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How Knee Cartilages Get Injured

Injury to the knee cartilages is very common in sports such as football and rugby, and one of the commonest injuries to have knee surgery for. Physiotherapy is important in the early stages of your injury to diagnose the problem and develop a treatment plan. Your physio can then guide you through rehab whether you require operation or not.

The knee cartilages

The knee cartilages (medically known as menisci) are C-shaped structures which sit like banked tracks on top of the flat surfaces of the shin bone.

One cartilage sits in each side of the joint. They are described more closely in the knee cartilages

How do the knee cartilages get injured?

The cartilages are relatively soft and squidgy structures, placed between the flat tibial surface below and the large mobile knuckled ends of the femur above (the femoral condyles).

They are compromised when we place abnormal strains upon them. When we get into certain positions, usually involving twisting, the menisci are forced to the ends of their movement by the femoral condyle and can get crushed between the two bones. This can lead to a tear of the cartilage, which can be of many different kinds.

Cartilage are not always injured in isolation but can be damaged in more complex and serious injuries involving the ligaments and bones of the knee joint.

Most of a cartilage has no significant blood supply and cannot heal once injured, although all injuries do not lead to problems.

In older people, the cartilage can develop degenerative tears which behave in the same way as ones due to injury.

Arthritis after menisectomy

In people who have undergone total meniscectomy (where the whole cartilage is removed), about 50% show knee OA on x-ray 20 years later. This can be quite young if they had the operation as a teenage sports person. Changes may occur in the articular cartilage as early as two years after the meniscal removal.

What happens with a knee cartilage tear?

Usually we know when we get a cartilage injury, because it’s painful at the time! The knee may swell over a day or so and be painful and difficult to walk on.

After the acute episode has setted the knee may give way, especially on twisting movements, or have a restricted range of motion. Sometimes the torn part of the cartilage blocks the motion of the joint and prevents straightening or bending of the knee beyond a certain point.

Types of cartilage tear

There are many types of cartilage tear, common ones being called a bucket handle tear and a parrot beak tear. Bucket handles are more common in the medial (inner) meniscus and parrot beaks in the lateral (outer) meniscus.

Meniscal cysts
A parrot-beak tear in the lateral cartilage causes fluid to develop in the knee joint and this can be forced through the tear towards the outside of the cartilage.

Here it can form a noticeable cyst, which increase in size with physical activity. Lateral cysts are often painful and can be seen and felt at the side of the knee when it is bent.

Read further for surgical and other treatment for meniscal problems.

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