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KNEE CARTILAGE 101: Common Problems, Treatments & Health Tips

dr andrew dutton knee cartilage 101 common problems, treatments, health tips
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The knee joint is a complex and vital component of human mobility and a marvel of the body’s engineering. It comprises intricate details facilitating movement and support, including the articular and meniscus cartilage. Each of these knee cartilages plays a distinct role in ensuring the optimal performance of the knee joint.

Articular cartilage — a smooth, shiny material covering the ends of the thigh bone (femur), shinbone (tibia), and kneecap (patella) — acts as a protective cushion for the knee joint. It serves as a friction-reducing layer, allowing the bones to glide smoothly against each other during movement. This knee cartilage is crucial for distributing force evenly across the joint and absorbing shock, enabling pain-free motion.

On the other hand, the meniscus cartilage, commonly referred to as the meniscus, is a C-shaped structure between the femur and tibia. It acts as a shock absorber and enhances stability by deepening the surface of the tibia. The meniscus’s crescent shape ensures the knee’s stability while absorbing and distributing forces exerted on the joint.

Explore our comprehensive resource on the complexities of knee cartilage issues. We offer insights into effective treatment options and preventative health tips. This blog aims to help you stay informed and proactive about your knee health.

At Dr Andrew Quoc Dutton Orthopaedic & Sports Centre, we believe that recognising the root cause is crucial in prevention and treatment as it significantly affects how care and rehabilitation are approached.

Learn more about A/Professor Andrew Quoc Dutton

Meniscus Tears: A Common Challenge in Singapore

Meniscal tears are common in Singapore and affect a significant number of residents each year. Worldwide, 60 to 70 out of every 100,000 people experience meniscus tear injuries annually, with men facing a higher risk. The presentation and causes of meniscal tears can vary based on age. Younger individuals often experience forceful twists leading to “bucket-handle” tears, while older individuals may face degenerative horizontal tears.

6 General Categories of Meniscus Tears

1. Radial Tear: This type of tear occurs in the area of the knee that isn’t supplied with blood, so it cannot heal on its own. If the tear is severe, surgery may be required. In the case of a radial tear, the surgeon will trim away the damaged part of the meniscus.

2. Horizontal Tear: A horizontal meniscus tear is one of the easiest types of tears to repair in the knee. Rather than removing the damaged portion of the meniscus, the surgeon will try to sew together the circumferential fibres of the meniscus.

3. Incomplete Tear: An incomplete tear is a partial tear of the meniscus. This type of tear may not require surgery and can often be treated with rest and physical therapy.

4. Complex Tear: A complex tear is a combination of different types of tears in the meniscus. This type of tear may require surgery to repair or remove the damaged portion of the meniscus.

5. Flap Tear: A flap tear occurs when a portion of the meniscus is pushed into the joint space. It causes pain and discomfort. The damaged part of the meniscus may be removed through surgery.

6. Bucket Handle Tear: A bucket handle tear is a vertical tear in the posterior horn of the meniscus that runs toward the anterior horn, forming a loose section that remains attached anteriorly and posteriorly. This type of tear may also require surgery.

Read our Patient’s Guide When Seeking Orthopaedic Care in Singapore

Recognising the Signs of Meniscus Tears

Knowing when to be concerned about knee pain makes a world of difference. For instance, sudden acute pain following an injury, accompanied by a popping sound, immediate swelling, or difficulty bearing weight on the affected leg, warrants immediate attention.

Chronic pain lasting weeks, limiting daily activities, or disrupting sleep should also prompt you to seek medical attention. Additional red flags include persistent swelling, redness, warmth around the knee or noticeable deformities — all of which may signify underlying conditions that need intervention.

A healthcare provider specialising in sports medicine will conduct a physical examination and may use imaging studies such as X-rays or MRI scans. Treatment options vary depending on the injury’s location and severity.

Non-Surgical Treatments: The Initial Steps

In any knee injury, the knee-jerk response should be the RICE method—rest, ice, compression, elevation. Resting entails avoiding activities that stress the knee, and using crutches to prevent it from bearing weight can aid recovery. Cold packs, knee braces, and elevation could reduce swelling and facilitate healing. Still, a doctor consultation is always a good idea.

Medication, including over-the-counter pain relievers and anti-inflammatory drugs, may effectively manage pain. In some cases, corticosteroid injections may be recommended.

Meanwhile, professionally guided physical therapy helps strengthen knee muscles, enhance stability, and promote healing. Lifestyle adjustments, including modifying exercise techniques and maintaining a healthy weight, are crucial in preventing further strain on the injured knee.

Feel like something’s wrong with your knees? Get the help you need now!

Surgical Options: Tailoring Treatment To Individual Needs

When non-surgical treatments fail, surgical intervention becomes necessary. The choice of surgery depends on factors such as tear location, severity, and pattern.

The primary surgical approaches are arthroscopic partial meniscectomy, meniscus repair with or without augmentation, and meniscal reconstruction. Arthroscopy is often preferred as it is a minimally invasive procedure involving smaller incisions, resulting in less pain and quicker recovery.

Meniscus repair aims to preserve a healthy meniscus, while reconstruction involves replacing the damaged meniscus with a graft.

Individual factors influence the most appropriate treatment, including age, comorbidities, and tear characteristics. Seeking advice from a trusted orthopaedic surgeon is crucial in determining the optimal course of action.

The choice between surgical interventions necessitates a nuanced understanding of the individual’s condition. Arthroscopic partial meniscectomy, a commonly performed procedure, entails the precise removal of damaged portions of the meniscus, offering relief for specific tear patterns and locations.

Contrarily, meniscus repair, with or without augmentation, is aimed at salvaging the existing meniscus, promoting long-term joint health. Meanwhile, meniscal reconstruction, a less standard procedure, becomes imperative for extensive meniscal damage involving replacing the damaged tissue with a graft.

These surgical options are unique and meticulously tailored based on age, associated health conditions, and the tear’s characteristics. Consulting a seasoned orthopaedic surgeon is pivotal in navigating these options, ensuring personalised care and optimal outcomes for each unique case.

Comparative Table of Meniscus Tear Surgical Options

PROCEDURE
INVASIVENESS
RECOMMENDED FOR

ESTIMATED RECOVERY TIME

Arthroscopic Surgery
Minimally invasive; uses small incisions
Based on individual factors and findings post consultation
Around 6 to 8 weeks
Meniscal Repair
Involves suturing the torn meniscus
Typically younger patients; for tears in outer third with good blood supply
Around 3 to 6 months
Meniscectomy
Removal of torn meniscus portion
Typically older patients; for tears in inner two-thirds with poor blood supply
Around 3 to 4 weeks

* As a rule of thumb, patients usually need to avoid weight-bearing activities for several weeks and engage in a rehabilitation program to restore strength and mobility to the knee. Note that timelines vary based on individual factors such as age, overall health, and the specific type of tear. Consulting with a healthcare provider or surgeon for personalised recovery guidelines is crucial.

The Takeaway

Choosing between surgical and non-surgical treatments depends on the patient’s specific condition, with a skilled orthopaedic surgeon’s guidance being crucial. Ultimately, treatment for meniscus tears and knee cartilage issues requires a personalised approach, considering each patient’s unique circumstances, activity levels, and tear characteristics.

The best way to determine if your knee problems warrant the medical procedures we mentioned is to consult a board-certified orthopaedic surgeon. Even if medically factual and vetted by a doctor, the information we provide should never replace a medical consultation.

A/Professor Andrew Dutton of the Dr Andrew QuocOrthopaedic & Sports Clinic is a certified medical professional who specialises in helping patients restore their knee health. With more than 25 years of medical practice, A/Professor Dutton has honed his hip and knee surgery speciality at the renowned Massachusetts General Hospital and Harvard Medical School. To book an appointment, you can call (+65) 6836 8000 or fill out the contact form on our website.

A/Professor Andrew Quoc Dutton Orthopaedic & Sports Clinic Insurance

The A/Professor Andrew Quoc Dutton Orthopaedic & Sports Clinic offers minimally invasive and surgical treatments for sports-related injuries and orthopaedic conditions.

To aid in the expenses that you may incur, we accept a number of corporate and international insurance. If you have any of the insurance plans below, please let us know when you book an appointment with us. If you need further assistance, you may drop us an e-mail at info@eliteortho.com.sg or call us at (+65) 6836 8000.

  • AIA Health Insurance
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About A/Professor Andrew Quoc Dutton

A/Professor Dutton, also known as, has been in clinical practice since 1996 after graduating from Marist College, Canberra and the University of New South Wales, Sydney, Australia. A/Professor Dutton has worked at the Prince of Wales Hospital, Sydney, and the St. George Hospital, Sydney, before completing his orthopaedic surgery training in Singapore. He is currently an associate professor of orthopaedic surgery at the National University of Singapore (NUS).

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