Cartilage / Meniscus Injury

Introduction

A meniscus was described in 1897, as a function less remnant of a leg muscle. By 1936 however, it was recognized that the meniscus actually plays a role in joint stability, lubrication, congruity, and chrondroprotection (Katz et al 2009). As a consequence of this the understanding and treatment of meniscal injury has evolved at a rapid rate over the past 20 years (Pyne, 2002).

The major advancements are in the area of surgical procedure and techniques used are universal. The surgical technique of repairing torn menisci in the human knee is constantly undergoing change. A more recent procedure employed by surgeons today in repairing peripheral meniscus injury is via the arthroscope ( Moyer et al 2003).So much so the arthroscopic procedure in partial meniscectomy  is now regarded as the gold standard  in symptomatic cases ( Singh et al 2004, Metcalf et al 2004).The major difference between these two studies is that (Singh et al) performs arthroscopy for all meniscal injuries ,compared to peripheral meniscal repair by (Moyer et al).When treating a peripheral meniscal injury  Metcalf takes into account five prospective variables which the other researchers seem to omit. These are;

  • Gender
  • Presence of effusion
  • Positive Mc Murray test
  • Varus alignment
  • Loss of extension of five degrees

cartilage

It would appear there are many surgical and non surgical procedures available to surgeons today and according to (Singe et al 2004, Boyd et al 2002) treatment options for meniscal repair include;

  • Non operative management
  • Meniscectomy
  • Meniscal repair
  • Meniscal replacement

meniscus

 

This study would differ from other research carried out in this area. Where 67% of arthroscopically repaired peripherical meniscal tears  proved  successful in 24 patients (Barber 1987). This compared with 71 meniscal repairs in 68 knees. The difference between the two studies is that, they compare surgical techniques. Open surgery versus the arthroscopic method, both proving successful for each patient, the failure rate being only 9.8% (Hanks et al 1991).

The knee is a very complex joint both anatomically and biomechanically therefore meniscal injuries are frequently observed in sport. In fact out of 17,397 patients and 19,530 sports injuries of varies types, 10.8% of patients presented with medical meniscal injury, played soccer (Majewski et al 2006)

Regardless of this rapid advancement in technology and medical resonance imaging (MRI) (Greis et al 2002), there is still no substitute for the history and physical examination that can be obtained from a patient (Orndorff et al 2005). Greis and his colleagues in their research in 2002, and Metcalf in 2004, also agreed that patient demographic information and physical examination can be useful in identifying a patient  who may have a peripheral meniscus tear.

knee 3                             knee 2

 


Added by :Eddie Jackman
Acupuncturist,Physical Therapist and Sports Therapist based in Waterford
For treatments or appointments please call 087 6701166