Meniscal injuries / Chondral injuries
World Class Meniscus Tear and Pain Treatment on the North Shore of Auckland
The menisci or cartilage of the knee joint are crescent-shaped wedges of fibrocartilage that sit on the top surface of the tibia or shinbone. They deepen the surface of the knee joint and play an important role in shock absorption. The menisci can be damaged with twisting at the knee or in combination with larger more traumatic knee ligament injuries. Irrespective of the injury mechanism, the menisci can be slow to heal as their blood supply is very limited. Meniscectomy surgery may be required to remove fragments or smooth down rough edges of the meniscus that are causing locking or catching of the knee. Regardless of the management of a meniscal injury, there is an increased risk of developing knee osteoarthritis down the track. Studies have shown that approximately half of those who have had a meniscectomy show x-ray evidence of osteoarthritis 10-15 years later (Lohmander et al., 2007).
A meniscal injury may have significant consequences. Several research groups have shown that four years or more after meniscectomy surgery, some individuals still have pain, muscle weakness, reduced balance and impaired function (Ericsson et al., 2006; Glatthorn et al., 2010). These findings are relevant particularly because weakness of the knee muscles is thought to be linked with degeneration of the joint. This seems reasonable considering that the thigh muscle is involved in shock absorption and that impaired shock absorbing abilities would insidiously overload the joint. A subtle yet important point is that pain does not need to be debilitating to have negative consequence – even low levels of background or occasional pain inhibit the thigh muscles. Interestingly even small amounts of knee joint swelling have also been shown to inhibit the action of these muscles.
Despite these well-documented long term effects of a meniscal injury, it is not common or routine for patients to receive any follow-up care or advice from a rehabilitation perspective following meniscectomy surgery within New Zealand and Australia.
Fortunately at KneeCare we have the systems, equipment, and knowledge to identify and measure accurately any deficits or problems, and we can provide you with an individualised programme to help recovery and reduce future issues. There is clear evidence that this kind of targeted approach works well (Ericsson et al., 2009).