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Vail-Summit Orthopaedics serves one of the most active sports populations in the world and with that comes a high number of meniscus injuries. Sports such as skiing, soccer, and tennis involve cutting and pivoting movements that strain the knee and increase the risk of meniscus damage.
At times, the meniscus can tear with an obvious injury. However, much more commonly, a meniscus is damaged by the"wear and tear" that occurs over many years of activity. The meniscus weakens over years of usage and then someone may be simply squatting down to pick something up and they experience a sharp pain on the inner or outer side of their knee. Knee pain associated with meniscus tears is usually well localized to the area where the tear exists.
The knee has both a medial (inner) and a lateral (outer) meniscus. These rubbery half moon shaped cartilages serve as shock absorbers between the femur (thigh bone) and the tibia (shin bone). They protect the all important articular or coating cartilage on the end of the femur and the end of the tibia where these two bones meet to form the knee joint. They function by distributing the contact forces between the femur and tibia over a wider surface area.
If one of the meniscus is badly torn or removed, then all the forces between the femur and tibia are concentrated in one tiny area. This causes the cartilage in this area to break down prematurely. Eventually the surrounding coating cartilage wears down as well leaving an area of exposed bone and eventually "bone on bone" contact or severe osteoarthritis. Therefore it is critical to try and protect and preserve one's meniscus cartilage."
There are a number of options for meniscus repair, depending on the age of the patient as well as the location and severity of the damage. Some tears can be sewn together with suture and will heal. Other tears are not repairable as they lack blood supply. In these cases, damaged and unstable portions of the meniscus are carefully removed.
Meniscus tears very seldom heal themselves as most have poor blood supply and thus poor healing potential. Meniscus tears usually cause popping, catching and most of all pain. Since removing large portions of a meniscus can predispose to arthritis, I always try to repair a meniscus tear if possible. If a tear is not repairable, my goal is to remove as little meniscus as I can while still alleviating all pain.
For patients over the age of 40, there is good news. Despite the fact that most meniscus tears in this age group are not repairable, most patients only need a very small flap of torn meniscus removed and 90 percent are back to their regular activities at one month from surgery.
My advice to anyone who suspects they may have damaged their meniscus is to come in as soon as possible. The repair may be a minor one that can make a big difference in your life and prevent the onset of osteoarthritis. Not only have I performed this procedure thousands of times, I've personally experienced the benefits of this surgery. Absolutely no regrets!