Once upon a time, if you suffered a meniscal tear, more or less the only option was to remove the damaged cartilage. There are several drawbacks to this approach, but the main one is that it can increase the risk of arthritis in the future. And, with more of us wanting to remain fit and active into old age, this is a big disadvantage.
Meniscal damage is particularly common among sportsmen and women and often occurs when people fail to warm up sufficiently before exercise. It is a painful condition that normally requires surgery.
Thanks to advances in technology and new forms of surgery, there is now a movement towards repairing meniscal tears rather than simply removing damaged cartilage. This less invasive form of treatment improves flexibility and reduces the risk of painful arthritis in later life.
What causes meniscal damage?
If you are wondering what the meniscus is, it is a thin fibrous cartilage between the surfaces of some joints, e.g. the knee. Damaged knee cartilage can occur as a result of participating in sports like running, football, tennis, rugby or contact sports.
Growing numbers of us are prone to knee damage as we are living longer so our knees are more likely to wear out. We are also generally bigger and heavier so our joints are under greater strain.
Preserving the meniscus
Whenever possible, the healthy meniscal cartilage should be preserved. For some types of tear, this can mean suturing (or repairing) the meniscus to allow it to heal rather than removing a tear. This tends to be possible for large tears, when there is an adequate blood supply to allow a good chance of healing.
In some centres, a meniscal transplant can be done, where there has been complete removal of the meniscus in an otherwise healthy knee.
Restoring associated damaged articular cartilage
Restorative technology is now making articular cartilage repair surgery available to more and more people than ever before.
Here are some of the state of the art treatments that are likely to become increasingly commonplace in years to come:
(1) Microfracture surgery uses tiny drill holes to expose bone marrow stem cells, which then generate new cartilage to cover the bone. In some instances, a small amount of cartilage stem cells can be taken from the knee, multiplied in a lab and then used to create a sheet of new cartilage. After six weeks this can be re-implanted into the knee.
(2) Another form of restorative technology is chondrocyte transplant. It is hoped that artificial cartilage substitutes will be grown in a laboratory in the near future.
(3) Already, platelet-rich plasma, which is derived from a patient’s own blood, can be injected into the knee to reduce pain and help restore mobility.
(4) In the future, stem cell technology – which uses stem cells from the patient’s own bone marrow to improve cartilage repair – is expected to become more widely available.
As technologies advance, restorative orthopaedics will continue to expand and patients will benefit from more and more ways of mending rather than removing damaged knee cartilage.
Carrothers & Norrish Orthopaedics are sports injury specialists and keep up-to-date with the latest effective treatment options to help you get back to the sports activities you love.