Dr. Venkatachalam

Meniscal Injuries 

The menisci are semilunar cartilages in the knee joint. When intact they distribute stress inside  the knee joint  and cat like washers. They also help in lubrication of the joint. They are two in number, the medial (inner meniscus and the lateral (outer) meniscus. Hey are sandwiched between the femur and tibia. Menisci do not have  any nerves and injuries  to them produce  symptoms  because of mechanical  obstructions like locking.  Meniscal injuries can occur when there is a twisting injury to the knee joint. They can also be injured along with the anterior cruciate ligament injuries. Tears can occur due to overuse in old age.

Symptoms

The knee can suddenly lock.  Pain, this happens if a flap after being torn is sandwiched and leads to over distension of the capsule or bag of the joint. Swelling, as compare to swelling of a torn ligament, swelling develops slowly and is not marked.

Risks

Old age , these tears are degenerative in nature.  Injuries, to the knees in sports and accidents.  Occupations, which stress the joints, like a plumber, construction workers and carpenters.  Meniscal injuries can occur secondary to cruciate ligament injuries.

If a swelling develops then one can use rest, compression, ice and elevation before seeing a doctor. The doctor after clinical examination may organ an MRI scan or recommend an arthroscopy. Ways of treating  a torn meniscus  include cutting  out the torn   part  if it  a small part (menisectomy), or suturing  it back  if  the tear is fresh and situated in a favorable area where there is a good  blood supply. Other methods are transplant   of a meniscus from a cadaver. Knees in which menisci have been removed  are at a risk of developing  osteoarthritis.

Meniscal transplant in India

Until now meniscal transplants were available only in the US and Europe. This procedure will soon become available in India with the procurement of donor menisci from brain dead persons and also a cold storage facility for preservation of menisci.