear. Because the menisci have no nerve endings, pain associated with a tear is actually due to swelling and injury to the surrounding tissue. With a small tear, you may experience minimal pain. Over several days, slight swelling may develop gradually. Often, you may walk with minimal pain, but bending from your knees, lifting, or rising from a seated position may increase the pain. Small tears may possibly heal on their own with a brace and a period of rest.

With a typical meniscus tear, you will feel pain at the side or centre of the knee, depending on the tear's location. Often, walking is not affected, but the knee may swell or feel stiff. You may also experience difficulty when bending your knee. Over time, symptoms may diminish but could recur with activities that involve twisting or overuse of the knee. Pain may appear and disappear over a period of years, and the tear may become larger if left untreated. Other symptoms include tenderness when pressing on the meniscus, popping or clicking within the knee, and limited motion of the knee joint.

The location of the tear may determine whether or not the knee is able to heal on its own. Tears at the outer edge of the meniscus tend to heal more easily because there is a good blood supply. However, the inner two-thirds of the meniscus do not have a good blood supply, which makes it difficult for tears to heal on their own. In time, this may increase the risk of developing arthritis of the knee.

Ice packs and restricting movement can be used for immediate treatment of almost any knee injury. Such simple measures will help to decrease swelling and pain in the joint. When a tear begins to interfere with everyday activities, arthroscopic surgery may be necessary to prevent additional damage and to restore the knee's full functional abilities.

Anterior Cruciate Ligament

Often with knee injuries, the Anterior Cruciate Ligament (ACL) which is one of the main knee ligaments becomes damaged or torn. This type of injury is quite common. Each year, about 300 0001 people worldwide undergo surgery to repair a damaged ACL. The injury is common among athletes, and it can also occur in the workplace in jobs that require physical activity. Women are more susceptible to such injuries than are men. Studies2 have shown that the reason for this may be that in sports, women tend to hold their upper bodies and hips in a more erect posture while performing running and jumping actions.

Meniscus Tear

Most ACL injuries occur during sports or actions that require sudden pivoting, change of direction or rotation of the knee.  The symptoms of an ACL injury may include a sudden giving way of the knee (this is when the knee suddenly 'gives out', causing one to stumble or fall), a "pop" at the time of the injury, or a sudden swelling of the knee joint and pain in the knee when walking.  When an ACL injury occurs, the knee becomes less stable. Such instability will make sudden turning movements difficult. This type of damage to the knee may also make you more likely to developing arthritis and cartilage tears. While you may still enjoy daily activities with little discomfort, activities which require sudden twisting or turning, may prove difficult. 

An ACL injury may be treated without surgery through rehabilitation and bracing. This is mainly effective for people who do not participate in twisting or turning activities or who are willing to give up high-risk sports and focus on low-impact activities like cycling and swimming. Although such a change may limit your ability to participate in the sports and activities you enjoy, it also reduces your chances for further injuries. A custom-made brace may also ease the pain associated with an ACL injury.

If the football field, tennis court, or ski slopes continue to tempt you after you've suffered an ACL injury, arthroscopic surgery may provide the best treatment option to restore your active lifestyle.

1-2Files held at Smith & Nephew Head Office.